Pain is inevitable, but suffering is optional.’ So goes a well-known but anonymous quote. For many athletes, pain is a normal everyday experience and success is often achieved in spite of pain. But what’s the best strategy for coping with and overcoming pain and how can athletes distinguish between benign and potentially damaging pain?
How do some people shrug off a painful injury? Remember that following an acute injury, such as an ankle sprain, pain receptors are first stimulated by the mechanical stress and strain placed upon the tissue. ‘Inflammatory soup’ soon floods the tissue leading to peripheral sensitisation. Several hours later, similar chemicals will also lead to spinal modulation. Pain and sensitivity to movement and pressure increase over a period of a few hours; the time between the transition from the original mechanical pain (which may pass) to the maximum sensitised state may provide athletes with a ‘window of opportunity’ to shrug off their pain and continue competing.
However, this mechanism is probably only the tip of the iceberg. When you are totally focused on your opponent, or consumed by the contest, supra-spinal and spinal modulation may act to inhibit the transmission or limit the awareness of the pain signal. We’ve all heard stories of sportsmen and women who have continued despite an injury which (theoretically) should have caused them to stop: a boxer with a broken hand, rugby players with torn ligaments, a long jumper with a strained hamstring etc. In the cut and thrust of competition, the pain system can ‘shut the gate’, and athletes are able to continue in spite of injured tissue. However, once your attention is drawn back to the acute pain (particularly following competition), awareness of the pain becomes strong again, especially if this also coincides with an increase in peripheral and spinal modulation. So, should you ignore pain and try to shrug off an injury?
Acute sensitisation is a normal, helpful process to encourage you to stop using the injured tissue and avoid further damage. It might be helpful to ask yourself the 3 C questions listed below. There are a few other questions, which are perhaps even more important. We’ll get to these another time. But remember, acute pain usually occurs for a good reason. It makes sense to seek professional advice as soon as you can. Sometimes people can overcome acute pain and continue to compete, but that doesn’t necessarily make it a wise decision!
REMEMBER the 3 C’s:
Can you cope with the pain?
Are you able to contribute a meaningful performance?
What are the consequences of continuing?