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STRATEGIES FOR HANDLING PAIN BY ATHLETES ARE EVALUATED


By Lina Vaisetaite

You probably quite often feel pain while you train – what do you do then?

Psychologists use the notion of “pain coping”. It describes behaviors that people engage in when they are in pain (not necessarily sport-related) – it includes all efforts to minimize pain sensation or to change one’s attitude towards it, in other words it includes all means to endure pain. Specific actions (both internal, e.g. thoughts, and external, e.g. behavior) are called pain coping strategies. We all use these strategies, however some are used more often than the others. In addition, our choice of strategies is based on the type of pain, i.e. whether it was evoked by excessive training load (muscle pain) or injury (e.g. broken leg), whether it is weak or strong pain, etc.


In summary, the most often used pain coping strategies in athletic setting are:

  • pain reduction (here and below stars signify the “popularity” of pain coping strategy) – this strategy encompasses behaviors like consulting a physician, use of medication, massage, special physical exercises, movements, relaxation of muscles, choice of a particular body posture, immobility of the painful body part, missing practice. All of these behaviors usually help to reduce pain and that is the first choice for athletes.
  • positive self-instructions (), or positive thinking. That is athletes engage in thoughts that carry the idea “I can endure this pain”, “it will pass”, “it’s not that bad”, “it won’t prevent me from achieving my goals”. They also encourage themselves by saying “go!”, “keep on!”, “don’t stop!”. When they use this strategy, athletes feel they can do something about the pain and this is one of the most often used strategies.
  • search for information () – it can be a talk with a coach or another competent person, an attempt to analyze what hurts and why. This strategy is important in a sense that it provides a necessary information and allows to understand pain better. Besides, following emotional reaction to the pain will also depend on the gathered information. For example, if an athlete during the rehabilitation after an injury feels pain, but was warned by the physician of the possibility of this kind of pain, it will be taken differently than in the case if athlete believes he should feel no pain at that stage of the rehabilitation. In the latter case it will probably evoke a great deal of anxiety (“something is wrong!”).
  • goal-setting (). The use of this strategy means that athletes set themselves specific goals (e.g., I must finish the race) or they design a plan, what to do to endure the pain. This kind of goal-setting accelerates the process of rehabilitation.
  • diversion of attention (). This strategy covers two aspects. Firstly, attention is diverted from the pain when an athlete engages in another activity, unrelated to sport. He can watch tv, listen to music, communicate with friends. Secondly, diversion of attention might mean focus on other things and sensations while exercising, e.g. thinking about something nice and pleasant, thinking of the fight or a race, disregarding the pain. Usually this kind of “tricks” takes place when the pain occurs during the competition and athlete needs to finish the course or the meet. When attention is diverted elsewhere, the sensation of pain seems decreased. The use of this strategy is reinforced by the observation that sometimes athletes notice an injury or painful body part only after they have finished competing. During the competition all attention is focused on performance-relevant cues and pain sensation is disregarded.
  • reinterpretation of pain sensation () – this strategy means that an athlete pretends he doesn’t feel pain, he tells himself that what he feels is fatigue or something else, but not pain. Although this is an efficient strategy it is not very common among athletes (so, the recommendation would be to use this strategy more often)
  • comparison () – when athletes use this strategy they remind themselves of the others who are in a worse position or of the times when they had been in worse situations themselves.
  • resignation (). Sometimes this strategy is also called “catastrophizing”. The point is that an athlete doesn’t take any constructive actions, because he doesn’t believe he can change anything. Instead he might cry, might feel sorry for himself, or might think only about the pain. Usually these actions are accompanied by the negative thoughts (“this is the end of my athletic career”, “I will never recover”, “rehabilitation is not working”, etc.) and a will to withdraw (“what do I need this for?”, “I wish it all ended soon”). This strategy is considered “nonadaptive”, i.e. it doesn’t help to manage pain, instead it makes things worse (pain seems to increase). However, the good thing is that this strategy is seldom used by the athletes. If an athlete notices he uses this strategy rather often, he should consider its benefits and whether it shouldn’t be changed for the sake of more adaptive pain coping strategies.

Having read the descriptions of these pain coping strategies, you must have found something that fits you. However some of the strategies might seem alien. I would suggest you pay attention at the ways you manage your pain and maybe you will try some new strategies!

This article covers those strategies that athletes use intuitively, however pain can be managed by some specific strategies such as relaxation and visualization (imagery). It is true, however, that these strategies need to be learned and practiced in order to render results. Therefore they might be more useful when the pain is chronic and commonsense strategies are not working.
“Popularity“ of strategies in this article shows the frequency of their use by athletes. This popularity is rather conditional, it reflects the results from a few research. The popularity itself doesn’t show the usefulness or uselessness of a particular strategy. Some strategies (e.g. reinterpretation of pain sensation) are efficient in the management of pain, but they are rarely used by people because of their unfamiliarity.