Instances of athletes playing while in pain have increasingly become common, and provide proof that they experience pain in a different way than non-athletes. However, scientific evidence on athletes' pain perception among athletes remains inconsistent and occasionally contradictory. Researchers from the University of Heidelberg led by Tesarz (2012) carried out a meta-analysis of existing research and established that athletes could tolerate a higher pain level compared to the normally active persons. The other notable finding was that there is no significant difference in the minimum intensity where the stimulus could be perceived as painful. The competitive environment of collegiate sports, genetic variation, regular exercises, cognitive strategies and mental toughness and type of games lead to an increased pain tolerance that allows athletes to endure more pain than people who do not exercise.
Athletes are known to tolerate a higher level of pain. Various studies demonstrate that regular exercises result in increased pain tolerance (Tesarz, 2012). Also, Tesarz (2012) established that athletes perceive pain differently compared to ordinary people considering the aspect of pain threshold. The analysis highlights that there is a significant difference in pain perception among athletes compared to active controls. Research among athletes provides the chance to evaluate the psychological and physical impacts of regular activity on the perception of pain that could enhance the adoption of useful exercise types for relieving pain in patients. Using a meta-analysis study design, Tesarz (2012) examined 15 studies that focused on experimenting athletes through the induction of pain. The significant finding of the study was that athletes could endure more pain compared to ordinary active people. More importantly, players who play games were found to have higher pain tolerance compared to endurance athletes. The study concluded that regular exercise could be the cause of higher pain tolerance and that pain patients could accrue benefits from regular physical activity. In other words, regular activity increases the likelihood of people with chronic pain to become better at managing it.
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Similarly, Anshel and Russell (1994) sought to confirm whether regular exercising was associated with better pain tolerance. To substantiate this, the authors explored the impact of aerobic conditioning as well as strength conditioning on the perception of pain. The researchers randomly divided 48 males that were non-athletes into four diverse groups: aerobic training, strength training, combined training, and a control group that did not train. Apart from the control group, all groups exercised a week thrice for 12 weeks. The researchers tested for appraisal, mood and pain tolerance after six and 12 weeks. Anshell and Russell (1994) established that aerobic training has a positive correlation on pain tolerance of patients whereas participants within the control group and strength training group had similar pain tolerance. The study findings demonstrated that aerobic training could improve one’s pain resistance, whereas demanding exercises, including strength training lack this effect. However, the critical gap in the two studies was that they failed to provide clarification on the exact link between regular exercise and changes in pain perceptions. The studies did not identify the psychological factors as well as the neurobiological processes involved. Despite these gaps, the evidence provided by the studies scientifically support some part of the thesis that athletes could tolerate compared to ordinary people. Gauron and Bowers (1986) sought to examine the techniques used for controlling pain among college-age athletes. The aim was to prove that simple pain control techniques could enable athletes to feel less pain. Measurement of the pain level of 53 athletes from diverse athletic teams was done twice. The first measurement only required athletes to use a 9-point rating scale for estimating their pain. In the second measurement, a pain control cassette was played as the athlete rated their pain. The pain felt by athletes was induced through injuries that had been sustained by athletes during that time. Findings of the study demonstrate that the pain-control cassette influenced athletes to experience less pain. The result highlights that training of athletes could help in the development of higher pain tolerance through regular exercise and learning methods for controlling the pain associated with injuries sustained during sporting activities. There is further need to examine the concept of pain threshold and ascertain whether it is similar to pain tolerance.
