Mindfulness Training

German-born Canadian spiritual teacher Eckhart Tolle’s The Power of Now has sold more than three million copies. I know this because it says so right on the cover. In the book, Tolle encourages readers to “Realize deeply that the present moment is all you ever have.”

If this advice sounds familiar, it’s because it is. First popularized by the Buddha in the fourth century BCE, the idea that happiness and enlightenment are to be found in the act of letting go of the past and ceasing to yearn for a better future has been a consistent theme in alternative spiritual doctrine in the West since the hippie era. Indeed, The Power of Now is in some respects a rehash of Ram Dass’ 1971 bestseller Be Here Now.

Living in the moment has a lot of merit, not just for spiritual seekers but also for athletes. Mindfulness training, which entails practicing being wholly present in the now, has been shown to alter brain function in ways that enable athletes to recover and perform better. A study conducted by Chinese researchers and published in Neural Plasticity, for example, found that five weeks of mindfulness training improved aspects of executive function in the brain (executive function being the faculty that allows us to override the desire to quit when we’re really suffering in a workout or race) and increased performance in a time-to-exhaustion test compared to controls.

As a coach, I routinely see the harm done by athletes’ failure to be here now—the discouragement an aging runner needlessly causes himself by comparing his current abilities to his lost youthful capacities, the anxiety a triathlete gins up within herself unnecessarily by brooding on how much work she has to do before she’s ready for her race, etc. Here’s the thing, though: Aren’t cows really good at living in the moment? No, seriously! While I recognize the value of mindfulness and I embrace the science showing its benefits for endurance athletes, I often see athletes sabotage themselves by living too much in the moment, forgetting to make use of the uniquely human capacity to consider now in the context of the past and future.


The most troubling manifestation of this phenomenon that I see in my coaching work is something I call workout myopia, where athletes forget the context of today’s workout and consequently inflate its significance, overanalyze it, and draw too many conclusions from it. A properly planned workout is just that—part of a larger plan—and is worth lingering on only to the extent that either A) the athlete’s performance falls below expectations in a way that demands modifications to future steps in the plan or B) something of such significance is learned in the workout that  subsequent training modifications are called for. Relatively few workouts meet these standards for qualifying as worthy of analyzing and drawing conclusions from, but athletes prone to “cow consciousness” linger on many if not most workouts, as I suppose any athlete would if they forgot they had ever done a workout previously and that they had many more workouts already planned for the future.

The consequences of this maladaptive form of living in the moment are many, and include seeing small problems where there are none, perceiving small problems as big ones, worrying when there is no need to worry, and wanting to change things when there is no need to change things. For athletes afflicted with workout myopia, a middling or poor workout is always an unprecedent crisis. If they feel a bit flat, they’re out of shape; if their times are a tad slow, the plan isn’t working; if their tummy is a little off, they need to radically overhaul their diet; if they feel a touch of pain, they’re permanently broken. Yet I’ve also seen athletes behaving myopically in relation to especially good workouts. An athlete experiences one of those rare and wonderful sessions where they feel like an Olympian, only to tear their hair out afterward trying to figure out how they can catch lightning in a bottle and replicate the experience in every future workout. Was it the breakfast I ate? That nap I took? The socks I wore? No, silly, it was the result of your coach methodically balancing hard work and recovery over time in such a way that you’ve gotten incrementally fitter without ever falling behind on recovery, a process that maximizes the likelihood of experiencing workouts like today’s but does not make their occurrence predictable or controllable in the mechanistic way you’re looking for.

As a coach, I sometimes struggle with this type of athlete because it’s almost as if we’re seeing two different realities. Think of the training process as a human form, where the head represents today’s workout and the body represents the temporal context in which it occurs. I look at each workout straight on, seeing mostly body (context) and less head (present moment). Athletes afflicted with workout myopia seem to look at their workouts from above, a vantage that distorts the form so that it appears to be almost all head. Left to their own devices, such athletes train erratically, continuously overcorrecting their training in exaggerated response to workouts interpreted out of context.

