Jenna Parker competes in the New York City Triathlon in July; she was the first female finisher.
Triathletes can tolerate more pain than the rest of us, a new study confirms, which helps explain why they would swim, then bike, then run, all because they want to and not because they are, perhaps, being chased by a bear.
That’s interesting on its own, but there’s more: Researchers say that understanding how athletes can withstand the pain of a grueling endurance event may eventually lead to potential treatments and therapies for people with chronic pain.
“It’s a very masochistic sport,” said Jenna Parker, who was the top female finisher in the New York City Triathlon in July. She was joking, but only kind of. “I guess to some extent, I always wondered what it is that makes people able to compete at a high level in athletics. Obviously there’s something that’s different that makes us able to push our physical boundaries in a way that other people can’t.”
It was a small study, with just 36 participants: 19 triathletes (10 men and nine women) and 17 non-triathletes (seven men and 10 women). The triathletes each compete in at least two national competitions a year – either Olympic distance or Ironman; the non-triathletes were active, but more casual exercisers – runners, swimmers, Zumba-ers.
In one experiment, the researchers asked teach volunteers to put a hand in cold water, about 53 degrees; they were told to remove it if or when they experienced unbearable pain. In another experiment, they experienced gradually increasing heat applied to a forearm with a computerized gadget, starting from about 95 degrees Fahrenheit. They were asked to press a switch when they first felt pain, and then press a switch when they could no longer tolerate the pain.
The triathletes and non-athletes registered pain at about the same temperatures. But the triathletes were able to withstand the pain for longer. “Triathletes appear to exhibit greater ability and/or motivation to endure pain in the experimental setup, and possibly, also in everyday life,” Dr. Ruth Defrin at Tel Aviv University in Israel and colleagues wrote in their report, published in the journal Pain.
But why? Do tougher people tend to become triathletes? Or does becoming a triathlete make you tougher? Defrin has a few theories. “Since triathletes experience repetitive pain during training and competitions, perhaps the pain inputs that reach the brain constantly trigger the brain stem structures responsible for pain inhibition, which, in turn, produce a more powerful pain modulation and tolerance, but this is yet to be tested,” Defrin said via email. So their brain-and-body chemistry grows accustomed to the pain, which makes it more bearable over time.
Another thought, which this study did test, was the triathletes’ psychological attitudes to pain. In a survey meant to gauge how afraid the volunteers were of pain, the triathletes self-reported less fear. And other studies support that psychological link: Being afraid of the pain before dental surgery, for example, can make it hurt worse.
This is a concept that has become a lifeline for Angela Durazo, who is a 28-year-old full-time triathlete who is a living example of the findings. In 2012, Durazo began chasing her dream of becoming a professional triathlete - she had sponsors, and she was doing well, placing fifth in her first international competition.
Angela Durazo trains for her next race. She says that the pain that comes with her training helped her learn how to cope with her rheumatoid arthritis, and vice versa.
But then she was diagnosed with rheumatoid arthritis, an autoimmune disease that attacks the body’s own tissues that can cause lifelong chronic pain. “It feels like you’re taking a hot knife and scratching against the bone,” Durazo says.
At one point, the pain was so great she couldn’t open a bottle of water by herself. At its worst, she couldn’t get out of bed. But after some intense months of physical therapy, counseling and a change to an anti-inflammatory diet, the pain is manageable and she's competed in seven triathlons this season.
Durazo says that competing in a triathlon helped her learn to distinguish between pain in her physical therapy she could push through, and pain that signaled a potential injury.
“You push through the pain of racing -- which is much different than chronic pain, but it’s pain nonetheless,” Durazo says. “I thought the more I could deal with chronic pain, that the more I could use that as my tool to become a better athlete.
“When I realized that, it made it so much easier to deal with my (rheumatoid arthritis). Like, this is just mental toughness training,” says Durazo.
The obvious disclaimer: Anyone suffering from chronic pain due to any condition should talk to a doctor before taking on a triathlon or other exercise program. But Defrin says that individually tailored exercise programs for chronic pain patients may help them to better cope with their pain. And Durazo is fascinated by the evidence she’s seen in herself.
“When you’re doing a race, you’re neck and neck – it boils down to, who can endure the most pain,” she says. “So the more I can deal with the chronic pain of my disease, the better athlete I’m going to become.”
First published October 15 2013, 5:52 AM