Pain during training is par for the course for numerous athletes. What is pain and how can and should an athlete assess it?

Endurance athletes all know the pain that arises when they reach the maximum heart rate zone during interval training and lactate floods the entire body. In order to be successful, ambitious athletes need stamina. Suffering in sports is beneficial and conducive to staying fit.

In an athlete’s life, however, there is also a kind of pain that has nothing to do with conquering your weaker self. «Pain is important and completely normal», says Michael Wawroschek, physician and Medical Director of med-athletics in Zurich. «Only through pain do we have the opportunity to appreciate and better understand our bodies». For this, it is crucial that athletes do not simply ignore the pain, but specifically deal with it and ask themselves: «Where exactly is the pain? Is it changing? Is it getting worse or easing off?»

Pain as a warning sign

To enable the human body to classify a stimulus, specialised receptors recognise painful signals and pass the information on to the spinal cord, where it is processed and sent to the brain. In the case of protective reflexes, such as withdrawing the hand from a hot stove, the body reacts automatically, without consciously classifying the pain. Only when it reaches the brain, is the pain consciously perceived, evaluated and processed for learning processes. Ambitious athletes usually tend to have a higher pain tolerance than non-athletes. Yet at the same time: pain is a warning sign that something is off kilter. Without pain we would constantly overload our bodies.

The correct classification depends on the individual. Sports physician Wawroschek finds that people generally react too anxiously when dealing with sports and pain. «Many avoid sports as soon as something hurts. But this is often a mistake because most people suffer pain from not exercising. It is therefore the other way around: sports and exercise can often eliminate complaints».

Sports is also a pain killer. However, dealing with pain in sports is not easy. Some athletes seek it, for example, when building muscle: little is achieved here without pain because only a load that feels painful will lead to muscle growth. «You can and should suffer this pain consciously», says Michael Wawroschek, «you simply have to push through».

Sharp pain is dangerous

But how does an athlete know how much pain is acceptable and when it is dangerous? Wawroschek distinguishes between three types of pain: «Muscle pain, tendon pain and joint pain». Most tend to be wrong when interpreting muscle pain: patient, doctor, trainer. «The extent of muscle pain is often underestimated and misdiagnosed». Therefore: «Every athlete should take muscle pain seriously and get it clarified by a doctor». Except in the case of harmless muscle soreness. Particularly dangerous is any kind of sharp pain. Wawroschek: «A torn muscle fibre feels like a knife stab, and in this case, you should stop doing sports immediately». Most of the time the body registers this automatically, but in a competition, it may also be that this reflex is drenched in adrenaline and thus doesn’t respond.

A good sign is when pain changes for the better. If your complaints become less during training, you can safely continue. Conversely: if the pain comes back during sports or gets constantly worse, you should stop training.

Respect for drugs

Many complaints in endurance sports are typically due to overloading. Such inflammatory pain – if it occurs locally, such as runner’s knee or periostitis – does not generally damage the body. And basically, any healing is associated with inflammation. The difficulty with inflammation is finding the appropriate balance between loading and relief. It helps to temporarily switch to other types of sports in order not to aggravate the area of inflammation. However, if the pain continues to get worse, you should go to the doctor. If the pain disappears again after sports training the next day, you can continue training in doses.

If and when an inflammation needs to be treated with drugs should only be decided upon after consulting a doctor and according to a plan. However, drugs should be used as little as possible when doing sports in general. «It is never a good idea to compete when suffering pain», finds Michael Wawroschek. And those who can only train with painkillers in the long term risk damaging their stomach and intestines.

There is one exception: in the case of arthritis pain in the joints, exercise is more pain-relieving and beneficial than immobilisation and protection. It may be advisable to reach for painkillers to ensure it is at all possible to exercise again. Even if athletes subjectively prefer to avoid pain, everyone will face it at some point. Or as Michael Wawroschek puts it: «Pain is part of life and it feels good to be able to fight it».

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