Paint tolerance significantly differs from pain threshold. Scientific research demonstrates that athletes and non-athletes have a similar pain threshold. However, the pain tolerance for athletes is higher. Conceptually, pain threshold is the point at which pain is felt while pain tolerance is the maximum level of pain that an individual could withstand before it becomes unbearable for them. Martin and Stager (1981) sought to explore ventilatory endurance or fatigue management in both athletes and non-athletes. The researchers argued that athletes tend to maintain performance for a more extended period under muscle fatigue compared to non-athletes. To confirm this hypothesis, Martin and Stager (1981) examined eight female athletes and eight female non-athletes. Findings of the study suggest that both groups managed their fatigue in the course of the short-term exercises. Contrastingly, during longer-lasting activities, athletes reported having better values for ventilation examination compared to non-athletes. The article provided better insight regarding the capacity of athletes to endure pain and force their body beyond the previous fatigue limits. Besides, it shows the ability of athletes to experience more pain, which is associated with muscle fatigue. Walker (1971) provided a more detailed study on pain and distraction among athletes and non-athletes. The article responds to concerns on whether female athletes have better pain threshold compared to sedentary females. The researchers controlled the pain threshold through electric stimulation of the ulnar nerve. The study findings demonstrate that the pain threshold variable was similar in both groups (Walker, 1971). The similarity is critical since it suggests that a lower pain threshold does not determine the tolerance among athletes since both athletes and non-athletes report feeling the same pain. The conclusion results in the assumption that athletes have a higher tolerance for pain because they have more ability to endure more pain.
Similarly, Ryan and Kovacic (1966) sought to ascertain the relationship between pain tolerance, pain threshold, and athletic activity. To determine this relationship, the researchers measured the pain threshold and tolerance of contact athletes, including hockey players and football players, non-athletes, and non-contact athletes through the inducement of controlled pain. The study established that there was no significant difference between the three groups regarding the pain threshold (Ryan & Kovacic, 1966). Notwithstanding, there was a substantial difference among the groups regarding pain tolerance. Contact athletes' tolerance to pain could be more than that of non-contact athletes whereas non-contact athletes endured more pain than non-athletes. The research provides great insight into the differences between athletes and demonstrates that athletes can tolerate more pain. More importantly, contact athletes had a higher capacity for enduring pain. The implication for the study is that understanding that athletes have similar pain sensibility like non-athletes is crucial, since it demonstrates that they experience the same pain, but have a higher level of tolerance.
Various authors have tried to determine the factors responsible for enabling athletes to tolerate more pain. The major factors that have been examined are exercises and competition. Sternberg et al. (1998) hypothesized that competition changes the perception of stimuli or pain among the male and female athletes. The researchers argue that athletes have the best pain tolerance during competition. To ascertain this claim, they examined pain perceptions of competing athletes before, during, and two days after taking part in a tournament. They used a cold pressure pain test for measuring the pain perception of participants. Findings indicated that competition significantly reduces the pain felt by athletes. However, the pain perceptions among non-athletes did not change. Therefore, the study demonstrates that a competitive environment reduces the pain perception of athletes. The researchers conclude that competition in college athletic environments make athletes to endure more pain. With higher competition, there is higher motivation for athletes to withstand more pain (Hall & Davies, 1991). Also, the researchers contend that higher competition leads to higher pain endurance since the motivation is to defeat the other. To become victorious, they push their body through the pain without focusing much on its extent.
Furthermore, some authors speculate that athletes can endure more pain compared to non-athletes because they have specific cognitive strategies that enable them to experience the pain. Antonini-Philippe, Reynes, and Bruant (2003) sought to determine whether elite athletes use associative strategies and whether non-elite athletes have a preference for using dissociative strategies. The authors argue that association happens when people focus on the act itself whereas disassociation occurs when the athletes think of a positive thing to be distracted. Association and dissociation were determined through interviews the researchers conducted among 60 athletes. The study established that there was no significant difference in the scores, but there was a considerable difference in the deployment of dissociative strategy among men and women. The study findings affirm the hypothesis that specific cognitive strategies are utilized by top athletes to endure pain.
Kress and Statler (2007) sought to determine the nature and impacts of cognitive strategies deployed by former Olympic cyclists for coping with pain during competition. Researchers asked nine participants to describe exertion pain and the way they managed it. The analysis was based on 224 quotes that they collapsed into six major themes. The major conclusions were that the level of pain was mainly perception, the satisfaction of the athlete determined pain, and participants used cognitive skills including imagery, positive self-talk, and goal-setting. The other conclusions were that the body and mind were perceived as dualism during the performance, the pain was deemed as a positive experience that is part of the sport and identity of the individual. Results disclosed that athletes use various cognitive strategies for coping with pain during training and competition. The two studies suggest that athletes tend to use multiple cognitive strategies to endure more pain.
