Push Your Pain Limit
Sometimes your body just doesn’t want to go any further. Before you quit, it’s important to block out the impulses and embrace the hurt.
Can you run nine marathons in one year? Maybe you can – but how about doing it in 72 hours? That’s what Charlotte Vasarhelyi did while competing in the 2012–13 Across the Years race in Phoenix, Ariz. The 37-year-old ultra star covered an epic 403.76k in three days, good enough for a new Canadian record. But what’s most amazing is that she did it with a pinched nerve in her back, sending shooting pain down her leg for much of the race. “After feeling so much pain over the years, you simply don’t register much of it anymore,” explains Vasarhelyi. “I’ve been doing this for 15 years, and my pain tolerance has increased with time. If my body registered every little ache, I wouldn’t be able to do what I do.” In a sense, running always involves pushing through some discomfort – persisting despite the voice in your head that says “stop.” It’s a delicate balance between body and mind. But the performances of people like Vasarhelyi – who views shooting nerve pains during a three-day race as a “minor ache” – suggests that we’ve been underestimating the potential power of the mind. “I just don’t feel pain,” she says. “I just don’t.”
The Science of Pain
The pain we feel is processed in the limbic system, which is the emotional part of our brain. Depending on what else is going on in that emotional centre, the same pain signal may generate totally different pain experiences. Researchers have found that being afraid or stressed, focusing on pain, and anticipating painful experiences can significantly increase how much pain we feel without changing the stimulus. For instance, one 2001 study looking at burn victims showed that integrating excruciating rehabilitation procedures with virtual-reality video games drastically reduced the pain they felt. There was no change to the pain stimulus; the brain was merely distracted, and therefore felt less pain.
The same effects can be seen in how athletes deal with pain. A 2010 study showed that the painkilling drug acetaminophen produced a two-per-cent increase in cycling performance. The acetaminophen didn’t change the body’s physical ability to perform; it just masked some of the pain, and as a result the athletes went faster. In fact, researchers are now realizing that athletes generally have a greater ability to endure pain than the average person. A recent study published in the journal Pain showed that athletes have the same pain threshold (i.e. pain is felt at the same stimulus intensity) as the general population, but have a much greater pain tolerance. In other words, athletes feel the same pain, but they’re able to cope with it more effectively.
So does Vasarhelyi really experience no pain? Or has she just learned to cope with it exceptionally well? A 2011 study published in the European Journal of Applied Physiology may hold the answer. In this study, 20 ultrarunners were monitored over the course of an 894k relay race that took place over 95 hours, with each competitor covering an average of 119.6k. Not surprisingly, the runners showed a significant increase in inf lammatory markers in their blood, as well as widespread muscle soreness after the race, with the calf and quadriceps faring worst. Physiologically, the athletes were in pain.
There’s no doubt that when Vasarhelyi runs, she experiences the same responses. In fact, she was one of the subjects in the study. She may hesitate to acknowledge pain, but the data shows that her body sends out inf lammatory markers and pain signals just like everybody else. Somehow, she just ignores them.
Separating Impulse and Reaction
Just as athletes like Vasarhelyi cope better with pain than the general public, some athletes cope better than others. “There is a psychological profile [of an athlete who] is able to productively cope with pain, and an athlete who cannot,” explains Kim Dawson, a professor in sports psychology at Wilfrid Laurier University, in Waterloo, Ont. The best runners see pain as a positive result of pushing their body to its limit, she says. They have a strong ability to separate impulse and reaction.
“You can develop and improve your coping mechanisms with coaching and practice,” says Dawson, who has worked on these techniques with a number of elite distance runners on the Canadian Olympic team. One technique Vasarhelyi uses to separate her decisions from pain-driven impulses is to count to 77, then 33, and then 77 again. She will repeat this 7 times, and then re-evaluate to see if she actually needs to stop. She never does.
In fact, Vasarhelyi has become so good at this that she has trained herself to almost entirely remove pain from her decision-making process. In the summer of 2012, she tore her hamstring while attempting a multiday record-breaking trail run. A sharp stabbing pain caused her leg to buckle, bringing her to the trail f loor. She kept going for another 130k, and only decided to stop when her knee would no longer come into f lexion during her stride. “I had no problem with the pain,” she recalls. “When something starts to not function, then logically I think, ‘Maybe, there is something wrong.’” The eventual decision to stop wasn’t an emotional response to pain, but a purely cognitive response to a lack of function.
In this case, she clearly should have stopped sooner. But it’s this ability to separate impulse and reaction that has prevented her from quitting prematurely hundreds of times before – and the same approach can help runners at all levels. As cyclist Greg LeMond once said, “It never gets easier, you just go faster.”
