Copy of blog post 9

What If Athletes Treated Pain the Same Way They Treat Fatigue?

Endurance athletes understand fatigue. Why wouldn’t they? Fatigue is the primary limiter of endurance performance. Athletes get better at marathons and triathlons and gravel races and so forth by getting better at resisting and delaying fatigue. Training is therefore focused on building fatigue resistance, which requires regular exposure to fatigue in workouts.

Understanding this, athletes treat fatigue as a normal part of the process, no cause for alarm. Which is not to say they don’t pay attention to it. Fatigue is information, after all, and as such it mustn’t be ignored. When an athlete experiences a high level of fatigue within a workout, they know they’re close to their limit, and should soon call it a day. When they carry a high level of fatigue into consecutive workouts, they know they’re behind on recovery, and should rest. And when their fatigue level is low, they know they’re ready to step up their training.

Pain is another story. Despite the fact that pain is nearly as common to the endurance training experience as fatigue, athletes don’t see it as normal in the same way they see fatigue as normal. Like fatigue, pain conveys information to the athlete, but it does so in the way of an air-raid siren. Pain is seen as bad news—a sign that something’s wrong. In particular, it signals that the athlete is injured or on the brink of injury. And the proper response to injury is to suspend its cause—exercise—and seek medical help.

As the title of this post suggests, I don’t believe that pain is really so different from fatigue. The International Association for the Study of Pain now defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” Kind of vague, right? And that’s the point. Pain is an experience, not a direct signal of tissue damage, with which it has a loose relationship, according to the latest science. As such, it is a lot like fatigue, which is an experience that has a loose association with things like low blood sugar levels.

In the vast majority of situations where athletes experience pain, there is no significant underlying tissue damage and the athlete has done nothing wrong. Which is not to say that pain is random or meaningless. When you feel a strain in your quadriceps during the ninth repetition in a set of ten barbell squats, the pain communicates that those muscles are nearing their functional limit. And when those same muscles scream at you as you descend a hill with a mile to go in a marathon, the pain is your body’s way of telling you that your quads aren’t used to having this level of punishment inflicted upon them and they hope you’ll consider stopping soon. And when you feel a sharp sting that’s localized in your left quadriceps the day after riding a borrowed bike that didn’t fit you properly, the pain indicates that the muscle did indeed incur some damage and that, although the damage doesn’t yet constitute an injury, it might become one if you’re not careful.

If someone told you that you should avoid experiencing fatigue at all costs as an endurance athlete, you would look at them like they were crazy. Yet most endurance athletes harbor a vague notion that they should avoid pain. Which is also crazy. If you train and race correctly, pain is inevitable, just like fatigue. Your goal should be not to avoid pain but to use it as information that helps guide the process of getting fitter and maximizing your performance.

In my one-on-one coaching work, I routinely guide athletes through this very process. A recent example involves Betsy, an athlete of mine who’s in the early stages of training to run across the United States. Things were going well until her left knee started bothering her, first between runs and then during them. I’d previously told Betsy it was only a matter of time before she encountered a speedbump of this sort, and I took the opportunity her sore knee presented to remind her of this, reiterating that pain is a normal part of the process.

“It’s actually a good thing,” I said, “because in working through the pain you emerge more durable, and you need to be durable to run 3,000 miles!” In this case, working through the pain entailed switching to an every-other-day running schedule for one week and making some changes to Betsy’s strength-training routine. These measures worked, and Betsy is now pain-free. Of course, it’s only a matter of time before something else starts hurting, and that’s okay.

I’d be lying if I told you I’ve always known what I’m teaching you here. I learned much of it in collaborating with Ryan Whited, a strength coach specializing in helping athletes with pain and injury, on the book Pain and Performance: The Revolutionary New Way to Use Training As Treatment for Pain and Injury, which was just released. Get your copy today—it will transform your relationship with athletic pain in the best possible way!

Ryan Whited

Matt Fitzgerald and Ryan Whited

1 Comments

  1. Andy on January 15, 2024 at 3:56 am

    OrkHi Matt

    Very thought provoking article! How are you these days? Last time we were in touch, you were still suffering badly from Long Covid.

    Just bought copies of your books 80/20 Running and Rules for Marathon/Half Marathon Nutrition for a colleague at work. Have both of these on my Kindle (plus some others of your books) and still refer to them often!!

    Cheers,

    Andy

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