Train­ing With Pain

Triathlon Magazine Canada - - Front Page -

Train­ing with pain is a form of graded mo­tor ex­po­sure, mean­ing you slowly in­tro­duce a stress­ful and painful stim­u­lus to your body. The body adap­tats. Stress­ing the body makes it stronger. We want to stress the body and ex­pe­ri­ence a lit­tle bit of pain so that with time our pain thresh­old will creep up as we slowly ex­pose our­selves to the threat­en­ing ac­tiv­ity. How­ever, if you ham­mer through pain and per­sist into ex­treme pain you can ac­tu­ally get bet­ter at deal­ing with pain. So how do we do this?

A triath­lete might only be able to run three kilo­me­tres un­til knee pain sets in. Around the time that knee be­gins to ache the ath­lete should slightly mod­ify his or her gait. For ex­am­ple, try run­ning with a fore­foot strike, an in­creased step ca­dence, run with a wider stride or a shorter arm swing arc. Pay at­ten­tion to the pain. If the pain is re­moved or only slightly in­creased con­tinue with that gait mod­i­fi­ca­tion but only run for five to 10 more min­utes. If there is no in­crease in pain the next day, this pain ex­po­sure ac­tiv­ity can be per­formed again.

This small amount of in­creased stress is how we sneak un­der the brain’s alarm sys­tem. If we can ex­pose our brain to the of­fend­ing trig­ger, but con­vince it that there is no need to be threat­ened you can in­crease your thresh­old where pain be­gins to be felt. By in­creas­ing ex­po­sure to run­ning slowly you can in­crease your vol­ume slowly and safely and can save a lot of time from avoid­ing the de­train­ing ef­fects that pro­longed time off can have on your train­ing.

Un­for­tu­nately, there is not a lot of re­search in this area. One area that has re­ceived the at­ten­tion, how­ever, is ex­er­cis­ing with per­sis­tent ten­don pain. In a pa­per in the Amer­i­can Jour­nal of Sports Medicine, Dr. Sil­ber­nagel showed that a group of ath­letes who per­sisted in their sport­ing ac­tiv­i­ties (run­ning and jump­ing) while still ex­pe­ri­enc­ing pain at per­ceived to be less than five out of 10 showed com­pa­ra­ble im­prove­ments to a group who avoided those painful ac­tiv­i­ties.

A warn­ing: this does not work for re­cent dam­age that has re­sulted in an acute in­jury. When you have acute in­juries, bony pain or un­ex­plained pain you need the usual time to heal. Graded ex­po­sure only works when there is a dis­con­nect be­tween the pain per­cep­tion and tis­sue dam­age. Real in­juries re­quire us to re­spect the pain. As al­ways, work­ing with a health pro­fes­sional that un­der­stands pain and per­for­mance can help in in­sti­tut­ing this form of re­ha­bil­i­ta­tion, and get you back to com­pe­ti­tion and do­ing what you love.

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