Lance Armstrong

Pain Tolerance and Endurance Athletes

Endurance sports, such as cycling, require a different set of skills over their game sport counterparts. The very nature of endurance sports, pushing oneself to the limit for extended periods of time, taxes the mind much differently then other sports.

In this article we will cover the relationship between pain tolerance and endurance athletes.

While there are plenty of heroic stories of football or hockey players playing through some ungodly injury, this is not inherent to the sport. When Ray Lewis sacks Tom Brady, it hurts but when Brady throws a touchdown pass, there is nothing inherently painful about this success. To win a bike race, though, is inherently painful. What is it about cyclists that allow them to tolerate this pain so well? Do they even feel it the same way we do? Does their mind approach the pain differently? Do they address the pain differently? The following seeks to answer some of these questions.

Certainly some individuals are blessed with a genetic gift that allows them and their physical systems to excel and some would argue that these genetically-gifted individuals are rare. It could also be argued that these people are less rare than most realize. As an endurance athlete, you are only as good as your mind allows and there are many individuals who are physically strong yet mentally weak and who cannot succeed. The fact is, winners and the ones at the top of the sport are different types of people. Not different from each other but different from you and me.

Grit is a Requisite For Success

Common sense tells us that top endurance athletes probably have a little more ‘grit’ than the average person. It’s that type of grit that allowed Tyler Hamilton to win a stage of the Tour De France with a broken collarbone. Hamilton, known for his incredible pain tolerance, embodies the difference between ‘them’ and ‘us’. The insane pain tolerance of him and his peers is obviously the difference, but what drives that difference? Perhaps their tolerance isn’t different, perhaps their pain is different. What if these athletes feel pain differently than you and me? That would be a convenient explanation but as it turns out it’s not likely true.

A 2012 meta-analysis of 15 pain-tolerance and pain threshold studies showed that athletes feel pain in the same way and same levels as non-athletes. The only difference was that they were able to tolerate the pain better. This tells us that their bodies aren’t different (they still feel the pain) but their brains might perceive the pain differently (they have a much higher tolerance).

Additionally, it was found that the type of sport seems to matter with endurance athletes mostly having similar pain tolerances and thresholds which were different than other sports. This indicates some similarity within but not necessarily across sports. A cyclist handles pain differently than a baseball player, for example. Higher pain tolerance in athletes may hold clues for pain management.

The Pain Does Matter

It would be easy to dismiss all this talk of pain tolerance and make an argument that it’s not the pain that matters, but the physical ability. It’s common to hear excuses in sport about why things didn’t work out as well as a cyclist might have liked on race day.
Claire Hallissey
Many like to cite physical differences and ability and at times people will note that they were just ‘off’ that day. These things are real, and they do matter, but it’s not the whole story. Alexis Mauger, Andrew Jones and Craig Williams of the School of Sport and Health Sciences at the University of Exeter decided to investigate the influence of pain medication on performance during time trial cycling.

Subjects were split into two groups and were given either acetaminophen (Tylenol) or a placebo prior to a self-paced 10 mile time trial. Subjects were also asked to rate subjective levels of pain. Although there was no significant difference in perceived pain tolerance, ie. all subjects felt the time trial was equally hard and equally painful, the group given a pain reducing medication had a significantly higher heart rate and a significantly better time trial time, which is to say that they pushed themselves harder.

This tells us that pain seems to be a limiter both in performance and in the ability to push oneself further. The findings would arguably be less interesting if the faster group stated that the time trial was less-painful, but the fact that they didn’t feel it was any less painful, and yet they went significantly faster, tells us that the a major speed limit is the individual’s pain tolerance. If an individual is able to tolerate pain better (or in the case of this study, merely reduce the pain), they can go faster.

In most sports, the ones at the top are often the most-quoted. Part of this is just because they are more in the spotlight, but what they say is also an excellent reflection of how they approach their craft. In a 1998 study by Jeffery Kress and Traci Statler of California State University, the quotes of Olympic cyclists were examined to determine how they attempt to deal with pain while training and competing.

Kress and Statler concluded that top cyclists utilize an array of tactics and techniques to address the pain associated with their sport. The key point is not that they are able to handle the pain better, it’s that they actually seek to embrace and deal with the pain, rather than ignore it as much of the population does during exercise. Simply put, top athletes approach the pain in a unique way by paying attention to it, rather than ignoring it.

Learning to Deal With Pain

With the above facts in mind a fair question to ask is whether or not this is a natural state or if it is a learned ability. Do cyclists and other endurance athletes learn to deal with the pain over time or are they born with these unique abilities?

A meta-study of pain tolerance and perception in athletes and non athletes, published in the journal, Pain, in 2012 seeks to answer whether or not pain tolerances and perception can be altered over time. The study looked at 15 studies including 900 individual subjects. The results of this meta-analysis, which are extensive, indicate that individuals can actually alter their perceptions and tolerance to pain over time through regular physical activity. Much like the act of strengthening the legs and the lungs, prolonged cycling seems to build towards a higher tolerance to pain.

What Placebos and Mental Illness can Teach us About Pain Tolerance

The placebo effect has long allowed scientists to test the effectiveness of medication (and other variables) but the effect itself has come under the scientific spotlight. The ability for a sugar pill to reduce pain, for example, opens up many questions about how pain works. Numerous studies over many years have proven time and again that a placebo can reduce pain in test subjects.

This indicates that pain reduction can be modulated both by external chemicals (in the form of pain medicine, for example) but also by internal psychological factors (which very well could ultimately alter brain chemistry as well).

Mental illness seems to affect pain tolerances as well. Elderly individuals suffering from dementia have different pain tolerances and thresholds. Additionally, the specific type of dementia seems to cause unique changes of these tolerances and thresholds.

Individuals that self-mutilate also, not surprisingly perhaps, have unique pain tolerances and thresholds. What is interesting about these individuals, though, is that the differences only seem to surface in instances of interpersonal distress. In other words, the very scenarios that would lead to a self-mutilating episode seem to be the only time they have a heightened tolerance to pain. This indicates that pain tolerances actually change depending on context.

Conclusion

Cyclists and other endurance athletes have to be able to face the pain inherent with their sport if they are to succeed. Although physical prowess is an obvious requirement to succeed in endurance racing, the ability to mentally deal with the physical pain is arguably equally important. It cannot go without saying that there are known genetic drivers behind individual differences in pain tolerance. This helps explain why some individuals are better at dealing with pain than others (regardless of their athletic ability).

It seems likely that to become a top cyclist one must have been born with both extreme physical ability as well as an elevated natural tolerance to pain. Beyond this, there are some differences that set the cyclists apart. Although they may have an inherent elevated tolerance to pain, the pain itself does not differ from other individuals.

We also know that pain is an important limiter in endurance sport and if a cyclist or other endurance athlete can manage the pain better they can go faster. Lastly, pain is very psychological so the way in which an athlete copes with it likely plays a significant role in their ability to deal with it. In the words of Tyler Hamilton a cyclist cannot block out the pain, but must embrace it.