Can pain hinder or improve performance?

Pain. I’ve never really been sure of what my pain tolerance is. But, people have been asking me this question recently as I approach the delivery of my son. But, the reality is that I have no clue on how to base my answer to the question. As a physical therapist, I have realized that pain can span quite a spectrum. There can be people that say they have a high threshold, and the moment you poke them, they squirm off the table! There can also be people that say they cannot handle pain, only to find out that when you distract them, they have no clue that you are actually quite aggressively stimulating pain receptors on their skin. I have also heard people exaggerate pain, overemphasize pain, and even belittle pain. So what is pain? And, can it truly hinder or enhance our performance as runners?

If you were to look up pain in a basic encyclopedia, you may find the Gate Control Theory of Pain. This is a physiological explanation of how pain is interpreted in your body. It is the science of how pain is transmitted. Now, this theory takes into effect when a noxious stimuli is applied to your body. Something has injured your body and caused you to interpret this as pain. “Sensory afferents”  located on the skin, in muscle, ligaments and throughout your body, have to be stimulated by something that will cause injury. Often, the example used is putting your hand on a hot stove. The hand experiences a sensory input that is transmitted to the brain and you jerk your hand away for relief. You reflexively move your hand because your brain is aware that it will cause you harm if you do not respond to the stimulus.

In the pain spectrum, however, there are many other types of pain that may have their derivative from psychological, environmental, and situational means. Chronic pain can fall into this category. If you have chronic low back pain, there is not necessarily a noxious stimulus applied directly to your back day in and day out. Even if you have a herniated disc or injury to the vertebre, the load at which a production of pain is capable is not constant. Therefore, there is some other means at which you are experiencing pain. Noxious stimuli is not the source of your pain, but rather situation, environment, and psychology play a role.

If you are running and note a sharp pain in your front leg muscle, what do you do? Do you keep running? Do you run a bit more and see if it works out? Do you stop running, stretch and then keep going? Or do you call for a ride home? For me, my perception of the this pain would be influenced by my clinical background, experience, and the situation. I know that it is my quad muscle. I know that there is probably nothing other than muscle that could be injured. I also know that if I am out running, I have to get back home, I cannot just stop and call someone. Therefore, I would perceive the pain as temporary, a result of fatigue in the muscle, or improper form. It means that I used critical thinking to deduce my actions in response to the pain. I could even deduce that continuing to run may increase the strength of the muscle thereby improving my performance at a later date.

There are certain injuries that will send up a radar to your brain that you cannot continue. One of those injuries is a stress fracture. I remember watching the Beijing summer Olympics and seeing Deena Kastor painfully quit the marathon at just 3 miles. She had a stress fracture in her ankle, not because of running, but tripping in her garden! The bone sent a signal to her brain that it could not handle the load. Damage to the bone is one that will not be influenced by situation, psychology, or circumstance. You cannot will yourself through running on a fracture. A fracture indicates damage and stimulates the Gate Control Cycle. Very different than my previous muscle scenario. Deena could use her critical thinking skills to realize that she was no longer able to apply constant load to that bone, because, the pain was relentless. She was able to deduce that this pain would hinder her performance not just in that moment but, in future moments.

When you find yourself experiencing pain, it is always good to go within yourself and try and deduce what you are feeling. Analyze the pain. Sometimes, runners complain of achilles pain within the first few miles of a run. Immediately, they think, “Oh no, I have a sprain.” Often times, if you look at the situation, you may find that you did not warm up appropriately or that you started your run on a hill. The pain needs to be evaluated, analyzed, and monitored in order to determine if it will hinder you or help you improve. We often want pain to stop at its first impulse. However, the reality is that pain may be very informative and can be used for your benefit. We may be able to assess that something in our training routine needs to change. We may even realize the pain is caused my a weakness that we need to strengthen. In these two instances, pain can help you to improve.

What is my pain threshold? It varies from situation to situation. But, I will tell you, that I am person that will embrace pain. I see it as an opportunity to learn more about my body. When I experience it, I don’t necessary feel the urge to run off to the doctor to have it checked out. Rather, I contemplate its cause and use it as a tool for performance. We need to be more in tune with our bodies, analyzing what we feel. If you have a burn, a fracture, instant damage to a structure in your body, you will know. You will hear, see, or smell something! Flesh burning, a ligament popping, a bruise or dislocated surface. This is pain that cannot be ignored, and you know it. It is clear that this type of pain will hinder you and your future attempts to perform.

My suggestion is that you become openminded when it comes to pain. Realizing that some pain can be productive and used for your improvement as a runner. And, the same is true that pain can also be an indication to stop running and rest and heal. Use your mind to connect with your body when you experience pain, and you will see better results.