Pain and Performance

January 3, 2005 03:28 PM

By Jim Brown, Ph.D., Editor, Sports Performance Journal (

John Heil, D.A., a sports psychologist at the Lewis-Gale Clinic in Roanoke, Virginia, addressed the issue of pain and its relationship to performance at a World Congress on Mental Training. Following is a summary of his comments.

It’s Part of the Game
The ability of athletes to tolerate pain is usually associated with one or more of six factors. The first is an expectation that pain can and will be tolerated. This expectation permeates sports. "Playing through pain," "no pain, no gain," "shaking it off," and "sucking it up" are common, even crude, expressions that reinforce the idea that athletes should expect and tolerate a certain amount of pain in order to be successful. For better or for worse, a "pain is part of the game" attitude is an accepted principle of sports participation.

A Positive Experience
The second attitude that helps athletes cope with pain is one of interpreting pain as a positive experience. In endurance sports such as running, swimming, rowing, and cycling. Pain is directly interpreted as a positive sign of effort. Sports psychologists and coaches encourage athletes to accept the discomfort brought on by extraordinary effort and to develop the mental toughness that is a key to successful performance."

Goal Orientation
A strong goal orientation is the third defense against pain. Most successful athletes have well-defined, long-term goals in regard to their athletic participation. It is ingrained through repeated training over a period of years. This goal-seeking behavior, which is particularly strong during competition, allows athletes to perform under a wide variety of circumstances, including pain.

Focus on the Activity
On a shorter-term basis (during an event), athletes are more likely to tolerate pain if the activity is at the center of his or her attention. External distractions, including pain, are not allowed or may not even be noticed. The focus is on the sport, not the pain.

A Matter of Survival
Pain can be more easily tolerated if it is seen in a survival context. While sport is seldom a true life or death situation, the personal investment in success and the personal cost of failure can be tremendous. The athlete who performs with pain in order not to be cut from a high school team is as threatened as the elite athlete competing to make the Olympic team or the college player hoping to be drafted by the pros. The decision to play while hurt is not necessarily a wise one, but it does serve the purpose of tolerating pain.

An End in Sight
Finally, athletes are more likely to tolerate pain when there is an end in sight. One study found that reports of pain severity increased as subjects' expectations of the duration of pain increased. In sports, the athlete is able to look ahead to a time when the event or the season will be over and the pain will cease.

Tolerating pain raises issues that have to be addressed by athletes, physicians, trainers, coaches, and parents. One is how to better tolerate pain brought on by sports training and competition. A second is how to manage pain without risking permanent injury or performing at a lower level. There are several other questions associated with the awareness of pain. Among them are:

• Is the pain routine and best ignored?

• Does pain mean that the athlete should adjust the pace (as in distance running) or to modify technique to avoid injury (one-handed vs. two-handed backhand in tennis)?

• Does pain signal a developing injury?

• If so, should you continue until the end of competition or get immediate medical attention?

• Does the potential psychological harm caused by quitting too early override the physical risks of quitting too late?

© 2004 HMS Publishing, Inc.
Jim Brown will be contributing new content to this site on a monthly basis. If you have a question for Dr. Brown please feel free to email him at