Pain is an inevitable part of endurance-sport training and racing. From an evolutionary perspective, when humans felt pain on the Serengeti 250,000 years ago (when we first became Homo Sapiens), it was an essential tool for our survival, letting us know when our lives were in danger, thus ensuring that we propagated the species. Paradoxically, as human beings, we are wired to avoid pain at all costs, yet it is also something we endurance-sport athletes seek out for the sense of accomplishment we experience when we overcome the pain. Another paradox is that pain is the greatest obstacle endurance athletes face as we pursue our goals and yet something we must embrace to perform our best.
Unfortunately, what worked for so many eons does you no good as you strive for PRs in running, cycling, swimming, triathlon, nordic skiing, and other endurance events. The right kind of pain is valuable to you in several ways. First, committing to an endurance sport is about pushing outside of your comfort zone and seeing what you are capable of physically and psychologically. Let’s be honest here, if it didn’t hurt, you wouldn’t run, bike, swim, XC ski, or what-have-you for so long or so far, well beyond it being fun. Second, pain can play an essential role in providing you with information about your training and race performances including your effort, the intensity of your training, and whether you can hold a certain pace to the finish. The problem is that your primitive brain and body don’t know the difference between the life-threatening pain that comes from tracking a gazelle for 25 miles before killing it (and needing to carry it home!) back when we were cavepeople and the life-affirming (though decidedly unpleasant) pain you experience during the last of 8×400 intervals, the last three miles of a marathon, or the last ten miles of a century ride.
Whether you use pain to help you thrive and strive toward your endurance-sport goals or you succumb to the pain that helped us survive for so many millennia depends on your understanding of pain and whether you can gain mastery over it. In the former case, you’re attempting to resist not only 100s of 1000s of years since we became human beings, but millions of years of evolution since living creatures climbed out of the primordial muck as reptiles. In the latter case, you might consider taking up golf or bowling.
The first step in mastering pain is for endurance athletes to differentiate between exertion pain and injury pain. Exertion pain is typically perceived as dull, more generalized, does not last long after training or races conclude, there is an absence of localized swelling or tenderness, and there is no long-lasting soreness. In contrast, injury pain is felt as sharp, localized to a specific area, experienced during and after exertion, and there is swelling, tenderness, and prolonged soreness.
The experiences of the two types of pain during training and races can lead to different perceptions and responses. Endurance athletes usually view exertion pain as positive, short in duration, produced voluntarily, and can be reduced at will. The reaction to exertion pain can involve feelings of satisfaction and inspiration, positive emotions, and can facilitate performance and enhance athletes’ overall sense of well-being. Conversely, endurance athletes perceive injury pain as negative, chronic, uncontrollable, and signal danger to their physical health. These perceptions can cause a loss of confidence and motivation to train and compete, and increased anxiety about the cause of the pain.
Perspective on Pain
Using pain to your advantage starts with gaining a realistic perspective on what pain really is. A number of years ago, I was out for a long, hilly (about 6000’ vertical) ride with friends north of San Francisco. At the end of the six-hour ride, one of the guys said, “That was a sufferfest!” Here is where some perspective on pain is needed. You need to understand the difference between suffering, pain, and physical discomfort.
Here is a simple fact: What you experience in your endurance-sport training and racing is not suffering (I think we use such language because it makes us feel tough and heroic). I used to give talks to the Leukemia & Lymphoma Society Team-in-Training groups and those talks put endurance-sport pain in perspective for me. People with cancer suffer because what they feel is severe, long lasting, life threatening, and often uncontrollable. What you feel when you exert yourself in training and races is not really pain. Real pain comes from injuries. This pain is similar to suffering, but injury pain—though sometimes severe—is not life threatening, typically doesn’t last that long, and can be controlled much more easily.
What you really feel in training and races is discomfort. It hurts and it interferes with your training and competitive efforts, but you can ease the discomfort by slowing down or stopping. For simplicity’s sake, though, let’s continue to call what we experience pain because it is commonly used, it is only four letters, and it makes us feel a little bit heroic. Plus, “That was a discomfort fest!” just doesn’t have the same ring to it! But even though we’ll call it pain, you now know what it really is. This perspective takes the first bit of edge off the pain you experience training and races. It also sets the stage for additional strategies for turning down the volume of your endurance-sport pain to a more manageable level.