Nicholls et al. (2008) sought to determine the impact of mental toughness on pain endurance among athletes. The authors’ findings support the association or disassociation concepts as coping strategies utilized by athletes in enduring pain. Nicholls et al. (2008) contend that both association and disassociation enhance performance and pain tolerance among athletes through the reduction of physiological stress. Disassociation could increase pain threshold when one is working at a low-moderate level of intensity whereas association tends to be more effective during higher intensities. The researchers also point out that relying on these instinctive strategies could also vary by gender because women are more dissociative compared to men. They also suggest that pain resistance could be learned over time, and higher exercise intensity could result in the release of endorphin. Also, Nicholls et al. (2008) supported the argument by Sternberg et al. (1998) that because athletes are quite motivated, they are determined to endure pain if it will enable them to win a medal, break their records, or prove that they have performed at their optimal levels. More importantly, Nicholls et al. (2008) argued that joining a football league may not make people to immediately endure through pain because the tolerance of pain is determined by an array of factors including the type of sport and genetics. Diatchenko et al. (2004) established that people with a specific gene variant have more likelihood of reporting higher pain levels, whereas contact-sport athletes can grin and endure it more. The researchers identified three major genetic variants of catecholamine O -methyltransferase that they designated as high pain sensitivity, HPS, average pain sensitivity, APS and low pain sensitivity. They also found out that the existence of even one low pain sensitivity haplotype reduced the risk of developing common pain conditions compared to HPS and APS. Consequently, they inferred that genetic variation plays a crucial role in influencing pain sensitivity. The compelling argument by the researchers was that the mind, especially positive thinking, mainly determines pain tolerance. Therefore, genetic variation is one of the factors that could explain why athletes can endure more pain.
Based on literature gathered, it becomes evident that athletes have a higher tolerance for pain compared to non-athletes. Potential gains in terms of medals, the status that comes along with winning, the desire to enhance performance, among others. It was also noted that pain tolerance is gender-based in that women are less likely to tolerate pain compared to men. Such a variation explains why they were found to be more dissociative towards than is the case with men (Nicholls et al., 2008). However, the research also demonstrated that pain tolerance can be learned making it more of a mental activity as opposed to one demonstrating physical endurance. While that is the case, one should not overlook the role that physical fitness plays in promoting endurance towards pain. For instance, in situations where individuals frequently engage in exercise, they are most likely to jog farther compared to those who are not active in such activities. Therefore, pain tolerance could be associated with continued exposure of the body to activities that increase stress on the body. In the context of athletes and non-athletes, one can notice that athletes’ continued exposure to exercise deems them capable of tolerating pain compared to non-athletes.
Conclusion
The first significant finding of the reviewed studies is that regular exercises enable athletes to endure more pain than non-athletes. The second finding is that the competitive environment enhances pain tolerance because it provides athletes with the capacity to ignore pain intensity. In other words, higher competition results in higher motivation for pain endurance. The third finding is that athletes use cognitive strategies, especially associative and dissociative strategies, to have higher pain tolerance. The other outcome related to cognitive strategies is the mental toughness of athletes that allows them to endure pain to achieve their goals and targets. Finally, the literature review has also identified that the type of sport and genetic variation also determine the endurance of pain among athletes. Athletics' genetic variation influences the various levels of pain sensitivity and tolerance. The findings of the reviewed studies support the thesis that the competitive environment, mental toughness and cognitive strategies, type of sport, regular exercises, and genetic variation result in better pain tolerance that enables athletes to go through more pain compared to non-athletes or those who do not exercise. However, athletes may not have all these factors or attributes. Thus there is a need for further research to determine the qualities that have the highest influence on pain tolerance.
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