What is the solution to workout myopia? I’ve had some success with simply explaining the phenomenon to its sufferers just as I’ve explained it to you here. It’s much easier to fix a problem you’re aware of than a problem whose very existence you’re oblivious to because you’re too busy being here now. You’re welcome.

I’ve been learning a lot about pain lately. My sudden interest in the topic was sparked by the collaborative work I’m doing with Ryan Whited on a book about self-managing athletic pain and injury. The new science of pain is utterly fascinating and completely contrary to prevailing beliefs about the deceptively familiar phenomenon.

I credit my ongoing crash course in pain science for the lack of surprise I experienced in reading a new study on knee pain in runners that may surprise many others. Led by Shahabeddin Bagheri of the University of Nahavand in Iran and published in the Journal of Athletic Training, the study investigated the effects of mindfulness training on “pain severity, knee function, fear of movement, and pain catastrophizing” in female runners dealing with patellofemoral pain.


A few definitions: Mindfulness is an intentional mind state that involves being maximally present in the moment and accepting of one’s thoughts and feelings as they are. Fear of movement (aka kinesiophobia) is just that, but it is also a vastly underappreciated contributor to the pain experience. Fear of movement literally creates pain. Finally, pain catastrophizing is a “tendency to magnify the threat value of a pain stimulus and to feel helpless in the context of pain.” Based on past research demonstrating that the pain experience is every bit as much psychological as it is physical, and that psychological interventions including mindfulness training can be helpful in pain management, this new study sought to determine whether supplementing traditional training modifications with mindfulness training could improve outcomes in athletes dealing with one of the most common running injuries.

The subjects of the experiment were women runners with an average age of 28, all dealing with persistent PFPS. Half of them were assigned to a standard, 18-week exercise treatment program focused on symptom control. The other half completed the same exercise program as well as an eight-week mindfulness intervention that started four weeks earlier and thus overlapped with the exercise program by four weeks. At the beginning, middle, and end of the 18-week exercise program, all 30 subjects rated their pain level at rest, during stepping, and during running, provided information of functional limitations of the knee, and completed questionnaires designed to assess fear of movement, pain catastrophizing, and pain coping strategies.

In a word, the mindfulness intervention worked. At 18 weeks, the subjects who received mindfulness training showed a 15.8 percent greater reduction in pain during running, an 8.2 percent greater improvement in knee function, a 20.8 percent lower fear of movement, and a 40.9 percent lower level of pain catastrophizing compared to the subjects treated with exercise only. Members of the mindfulness-plus-exercise group also demonstrated greater reliance on the coping mechanisms of ignoring pain sensations and distancing from pain.

The funny thing about this “new” way of managing athletic pain is that it isn’t new at all. Rather, it represents how everyone used to deal with pain before it became medicalized in modern society, transformed from a normal part of everyday life, like appetite–mere somatic information that’s useful in choosing appropriate subsequent goal-seeking actions–into a cataclysm to be feared and avoided at all costs. The catastrophizing of pain and the fear of movement that mindfulness helped the subjects of this study overcome are modern creations. When an 18th century rancher developed knee pain, they worked around it and through it quite adeptly without giving it more thought than was strictly necessary and certainly without complaining about it to anyone else. But when a 21st century runner develops knee pain, they freak out and stop cold and run (sorry, walk) to the doctor.

Don’t get me wrong—it’s nice that we have doctors. What studies like Bagheri’s are showing, however, is that we need to start to undo the damage that the medicalization of pain has done to the athlete’s psyche without throwing away the evidence-based diagnostic tools and treatments that help athletes get past the few nontraumatic injuries they aren’t capable of managing outside of the clinical context. Ryan Whited and I are doing our part to push what we both perceive as a coming revolution in the management of athletic pain. While our book is still at least 18 months away from publication, I’m certain I’ll be sharing more of what I learn about the subject here in the interim, so keep an eye out.

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