Cycle sport is intricately mythologized with the heroism and agony of suffering. We watch and marvel not just at the speed and power of the pros, but for the thrill (for us) and suffering (for them) inherent in racing over cobbles, high mountains rain, extreme heat, and even snow. Does being fitter also make you tougher? Does improved fitness actually alter pain tolerance?
‘It still hurts just as much, you just go faster’ – Greg LeMond
My 2005 Rehab
Back in 2005, I did a bit of a break and enter at high speed through the back of a hatchback which zipped out of the driveway without looking. The road to rehab was long but straightforward, despite a shattered scapula (8+ cracks) and a few broken ribs. At the time, many friends remarked how quickly I recovered, and claimed that it must have been my fitness.
Thinking through the process, I felt it wasn’t anything to do with my physical state of fitness, but more that I was used to the distinction between pain as a dangerous signal versus discomfort from daily training. That is, I was willing to push myself in rehab right to the point of actual pain, as opposed to mistaking tiredness or discomfort as pain.
Jones et al. 2014
Surprisingly, very little research, if any, has directly explored the relationship between aerobic training and pain perception. What we generally know from scientific studies is that acute exercise provides a hypoalgesic effect. That is, the endorphins you produce during exercise also reduces your pain perception in the short term. Chronic exercise also decreases pain sensitivity in patient populations suffering from chronic pain. However, the presence of persistent pain as a confounding factor in these studies means that we cannot directly translate such findings to otherwise healthy populations.
A group from University of New South Wales in Australia decided to tackle this topic, and their results were published in the prestigious journal Medicine and Science in Sports and Exercise. They chose to train moderately fit individuals over six weeks, and tested both their pain tolerance and also pain threshold (point at which pain is noticeable or significant). Some of the methodological details:
The Painful Truth
A straightforward and solid experimental design overall. It was critical that they had a control group for this study, as the whole point is to compare training versus no training. The caveat is that you’re comparing two groups of individuals, so there’s some potential variability inherent between the two groups.
Here are the main findings:
Analysis
As noted above, the overall experimental question was interesting and the design was sound. This study was nice in being the first to clearly demonstrate that chronic exercise attenuates pain perception and tolerance in otherwise healthy individuals. In turn, this definitely supports the general idea that fitness is not just a physical state, but also a psychological state in that it improves pain tolerance.
Interestingly, the similarity in both groups for pain threshold response suggests that fitter individuals still recognize a noxious stimuli as painful, but that they are better able to tune it out and put up with it. This also supports the underlying theme that training isn’t just about improving your physical state, but also your psychological tolerance to discomfort or pain.
The same general findings were also reported back in 2002 in my former lab in Toronto, where both moderately and highly fit individuals experienced similar levels of physiological strain during prolonged exercise in the heat. In that study, while the moderately fit group’s perceived strain closely matched their actual physiological strain, the fit group’s perceptual strain was much lower than their actual physiological strain.
Summary
This study further adds to the whole renewed emphasis on the athlete as a holistic mind-body system. For example, the data suggest that psychological interventions focused on reducing or managing discomfort and pain can greatly benefit athletes in training and competition.
So with the off-season upon us in the northern hemisphere, consider devoting time to improving not only your physical but your mental toughness. And as you plan for 2019, consider workouts that challenge you to push your mental limits too.
Reference
Jones MD, J Booth, JL Taylor, BK Barry. Aerobic training increases pain tolerance in healthy individuals. Med Sci Sports Exerc 46:1640-1647, 2014.
Tikuisis P, TM McLellan, G Selkirk. Perceptual versus physiological heat strain during exercise-heat stress. Med Sci Sports Exerc 34:1454-1461, 2002.
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