Thinking About Pain – Part 1

What is pain?

We all know what it is, but yet it’s a hard word to define both precisely and broadly enough to cover all the ways we experience it.

There is good pain and bad pain. There is physical pain and mental pain and emotional pain. There is tiny annoying pain and there is enormous, brain-blowing pain. There is sore pain and aching pain and burning pain and tearing pain and pain like spikes being driven in. The is pain you volunteer for and pain imposed upon you. 

Fortunately, we only deal with certain kinds of pain in our athletic activities. Yet, we could still use some help defining what those are.

 

Differentiating Pain

To assist my previous discussions in our athletic context (such as in Pain And Peace, and in Comfort Needs Discomfort) I’ve made some distinctions between a few kinds of pain: 

Plain Pain

There are unpleasant sensations – pain signals – that indicate threat of injury. I tend to use the main word ‘pain’. They declare, “Beware of damage to your body.” The brain is programmed to send these signals in order to get you to hold back from hurting yourself. The brain really needs you to respond and do something about that threat.

Discomfort

Then there are unpleasant sensations – uncomfortable, if not painful signals – that indicate that stressful internal changes are taking place in response to proper, ongoing athletic effort. I tend to call this ‘discomfort’, though that word is a bit soft for the more intense versions of it. They declare, “Beware of longer and more difficult recovery if you keep this up!” The brain is programmed to send these signals in order to keep you far away from depleting your resources, and weaken your defenses (for a while). 

Suffering

Then there is the suffering from pain, which is totally a mental experience. It has to do with one’s perception of and attitude to that pain or discomfort. 

To apply all these to an example, let’s consider someone who is adapted to cool/cold water swimming and goes regularly. When she gets in, there might initially be pain as the body is first shocked and triggered to quickly shift into heat-conservation mode, but then it goes away. There is discomfort of cold water against bare skin, and gradually numbing fingers and feet, and later on in feeling the icy fingers crawl their ways toward the bones, but at least for a period of time, the swimmer would likely describe all this as pleasant, even invigorating. And, there is no suffering because this person actually likes the whole experience and seeks it out regularly. She has a net positive association with all of these sensations. But throw a non-adapted person into the same water and there would be plenty of pain, discomfort and suffering! 

 

Enduring More Pain

I am an advocate for the hypothesis that we can mindfully train for great achievements, to do more difficult things, in such a way that training feels more pleasant than how it would be without such a mindful approach. If mindfulness training can be applied with measurable results to clinically distressed, those with chronic and acute pain, and to those with life-threatening illness  (see MBSR and Jon Kabat Zinn), why not apply it to athletics and the voluntarily induced pain involved with athletic growth? If it can help us get through terrible times imposed upon us in normal life, could it not help us walk (or run, or swim) more peacefully through incredibly challenging athletic efforts that we eagerly volunteered for?

I’ve been taking my mindful approach for swim training onto the road and trails, since ultra-distance running provides even more challenging situations for confronting pain. In running, even when going at an easy pace, even with great fitness on board, after a while all that pounding on the ground makes the body hurt in ways it would never feel in the water.

So I have these questions building up as I venture into longer and longer runs and experience pain in new ways, and occasionally find breakthroughs in delaying it or reducing it. What’s going on in my body? How can I make this feel better using things I can control? How can I improve my attitude to all those things I cannot control?

Currently, I am reading Alex Hutchinson‘s book Endure (and listened to his interview) to gain some insight on endurance, pain, suffering.

[By the way, that is Steve PreFontaine on the cover, running along the famous University Of Oregon track (which is being demolished for a new fancy stadium). He was very fast, but died young and became a running legend.]

The book starts out looking at the ways the body experiences its limits or the way the brain tries to limit what we do with the body, and it describes the debates among scientists. Then it gets into the various parts of the performance system which create limitations, and subsequently provoke the pain which tells us we’re reaching one. The tricky part for science is in measuring and in the sorting out the complex cause and effect relationships. Some of these things can be isolated and measured externally, measured objectively. But the actual conscious experience of pain is subjective and quite personal. How do you accurately compare the pain one person is experiencing to another?

 

Hard To Measure, Hard To Interpret

The stuff going on in your brain is messing with these pain and discomfort signals and your interpretation of them. Your implicit and explicit memories are messing with these. Your personal narrative is messing with these. Your training patterns are messing with these. Meaning, its hard to sort through which is which, and how much buffer there is between the signal and the actual consequence they are warning you about. Sometimes your brain tries to hold you back with false or overly-conservative caution. But sometimes you are so high on the activity or distracted by something external that you don’t feel that internal resistance soon enough.  

To further complicate matters, your perception of extreme effort is not the same thing as pain threshold apparently. Maximum effort does not necessarily track with maximum pain threshold. Pain could be higher while effort is lower, or vice versa. 

Different kinds of pain-inducing activities produces different kinds of pain, using different parts of the brain. Not all pain is equal in how it is generated and in how it is felt.  

And how can we tell if two people doing the same extreme effort – like two marathon runners neck and neck on the last mile to the gold medal, for example – are enduring the same amount of pain? Is the one who wins simply the one who could tolerate more? Or if she felt less, why didn’t she go even harder with that spare tolerance, to leave her competitor farther behind?

The book Endure is a discussion of this puzzle. 

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More thoughts about pain coming in Part 2…

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