The next step to overcoming pain is to understand that pain isn’t just a physical experience that you have to tolerate in your training and races. Pain also has a major psychological component to it; how you think about it and the emotions you connect to it affect the pain you feel. How you interpret your pain either propels you to new heights of performance or drags you down to new depths of struggle.
Pain as Your Enemy or Ally
Pain as your enemy. Pain becomes your enemy, first, when you start with negative perceptions about pain like, “Pain is bad,” “Pain means I am weak,” and “Pain means I will fail.” This attitude toward pain puts you in a defeatist mindset in which your first experience of pain in training or competition sets off a downward psychological and physical spiral. When you are doing those 10×100s in the pool, those hill repeats on your bike, that 30-minute tempo run, or a similar workout in another sport, and you start thinking, “I hate this. What am I doing out here? Is this really worth it?,” this negative orientation actually increases the pain you feel. Your thinking goes to the “dark side,” your motivation declines, you experience unhelpful emotions, and your focus turns away from your efforts and onto the pain. With this reaction, you actually feel more pain, your ability to fight through the pain decreases, your efforts lessen, and, as a result, you limit the benefits and satisfaction you might gain from your training and race performances.
Second, the emotions that you connect with your pain have a significant impact on how much pain you feel. I’m sure you’ve had the experience in a race when you start to hurt. You begin to get frustrated that you won’t reach your goal time. You get angry at yourself for not having trained harder. You may even despair of your ability to finish. When you connect these negative emotions with your pain in training or a race, you feel more pain. Between the pain you feel, your negative self-talk, and the negative emotions, you have little chance of giving your best effort in training or being successful in races.
Pain as your ally. Making pain your ally starts with accepting that pain is a normal and important part of training and competition—“no pain, no gain,” as the saying goes. Because pain tells you that you’re working hard toward your goals, you can embrace the pain you feel in training and races. It also involves experiencing your pain as objectively as possible and using it as information to get the most out of your efforts. Pain tells you how hard you are working and whether the discomfort you are feeling is due to exertion or injury. With this information, you can adjust your pace, modify your technique, change your body position, shift your tactics (or stop if the pain is due to an injury). Making these changes will help you reduce your pain and also maximize your performances.
Just as negative self-talk can increase the pain you feel, positive self-talk, such “I’m getting stronger with every step,” “This is making me tougher,” and “I’m working hard toward my goals,” can have the opposite effect, actually reducing your pain. It also has psychological benefits including a greater sense of control, increased motivation, greater confidence, better focus, and more positive emotions.
Much as negative emotions increase the experience of pain, positive emotions can reduce your perception of pain. Connecting positive emotions such as excitement, pride, inspiration, and satisfaction with the pain you feel in training and races reduces the pain and makes it more tolerable (unfortunately, it doesn’t alleviate the pain completely; it will still hurt!). Positive emotions create more positive self-talk and have other psychological advantages, such as greater motivation and confidence. Physiologically, positive emotions release endorphins (neurochemicals that act as our internal painkillers) which not only reduce the perception of pain, but actually lessen the physical pain.
Inspiration is my favorite positive emotion to experience when I’m training and racing. I view the pain I feel as part of an epic challenge to overcome my perceived limitations and achieve my goals. My pain tells me I’m working hard and making progress toward my endurance-sport dreams and that fuels my passion that motivates me to be an endurance-sport athlete in the first place. To that end, I have a two-pronged strategy that combines generating positive self-talk and positive emotions. When I’m in a lot of pain, for example, riding up the Seven Sisters in Marin County or doing swim laps at Aquatic Park in San Francisco (really cold!), I smile and say, “Money in the bank, baby, money in the bank” (you have to say “baby” or it won’t work!). Smiling creates positive emotions and releases those pain-killing endorphins, and the self-talk tells me that I am making deposits on my fitness that I’ll be able to withdraw in races (unlike debit cards, endurance sports don’t have overdraft protection).
Misery Loves Company
Another useful way to respond to your pain is to realize that others around you are in pain too. It can be frustrating late in a race to be hurting pretty badly and looking over at other competitors who appear to be having no difficulty at all. Don’t be fooled by this! You can’t see inside of them and experience their discomfort. On the outside, you probably look cool, calm, and collected too, even though inside you may be in agony. If you’re in pain, the chances are those around you are too. Take comfort in knowing that misery loves company.
