Is It Soreness, An Injury, Or Just Hard Work?

By Elizabeth Carey for DyeStat

Training and competing can really hurt. 

In cross country, for example, legs burn, lungs tighten, and stomachs turn when running hard, fast, or long. Athletes feel fleeting sore muscles, cramping sides, achy bones and even waves of nausea. They also commonly get injuries, like stress fractures, which may keep them off starting lines for weeks, if not months. 

The pervading pain of pushing one’s limits is glorified in sports. Maybe you’ve seen the shirts at meets:

No Pain, No Gain.

Pain Is Weakness Leaving The Body.

Our Sport Is Your Sport’s Punishment.

Pain Is Temporary; Pride Is Forever.

But is all pain worth pushing through? What’s the difference between potentially perk-producing pain and damaging pain? Where’s the line between an ache and an injury? 

It depends. 

Pain is a personal experience. It’s simultaneously physical and psychological, rooted in both an athlete’s biology and emotional experience. The nervous system (including nerves, spinal cord and brain) relays pain signals. The pain of injury is relayed by receptors called nociceptors. The brain, in its efforts to protect its human against physical and psychological threats (including death), anticipates harm and tries to keep its human safe. 

The distinct discomfort of exercising and competition comes from stressing body parts — including the cardiovascular, musculoskeletal and even digestive systems — coupled with emotional responses and mental chatter about resulting sensations. That’s not to say “It’s all in your head,” but that it’s messy. 

Research suggests that pain tolerance varies from person to person. It arguably varies from group to group, too. Newer athletes, for example, might squirm at slight discomfort. They’re getting acquainted with the challenging sensations of running and gaining fitness. 

Is an athlete open to the feelings of hard work? Is she overriding her body’s fight or flight response with a growth mindset? Is she flirting with her comfort zone, stepping out into what Melody Fairchild calls the Unknown? Or is she pushing through an acute, sharp sensation because she feels it’s necessary or someone is pressuring her to do so? Context matters. 

Distinguishing between the pain of an injury and that of hard work can be tricky. Ellie Somers, doctor of physical therapy (DPT) and a running and strength coach, recommends athletes check in with themselves about potential injury pain. She asks: Are they OK with the pain? Is it acceptable? Can I finish the task at hand? 

Those questions can help draw a line between a discomfort and an injury, however blurry or sometimes razor-thin. 

As a coach who — disclaimer alert — is definitely not a healthcare professional or expert, I use a few questions to guide athletes with potential injury pain. Is the sensation getting worse while running? Is it sharp or shooting? Is it altering your stride? Is it more than a 4 on a scale of 0 (nothing) to 10 (excruciating)? Has it been bugging you for a few days? If an athlete answers yes to any of those questions, I generally suggest they pause. Whether we opt to rest or alter the day’s workout or week’s schedule, I generally recommend they see a sports medicine expert — such as a PT, athletic trainer, or doc. (Also that they eat and sleep, ASAP!)

Another group of athletes, the recently injured, might be hypervigilant — obsessing over aches and balking at twinges. That’s a natural response, especially if they’re really into their sport and scared to get hurt again. Fear of pain itself may increase pain responses.

“In physical therapy, kids who tend to struggle with pain more have really overprotective parents. It has a strong influence,” Somers said. 

Research shows, though, that athletes have a higher tolerance for suffering. Perhaps that’s due to practice. In coach-speak, that's called callousing. 

“Repeated exposure helps to de-threaten the experience because you know what to expect,” she said. 

But there’s a dark side to the pain = gain mindset. That’s “the myth that you have to destroy yourself to be good,” Somers said. 

Take, for example, runners racing on a bone stress injury or stagger-crawling to the finish line despite obvious distress. Or coaches encouraging athletes to restrict nutrition and over-train, while ignoring or encouraging eating disorders and mental health issues. Self-harm, and harm encouraged by exploitative coaching and toxic culture isn’t helpful for athletes. In fact, that real pain is harmful to health and performance. 

While being a human-athlete involves pain, it certainly need not involve trauma, abuse or sacrificing mental health. 

Being a human-athlete is a physical and emotional experience, with blisters and chafing and joy and triumph. 

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Elizabeth Carey (https://elizabethwcarey.com/) is a writer and running coach based in Seattle, Washington. Her first book, GIRLS RUNNING, co-authored with Melody Fairchild, is available at your local bookstore and here: https://shop.aer.io/GirlsRunning/p/Girls_Running_All_You_Need_to_Strive_Thrive_and_Run_Your_Best/9781948007184-9934.