Training in pain is a part of life for many athletes. How can and should an athlete recognize and assess pain?
Pain in Training
Endurance athletes know it, the pain when their pulse is racing in the maximum range during interval training and the lactate floods the entire body. Or when the last pull-up or squat in the weight room can only be done with a strained face and mouth open. The feeling screams “stop,” the mind says “keep going,” because enduring pain in sports is advantageous and improves one’s form. Ambitious athletes need perseverance to succeed.
In an athlete’s life, however, there is also pain which is a warning sign telling us that something is wrong. “Pain is important and something quite normal,” says Michael Wawroschek, doctor and director of med-athletics in Zurich. “Only by experiencing it do we even have the chance to perceive our bodies and get to know them better.” Crucial to this, he says, is that the athlete doesn’t simply ignore the pain, but deals with it directly and asks questions: “Where exactly is the pain? Is it changing? Is it getting stronger, is it subsiding?”
Pain as a warning sign
In order for the human body to classify a stimulus, specialized receptors detect painful signals and transmit the information to the spinal cord, where it is processed and sent to the brain. Pain receptors are distributed throughout the body. The receptors are neurons which extend into the respective tissue, such as the skin, where they pick up mechanical, thermal or chemical signals from the environment.
In the case of protective reflexes, such as withdrawing the hand from a hot stove, the body reacts automatically and without consciously classifying the pain. Only when it reaches the brain is the pain consciously perceived, evaluated and processed for learning processes. How strongly a pain is perceived is enormously individual. Some people overreact and panic, others are hesitant, others suppress it. And for others, it motivates them or even makes them euphoric. Ambitious athletes usually have a higher tolerance for pain than non-athletes. At the same time, pain is a warning sign that something is out of balance. Without pain, we would constantly overload our bodies.
In everyday life, common sense tells us how to deal with pain. We know how to classify and alleviate it when we have a sunburn, bang our knee, or step over our foot. It becomes more difficult when a feeling of pain is accompanied by existential fears, such as after a heart attack or a terrible diagnosis of illness. Small children do not yet have an “understanding of pain”; to put it bluntly, they are afraid of dying from any kind of pain.
Sport as a pain killer
Sports physician Wawroschek thinks that people generally react too aggressively when dealing with pain in sports. “Many avoid exercise as soon as something hurts. But that’s often a mistake, because most people have pain as a result of not moving. So it’s more the other way around: sports and exercise can often eliminate discomfort.”
Therefore, exercise is sometimes a pain killer. Still, dealing with pain while exercising isn’t easy. Some athletes seek it out, regularly scheduling a tough and painful massage, for example, because they know they’ll feel better afterwards. So this kind of pain can be quite useful. The same applies to muscle building: without pain, little will happen, because only a load that hurts will cause the muscle to grow. “You can and should consciously suffer this pain,” says Michael Wawroschek, “you just have to go through it.”
Stop with sharp pain
But how does an athlete know how much pain is tolerable and when it becomes hazardous? Michael Wawroschek distinguishes between three types of pain locations: “muscle pain, tendon pain and joint pain.” When it comes to interpreting muscle pain, he says, everyone is usually wrong: patient, doctor, trainer. “Muscle pain is often underestimated in its extent and misdiagnosed.” That’s why “every athlete should take muscle pain seriously and have it checked out by a doctor.” Unless it is harmless muscle soreness. Any sharp pain is particularly dangerous, he says. Wawroschek says, “A torn muscle fiber feels like a knife stab, in which case you have to stop exercising immediately.” The body does this automatically most of the time. However this reflex is often blocked by adrenaline in competitions and fails to appear.
A good sign is when a pain changes for the better. Athletes often have difficulties getting started. If the discomfort decreases in the course of training, one can confidently continue. Conversely, however, if pain returns during exercise or becomes increasingly severe, the strain should be stopped.
Beware of medication
Many injuries in endurance sports are typical overuse complaints. Such inflammatory pains – if they occur locally, as in the case of runner’s knee or periosteum inflammation – do not generally harm the body. And fundamentally, all healing involves inflammation. The difficulty with inflammation is finding the right balance between stress and relief. It is helpful to temporarily switch to other sports in order not to further irritate the inflamed area. If the pain nevertheless continues to increase, you should see a doctor. If the pain is gone the next day after a training session, then you can continue to train in a measured manner.
A doctor should decide when an injury needs to be treated with medication. Generally medication should be used in training as little as possible. “Going into a competition with pain is never a good idea,” Michael Wawroschek thinks. Anyone who can only train with painkillers in the long term risks damage to the stomach and intestines. In addition, the body feeling is lost.
There is one exception: In the case of arthritic pain in joints, movement is more pain-relieving and beneficial than immobilization and rest. In such cases, painkillers may be indicated to make movement possible again. Even if athletes would subjectively prefer to prevent pain, they are all confronted with it at some point. Or as Michael Wawroschek says, “Pain is part of life, and being able to fight it is a nice feeling.”
When should you stop?
Body awareness is essential for correctly assessing pain, especially when under the influence of competition. Here’s how to proceed:
- Differentiate: Is the pain more dull or sharp? If it feels like a knife stabbing, the training must be stopped immediately.
- Classify: A common approach to classifying pain is to rate it on a scale of 1 to 10. If the score is above 5, training should be stopped.
- Observe: If a pain occurs at the beginning of an activity and then goes away, that is a positive sign. However, if it becomes more and more severe, the sport session should be cancelled. Likewise, if the painful area swells, then something is mechanically injured and a break is also mandatory.
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