Training to live with pain: What we can learn from Olympic athletes
“Pain is more than one thing,” explains Dr. Jeffrey Mogil, the head of the Pain Genetics Lab at McGill University. It’s a sensation, like vision or touch; it’s an emotion, like anger or sadness; and it’s also a “drive state” that compels action, like hunger.
For athletes, all of these effects mingle together in different ways depending on the nature of the pain they’re experiencing and the demands of their particular sport – the sudden shock of a stiff body-check versus the relentless burn of sustained effort.
Some individual variation in pain sensitivity is genetic – Mogil pegs the fraction, very loosely, at a bit less than 50 per cent. He and his colleagues at McGill have identified 10 genes associated with pain response, and researchers elsewhere have identified another 50 or so, but there are still thousands more awaiting discovery. The rest of the variation is environmental, driven by factors such as age, diet and, most importantly, prior experience with pain. In general, the more pain you experience, the more sensitive to pain you become.
There are, however, some intriguing hints that the long hours of training endured by Olympic athletes produce the opposite effect. For example, a British Medical Journal study in 1981 found that elite swimmers displayed increasing tolerance to pain inflicted by cutting off circulation to their forearms as their training progressed toward a competitive peak. Their tolerance then declined again when they took a break from training.
To Dr. Alexis Mauger, a researcher at the University of Kent in Britain who is studying the relationship between pain and the limits of athletic performance, this suggests pain tolerance can indeed be trained. In part, he says, it’s about: “Learning to break through a conservative pain barrier so that you can operate closer to a true physiological limit.”
In other words, your brain tells you to stop before your body really has to. Mauger has led a series of studies in which cyclists taking acetaminophen (i.e., Tylenol) are able to cycle farther or faster than those given a placebo. The difference in speed is most pronounced late in the trials, when the cyclists are in the most pain.
Many have been tuning in to the Winter Olympic Games and during the events, we undoubtedly will see not only efforts of athleticism and valor, but also potentially painful crashes and injuries. Does this ever make you think about what separates you from these world-class athletes (besides the athletic physique and the stretchy neon speedsuit)? Are these individuals better physically suited to perform? What allows them to achieve, and, maybe the most often asked question: are they oblivious to pain? What allows these individuals to push themselves beyond what “normal people” would or should endure to strive towards gold?
The article raises some interesting points to ponder
Do athletes have the same pain threshold as “the rest of us”?
What happens in your body as you experience more pain?
Can pain tolerance be trained?
Can you learn to use your pain positively?
-Jennifer Martin
Jennifer Martin PT, OCS, FAAOMPT, completed her physical therapy coursework and played volleyball at Marquette University. She has worked and taught education courses in several countries, but now calls Minneapolis, Minnesota, home – where she has an orthopedic practice and treats sporty types, professional dancers and musicians, as well as everyday folks with everyday injuries. When not working or teaching, she is often planning a travel adventure or doing something sporty herself.
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Such an interesting article! I’ve been watching the games regularly, and have seen ACL deficient knees land ridiculously complex jumps from huge heights, a snowboarder board with a newly fractured wrist, and some hideous looking crashes, yet they get back up and keep on going almost immediately.
I wonder what the mechanism is?
Hi Jennifer,
I think the topic is highly relevant. When I hear winning athletes interviewed, they often comment that the pleasure of winning is worth the pain of training and competing. Whilst it is possible to train one’s mind to ignore pain to some degree, there is one thing that is impossible to do – ignore pain one moment, then suddenly open oneself up to pleasure the next. Pleasure and pain are two sides of the same coin. To allow one is to allow the other.
We really cannot understand any of this stuff properly without getting philosophical. It just can’t be done, in my view. So anyway here’s a quote I like, which may ring true for some:
“The problem arises only when the memory of past pains and pleasures — which are essential to all organic life — remains as a reflex, dominating behaviour. This reflex takes the shape of ‘I’ and uses the body and the mind for its purposes, which are invariably in search for pleasure or flight from pain. When you recognise the ‘I’ as it is, a bundle of desires and fears, and the sense of ‘mine’, as embracing all things and people needed for the purpose of avoiding pain and securing pleasure, you will see that the ‘I’ and the ‘mine’ are false ideas, having no foundation in reality. Created by the mind, they rule their creator as long as it takes them to be true; when questioned, they dissolve”.
~Nisagardatta
Regards,
EG
What a great post, thanks.
From my experience (which is a “weekend warrior runner” not an elite athlete! however I still took it seriously) athletic training was about learning how to suffer as much as it was about training the tissues of the body.
And I suppose its the meaning of the pain that is important. Cyclist and runners actually use pain to pace themselves and if you take the pain away they get slower! So pain is normal even useful, is has no threat value.
It a useful concept in treating patients, what does the pain mean to them. Often you can change their reference from pain meaning damaged tissue to pain meaning deconditioned tissue that actually needs training to get healthier.
I am disappointed that the author did not make the important separation between nociception and pain in the article. I believe that athletes develop a tolerance for and acceptance of nociception, but that training/conditioning effect can be highly variable. As we all know, we can experience nociception without pain, and can experience pain without nociception. I am always concerned when I see a blog or article where the term pain is used so loosely or we define pain as a sensation. I am even more concerned with an article on “pain” where the term nociception does not appear. Johnb
Nice comment John. Isn’t one of the mantras of the NOI ” Hurt doesn’t necessarily mean harm” and don’t we have that wonderful poster showing such things as protect by pain and tissue tolerance lines. Both physically and emotionally, I am certain that each and everyone of us has “Raised the bar” when push came to shove. Yes we have the science and research to begin to explain how and why but let’s not forget that which life demonstrates to us each and every day. Stay focused on reality and the lessons of life, and don’t forget them when entering into the realms of academia…….