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A friend of mine, The Iron Kahuna, writes a great blog called Tri Geek Dreams. Today, he wrote a post entitled, "An Essay on Pain," in which he talked about reading an article in Outside magazine noting that the Navy is trying to recruit triathletes into the SEAL program because they are "largely indifferent to physical discomfort." My friend added his own comments:

I agree with the Kahuna. Althletes, particularly endurance athletes, do feel pain. They just manage it differently than other non-athletes do. The Iron Kahuna's post about pain got me thinking about some research I reviewed a while back on the psychology of pain. While it may not be the most current literature, it will provide you with a great overview of the science of pain and the significance of pain in sport. I'll warn you that this post is a bit more techincal and a bit longer than previous posts. But if you're into pain (wink, wink) it's worth the read.

The Psychology of Pain

Triathlon and pain have been intimately linked from the sport’s inception. The popularization of the endurance sport of triathlon can be traced to a few minutes of air-time on a 1982 television broadcast of ABC’s Wide World of Sports. Viewers around the world watched in shock as a 23-year old college student doing research for her exercise physiology thesis stumbled and crawled across the finish line of a then relatively unknown event called Ironman Hawaii.



Julie Moss’ struggle to master her body and the pain she experienced became what ABC Sports has called one of the defining moments in sports (Mackinnon, 2003). Thousands of athletes found inspiration in Moss’ story and set out on the path to become endurance athletes. Along that road, they, too, would come face-to-face with the pain that epitomizes the sport.

According to the International Olympic Committee (IOC) Medical Commission (Shepard & Astrand, 1992), sports are broadly classified into two types of events: those that demand great strength and events that demand tremendous endurance. In contrast to strength events that require the development of fast-twitch muscle fibers, events like triathlon, marathon, cycling and distance swimming depend not only upon the development of slow-twitch muscle fibers but also on an athlete’s body’s ability to supply these muscle cells with adequate amounts of oxygen and essential nutrients while eliminating heat, carbon dioxide and other waste-products. Physiologically the process of competing in an endurance event requires the body to combat, “the depletion of intramuscular and hepatic glycogen reserves, a dispersal of the calcium ion reserves needed to initiate muscle contraction, and an escape of intracellular potassium ions that threatens the normal electrical function of the muscle membranes” (Shepard, 1992, p. 7). The IOC Medical Commission acknowledges that all of these physiological requirements are tempered, however, by the need for “psychological toughness – a motivation to endure and excel in the face of pain and discouragement” (Shepard, 1992, p.7).

In his article on the psychological aspects of endurance performance, O’Conner (1992) asserts the widespread belief that an essential aspect of outstanding endurance performance is an athlete’s willingness to tolerate pain. This is consistent with more recent research on “mental toughness” in elite athletes. Acknowledging differences of opinion regarding an exact definition of the construct, Jones, Hanton, and Connaughton (2002) conducted a study of top international athletes in sports including triathlon, distance running, and swimming in an attempt to identify key attributes underlying mental toughness. The seventh ranking attribute was, “pushing back the boundaries of physical and emotional pain, while still maintaining technique and effort under distress in training and competition” (p. 212). This process was illustrated by a quote from one of the study’s participants:

The well-known relationship between pain tolerance and performance fostered researchers to conjecture the existence of personality characteristics that act as mitigating factors in athletes’ ability to tolerate pain. Egan (1987) suggests that an athlete’s ability to cope with pain is a function of four factors: the type of training he or she undertakes, the characteristics of the sport itself, the type of personality that is typically attracted to the sport, and perhaps most importantly, the meaning he or she attributes to pain. In adding this fourth factor, Egan acknowledges what was at one time a controversial proposition: that pain has a subjective or psychological component.



No Pain, No Gain: The Significance of Pain in Sport

In her chapter, Sport and the Psychology of Pain, Kirsten Kaya Roessler (2005) provides a concise historical overview of the psychology of pain. She traces the start of the study of pain to the founder of experimental psychology, Wilhelm Wundt, who organized feelings along three continuums: pleasurable and unpleasurable, exciting and subduing, strain and relaxation. Pain is understood to be an unpleasurable feeling that stands alone without the addition of any other form of feeling. Roessler then turns her attention to Sigmund Freud’s proposition that if the body can be injured and experience pain, so to can the psyche and that both can be treated according to the principle, “cesante causa cessat effectus: if the cause disappears, the symptoms disappear as well” (Roessler, 2005, p. 86). Moving into the modern age, Roessler turns her attention to a more holistic approach to pain, the Gate Control Theory.

According to the Gate Control Theory, pain is not a simple mechanical process of stimulus-response but rather a complex event that includes circumstances where pain is present without a somatic basis. Additionally, pain can be described in many ways – sensory (e.g., sharp), affective (e.g., merciless), or relative (e.g., unbearable) – all subjective (Roessler, 2005). Pain impulses must pass-through a “gate” in the spinal cord that regulates pain and which itself is controlled by subjective factors like awareness, fear or concentration. While research providing empirical proof for a spinal cord “gate” has fallen behind attempts to confirm genetically-based neuromatrix theories, the Gate Control Theory makes for a convenient and easily understandable metaphor for how pain is processed.

In The Significance of Pain in Sport, Prokop (2000) broadens the gate-metaphor by relying on the construct of pain-threshold. In describing the “wall-phenomenon” in marathons, he writes that initially runners barely notice certain low-level discomfort or accept them as fate and do not take them too seriously. However, as the intensity of pain increases a pain-threshold, the minimum quantity of irritation necessary for the excitation of various pain receptors, is breached. This threshold is highly subjective; Prokop writes

Furthermore, the intensity of the individual athlete’s pain depends also decisively on his/her psychic condition, his/her situation and his/her form on that day. That means that the same cause of pain can be registered quite differently and because of that the intensity as well as the activity of the pain vary considerably. (pp. 79-80)

Prokop does not restrict his discussion of the significance of pain solely to negative attributes. He recognizes that pain also has a connection to exceptional performances in sport. He writes that, “pain can even stimulate the athlete to give a better performance and therefore cause rather atypical emotions which enable the athlete to meet special athletic requirements” (p.81).

Roessler (2005) presents two interpretations of pain that have significance for endurance athletes: pain as an expression of self-realization and pain as an accepted by-product. In the first, pain is seen as “good,” an outgrowth of dedication and self-control and is highly related to increasing performance. She offers an example from one of the marathon runners in her study.

When pain is viewed as an expression of self-realization, pushing limits, an essential component of endurance athletic events, provides an athlete with the opportunity to expand his or her limited self-concept. Pain, then, serves as an indicator that these limits have been reached and that, “’self-enhancement’ has begun” (Roessler, 2005, p. 98).

Roessler’s (2005) second interpretation of pain acknowledges that pain is an inseparable part of physical development and improving performance. Here a distinction between “good pain” and “bad pain” is also made but in a way that differs from that of the self-realization interpretation. Roessler distinguishes between the two as follows: “The pain of injury is unpleasant and bad, and it should disappear. But the pain that is connected with hard training or with competition is good” (p. 100).

Endurance athletes experience both somatic and psychic pain. The significance an athlete attributes to his or her pain can have an immediate and direct impact on performance. How pain is interpreted is an existential choice each athlete must make him or herself.

Want references? Email me and I'll be more than happy to send them to you.