“You can train up to, but not into pain”
Brief Overview
Pain is a protective mechanism the body employs to warn of possible trauma or to indicate that further injury may occur if precautions are not taken. Pain can be categorized as “positive” or “negative.” Positive pain is discomfort associated with physical conditioning; negative pain is discomfort associated with injury. Pain that continues beyond seven to 10 days is negative pain and an indicator that medical attention is needed (1)
Pain lets one know when the body is stressed beyond its normal limits. Most exercise-related pain is due to the accumulation of lactic acid and other metabolic waste products and their effects on pain receptors located in the muscle tissue. Tonic reflex muscle contractions caused by sustained, localized spasm of motor units are responsible for delayed soreness, which is experienced 24 to 72 hours after unaccustomed exercise (2).
Many athletes are socialized into believing that they must train through pain, and that more is always better. This mind-set can lead to overstraining and injuries like shin splints, swimmer’s shoulder and tennis elbow. Hard physical training does not have to involve excessive discomfort. Athletes and exercisers need to be taught to distinguish between the normal discomfort that accompanies overloading and increased training volume, and pain that indicates the onset of an injury (3).
Most serious or highly competitive athletes throughout their career learn to distinguish between good and bad pain. They understand the negative result of pushing through pain; injury, resulting in a possible modification from their training schedule and competition. They usually don’t want to take that risk. However, there are still some athletes that may want to achieve a goal so badly that they cannot differentiate or refuse to pay attention to the normal pain signals. This is risky behavior and may result in serious injury or even death.
We, as sports performance trainers and coaches of athletes may need to take a close look at our tactics for motivating athletes. How are we communicating with our athletes? Asking athletes to “walk it off,” “forget about the pain,” or “suck it up,” is not teaching them the proper coping mechanisms and may push people to injury, especially if they are new to the sport, de-conditioned or new to exercising. Athletes not completely aware of their bodies and physical capabilities rely on us, the trainers or coaches, to be the barometer by which they measure how much effort their bodies can sustain. As a former Division I college level athlete and former college coach, I think it is always best to error on the safe side when dealing with athletes that you believe have suffered an injury or are in pain. Athletes will hide pain from us. Why they do this or why they push themselves to the point of serious injury or even death is another article in itself. (To read more on the Psychology of Sport and Exercise Injury, go to “A Pain In The Brain,” March 2002. IDEA Health and Fitness Source, by Daniel R. Ball, MS., 38-50.) In most cases coaches can see if an athlete is in pain, it is usually reflected in their facial expressions, their bodily movements and altered style of play. When I was a college coach, I always impressed upon my athletes and their parents the importance of letting me know if they were hurting or had injured themselves. Whatever the level of pain, I would have them evaluated by an athletic trainer. The dialogue between a coach and an athlete in regards to injuries needs to be open, respectful and positive. Athletes must understand that “you can train up to, but not into pain.” In my opinion, it is always best to seek out the help and advice of an athletic trainer. An athletic trainer specializes in the care and prevention of sports injuries and they are individuals best equipped to make a decision on whether or not an athlete can return to competition or remain on the sideline. If you need to see a physician, seek out the help of a sports medicine doctor. The coordinated efforts of a sports medicine doctor, physical therapist and athletic trainer can help get an athlete back on the playing field in the shortest recovery time possible.
Athletes and exercisers who take pain medication prior to physical activity may mask the natural sensations that stem from an injury and indicate that a physical problem exists. Failure to pick up these signals can lead to further trauma and possibly permanent injury. Coaches and trainers; know when your athletes are self-medicating for pain and inform them of the potential hazards.
REFERENCES
- Ball, D.R. The Psychology of Sport and Exercise Injury. IDEA Health and Fitness Source. Mar. 2002; (38-50).
- Kelley, M.J. Psychological risk factors and sports injuries. Journal of Sports Medicine and Physical Fitness. 1990; 30(2): 202-21.
- Weinberg, R.S., & Gould, D. 1999. Foundations of Sport and Exercise Psychology. Champaign, IL: Human Kinetics.