Pain-focusing tools involve directing attention onto (association) or away from (dissociation) the pain as a means of reducing or altering your awareness of pain. Thus, they do not have a direct physiological effect on the pain, but rather decrease the perception of pain.
External focus involves directing attention externally away from the experience of pain. Examples of external focus include looking at the scenery during a training ride, talking to those around you, or focusing on competitors ahead of you. It is believed that if you are not paying attention to your pain, you will perceive the pain as less discomforting.
The downside of this tool is that, at some point, the pain you experience will begin to yell at you so loudly that you simply can’t ignore it. At that point, you’ll need to direct your focus inward and confront the pain, hopefully in a constructive way by using some of the pain-reduction tools described below.
Rhythmic Cognitive Activity
This tool involves focusing on a repetitious or structured task. Rhythmic cognitive activity is commonly used by swimmers, runners, and cyclists in the form of counting breaths, strides, or pedal revolutions. By becoming absorbed in the repetition of these tasks, you will be less aware of the pain you experience.
Dramatic coping consists of putting the pain in a different context, in this case, seeing training and competitive pain as part of a grand challenge. Putting pain in a heroic context can be real or imagined. For example, a marathoner training for the Olympics is, indeed, challenging the pain in pursuit of an Olympic berth. Similarly, a weekend cyclist can imagine during a training ride that he is competing in the Tour de France, thus making the pain he is experiencing seem a worthy sacrifice. Dramatic coping can be further facilitated with the use of emotionally powerful music, such as the scene in the movie, “Rocky,” in which the fighter runs through the city to the steps of the Museum of Fine Art with the inspirational music playing in the background.
Deep breathing may be the simplest, most essential, yet most neglected tool to reduce pain. Pain inhibits breathing, lessens blood flow, and causes muscle tension and bracing, which worsens pain. Deep breathing diminishes pain by transporting sufficient oxygen throughout the body, relaxing muscles, and decreasing generalized sympathetic nervous system activity. Deep breathing also acts as a distraction. If you are focused on your breathing, you will be paying less attention to your pain.
Deep breathing can be incorporated into many aspects of training and competition. You can focus on deep breathing during intensive training sessions, for example, before you begin an interval, during the interval, and to have a faster recovery before the next interval to ensure that you reduce the pain you are experiencing, thereby improving performance. During races, you can use deep breathing to stay relaxed and to redirect your attention away from the pain you feel.
Muscle tension and bracing in response to pain is common among endurance athletes. It is often seen in tight neck and shoulders muscles of cyclists, or a clenching of the fists and arms of distance runners. Two types of muscle relaxation techniques, passive and active relaxation, can be used during training and races to relieve muscle tension that further exacerbates pain. Passive relaxation involves simply focusing on the tense muscles and, with a series of deep breaths, feeling the tension drain out of your muscles and becoming increasingly more relaxed.
Active relaxation, seemingly counterintuitive, consists of tensing the muscles even more than they currently are, then relaxing them. The muscles’ responses to this tensing and relaxing pattern is to rebound past its previous level of tension to a more relaxed state. Active relaxation is a tool that I have used with endurance athletes with whom I have worked with great success. I encourage you to make active relaxation a regimented part of your training and competitive routines. For example, in running, at each mile of a workout, you can practice active relaxation to prevent muscle tension due to pain. When you get to a race, this tool has become habit, so you do it automatically to reduce muscle tension and ease pain.
While you are training or between intervals, tighten for five seconds the muscles that you experience tension in, for instance, your shoulders during a bike or run workout. Then release the tension that you created, relax the muscles, and take a deep breath. Repeat this exercise several times to both relax your muscles in the moment and to train your muscles to relax more readily in future training and race situations.
Muscle relaxation training is also a comforting tool following training and competition when pain is high and resources to manage the pain are low. By using the muscle relaxation exercises at the end of training and races, pain will be decreased, and a general sense of physical comfort and well-being will be returned.
Finally, perhaps the greatest lesson I have learned as both a sport psychologist and an endurance athlete is this: The physical pain you feel in training and races in no way compares to the emotional pain you will feel if you don’t achieve your goals because you didn’t master the pain in the first place. By constructively facing the pain now, you are rewarded by experiencing the satisfaction, pride, and joy that comes from overcoming your training and race pain and achieving your race goals.