Pain & Performance

Pain and Performance

How a Chance Encounter Blew My Mind and Transformed My Relationship with Pain and Injury

Have you ever learned something that instantly validated a whole chunk of your experience, making sense of life events that had defied all previous efforts to explain and assuring you that you weren’t crazy after all? That’s what meeting Ryan Whited was like for me.

It happened at Paragon Athletics, a training facility that Ryan and his wife, Betsy, operate in Flagstaff, Arizona. I showed up there on a Friday evening in October 2019 as a participant in a running camp hosted by champion ultrarunner Rob Krar, a client of Ryan’s who’d asked him to deliver a presentation titled “Pain and Performance” for an audience that, in addition to Rob’s campers, included a diverse mix of local athletes and healthcare professionals. I didn’t know anything about Ryan before I walked in the door, but his words and slides blew my mind and subsequently transformed my athletic experience.

I like to say that no runner my age has ever suffered more injuries than I have—an unprovable claim, but probably not far from the truth. It’s not that I’m accident-prone or have a low pain tolerance or take a lot of stupid risks in my training. I just have a propensity for breakdowns, particularly in my joints, that may be genetically rooted—I’ve seen research suggesting that athletes in whose tendons a certain type of collagen is predominant get hurt a lot. Whatever the underlying cause, I’ve suffered more than my fair share of minor injuries in my long career as an endurance athlete as well as three major ones—right knee, left Achilles tendon, right hip—that have kept me out of racing for more than a year apiece. Different in most respects, these three protracted injuries had one thing in common, which is that none of the obvious healing and treatment measures applied to them helped. Everything from rest to manual therapy to surgery didn’t work. What ultimately did work, in each case, was the very thing that seemed to have caused the injury: exercise.

If it had only happened once, I probably would have dismissed the phenomenon as a fluke. If it had happened twice, I might have called it a coincidence. But three times is a pattern, and in fact, I’ve seen the same pattern play out with a number of my lesser injuries as well. Eventually, I decided not to even bother calling my health insurer when some part of my anatomy started to hurt, choosing instead to heal myself by training around and through the issue as my symptoms allowed, and it is a decision I do not regret. By the time I had my mind blown by Ryan Whited at the age of 48, I was losing much less training time to injuries than I had in my 20s.

The specific thing about Ryan’s presentation that blew my mind is encapsulated in a graphic he shared. Adapted from a study published in the online journal PLOS One, it summarizes the latest scientific research on what does and what doesn’t work to treat nontraumatic musculoskeletal injuries, and as you see, it jibes quite well with my personal experience.

When I saw this slide and listened to Ryan explain it, I realized I wasn’t crazy after all, some bug-eyed endorphin junkie who’d convinced himself of the self-serving notion that exercise is the best way to overcome exercise-related pain. Nor was I a freak, the only athlete on earth for whom exercise really was the best way to overcome exercise-related pain. On the contrary, according to Ryan—and to the science on which his beliefs are based—this surprising truth is true for everyone. With obvious passion, Ryan told us he’s on a mission to “demedicalize” the management of athletic pain and to treat injured athletes as athletes, not patients, replacing therapists with coaches and therapy with training.

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Training as Treatment is Ryan’s name for the systematic method he’s developed to treat exercise-related pain and injury through exercise. My fellow campers and I got a taste of it the day after his talk, when we returned to Paragon to sweat our way through a series of unfamiliar yet fun exercises, many of which Ryan himself invented to help athletes train through and around pain.

I returned home to California inspired to put what I’d learned into practice and thereby take my own informal method of self- managing athletic pain to the next level. For starters, I stopped referring to myself as “injury-prone.” During his talk, Ryan had explained the importance of what he called pain self-efficacy, or belief in one’s ability to manage pain and steer the recovery process. By the same logic, I gave up familiar crutches such as nonsteroidal anti-inflammatory drugs (NSAIDs) and muscle taping, putting all my chips on Training as Treatment techniques, including graded exposure and symptom management, to get on track and stay on track with my training.

It so happened that I was dealing with a flare-up of my old hip injury at the time of my encounter with Ryan. By relying on his approach, I was able to return to full training in time for the start of the 2020 racing season, which turned out to be one of the most successful and injury-free years I’ve had. I ran my fastest half-marathon in 11 years, finished 14th overall and 1st in my age group at the Atlanta Marathon, ran my fastest mile since high school, and set a new personal best for 10K at age 49. Honestly, if someone had told me at the beginning of the season that I would accomplish all of this by year’s end, I would have said it wasn’t possible. The fact that I did wasn’t a matter of defying Father Time or achieving miracles, how- ever. I had simply discovered what is possible for any athlete who’s able to stay healthy for an extended period of time.

The year was not without its hiccups. In late July, while attempting to set a marathon personal record (PR) in a small event in San Jose, California, I strained some tendons in my left foot. The silver lining to this setback was that it afforded me the opportunity to experience what it’s like to work one-on-one with Ryan (remotely, via FaceTime). Right away, I was struck by how different Ryan’s approach was from that of the many physical therapists, chiropractors, and other clinicians I’d seen for past injuries. Instead of prescribing a one-size-fits- all rehabilitation program to address the ankle-mobility limitation that had contributed to the injury, Ryan asked me how motivated I was for the process, explaining that he didn’t want to stress me out or set me up for failure by giving me too much. I assured him that with the duathlon national championship looming, I was highly motivated to do whatever it took to return to full training as quickly as possible, and with Ryan’s help, I was able to do so within three weeks. What’s more, those three weeks during which I was not able to train normally were far less anxiety filled than they would have been without the tools I learned from Ryan. I felt more in control of my situation and less burdened by uncertainty.

By this time, Ryan and I were already well along in the process of writing this book, having first discussed the idea of working together a few weeks after I came home from Rob Krar’s camp. We were well matched: Ryan had the message, I had writing experience, and we now shared his conviction that the product of our collaboration would meet an urgent need in the athlete community. As both an athlete and a coach, I know that pain and injury are universal experiences not just in my main sport of running but also in Ryan’s sport of climbing and every other sport you can name. I also know that very few athletes are aware of the Training as Treatment method of musculoskeletal care or the new science of pain it’s based on—heck, it took me several decades and a little dumb luck to find them myself! And now, with this book, you’ve found them, and I’m confident that what you learn in the pages ahead will transform your athletic experience for the better, just as my mind-blowing experience in Ryan’s facility did for me.

Less pain, fewer injuries, less downtime from training, fewer visits to clinicians, less anxiety about pain and injury, less time and money wasted on treatments that don’t work, better performance, and a more fulfilling athletic journey. . . . How does all that sound? I thought so. Let’s make it happen!

[Excerpted from Pain and Performance: The Revolutionary New Way to Use Training as Treatment for Pain and Injury, by Ryan Whited and Matt Fitzgerald]


  1. Nico DECOURT on January 14, 2024 at 2:08 pm

    How can I purchase a copy of the book for my Amazon account in the UK (linked to my Kindle) please?

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