Perceptions of Pain
Another key element of Vasarhelyi’s success is her attitude to pain. While some view pain as harmful and intimidating, she sees it as a sign that she’s working hard and pushing at a level that will lead to success. Researchers have repeatedly found that people who equate pain with harm take longer to recover from injuries and are more likely to develop chronic pain. To conquer pain, you need to understand that hurt and harm don’t always go together. Of course, different events require slightly different approaches. “We teach [middle-distance runners] to fully stay in the moment and feel the pain,” she explains. For these short, intense races, it’s important to “stay in the pain” to maintain the fastest possible pace. In longer races, on the other hand, you’re better off tuning out the pain as much as possible.
Conquering Injuries
Researchers are now realizing that athletes generally have a greater ability
to endure pain than the average person.
The pain of injury is very different from the pain of exertion, but similar strategies can be helpful. In many cases, injury pain is as much about what is going on psychologically as it is about what we can see anatomically. For example, studies have shown that chronic low back pain is more strongly correlated with factors such as anxiety, depression, socioeconomic class and level of education rather than findings from mri or radiographs. The mind seems to matter more than the body when predicting chronic back pain.
Another example that is familiar to runners is the ever-challenging chronic Achilles tendon pain. In acute cases, Achilles tendon pain is related to tissue tears and inf lammation. However, we now know that in chronic cases, anti-inf lammatory medication is no better than a placebo for improving pain. The reason is that chronically painful tendons are no longer inf lamed. Researchers say we still experience pain in these situations because lingering neurotransmitters keep relaying a pain signal to the brain. But obeying that pain signal won’t fix the injury: instead, a progressive rehabilitation plan that involves pushing through tendon pain is the best fix.
Of course, pain is often a good indicator that you should stop. But in some cases, learning to run through soreness is a valuable psychological skill – and in the case of Vasarhelyi’s pinched nerve, it even led to a Canadian record.
Anticipation of Pain
While consciously managing pain can improve performance, we’re not always aware of the tricks our brains use to slow us down in an attempt to avoid it. For instance, when you exercise in hot conditions, you slow down because you start to overheat – or at least, that’s what it feels like. But in a fascinating 2012 study, cyclists performed 30-minute time trials in three different conditions: a moderate temperature, a warm temperature, and the same warm temperature while being deceived into thinking it was colder. Not surprisingly, the riders pushed a lower average wattage in the warm conditions. But when they were tricked into thinking they were riding at a lower temperature, the difference between the groups vanished. Simply put, the brain decided to slow down the legs in pure anticipation of overheating, not in response to overheating.
In a similar way, the mind can also unconsciously decide to let us go faster. A newer line of research shows that rinsing your mouth with a sugary solution will result in an increase in performance. One 2006 study showed that runners went 1.7 per cent further during a 30-minute effort when they rinsed with a sugary solution. Another study showed that cyclists displayed a 2.9 per cent decrease in a time trial with rinsing. In both cases, no sugar actually needs to be ingested; the brain just anticipates that fuel is coming and tells the legs to speed up. In the end, what pushes us to slow down or speed up is very complex and extends far beyond a conscious decision to positively react to pain. Learning to cope with the pain we feel is valuable, but is only one piece to the puzzle of maximizing performance on a given day.
Limiting Pain’s Influence
To run your best, there is no doubt that developing the skills to react to pain in a positive way will help you go faster regardless of ability. Even if you don’t feel equipped to respond well to pain, learning and improving is always a possibilit y. In fact, even observing people with good pain tolerance will increase your own tolerance. In one study, subjects who were exposed to a low-intensity shock said it was painful 77 per cent of the time when they observed actors with low pain-tolerance first. However, when they observed high-pain tolerance actors, only three per cent of the subjects considered the same stimulus painful. This shows that what constitutes pain in the human brain is transient and fickle, and can easily be inf luenced with the right strategies.
For Charlotte Vasarhelyi, the coming year will bring the 24-hour world championships, plus a shot at the Rideau Trail record, a route that runs from Kingston, Ont. to Ottawa. With techniques like separating impulse from reaction, viewing pain as positive feedback, and understanding the difference between hurt and harm in injuries, she has the mental tools needed. “She has developed some serious psychological mechanisms that work for her, and that allow her to be very good at what she does,” Dawson says. With practice, you can develop your own coping mechanisms in order to compete at – or beyond – the limits of pain. Sean Delanghe is a Waterloo and New Hamburg, Ont.-based chiropractor, coach, journalist, and age-group athlete.