Get chronic pain on the run …….

Running hurts ……. and sometimes it hurts a lot. We’ve all experienced the point when the brain convinces the body that it is no longer possible to put one foot in front of the other (Tanaka et al., 2011). The inner voice “Just slow down, no one will mind, forget the personal best!” But personal bests are broken when people push the edges of their ability, disregarding their perceived pain and physiological limits. Running and exercise performance may not only be limited by levels of will power but more importantly by the ability to tolerate pain and discomfort – YOU HAVE TO SUFFER!! In order to resist the urge to give up and slow down when feeling miserable, the limits of pain tolerance most be broken in training. Suffering is something you have to practice if you want to run longer, farther or faster because improvement lies at the blurred margins of pain and agony.  This is as true for the runner attempting to complete their first couch to 5km as it is for those hoping to compete in the Olympics. The internal struggle fought between running and mental will ultimately leads to redemption and liberation through achievement.

In testing the pain tolerance of athletes in 1981, researchers induced ischemic pain (the kind of oxygen-deprivation pain felt when running a race) using a highly pressurized blood pressure cuff around the upper arm. The elite athletes were capable of suffering for longer than the club athletes, who in turn lasted longer than the non-athletes. This showed that the best athletes were willing and able to suffer more and for longer (Scott & Gijsbers, 1981).The ability to tolerate the pain and suffering of hard training isn’t inborn.  The same study in 1981 measured the pain tolerance of the athletes several times over the course of a competitive season. Their pain tolerance was modest early in the season, when the training load and level of competition was low; and it was highest in the peak season during hard training and racing. So an individual’s pain tolerance is clearly trainable to a certain degree, but only through familiarization and adaptation.

pain runSo in fact as much as running hurts from time to time, it can also reduce pain—so much so that exercise may be used as a pain-management option for sufferers of chronic pain.  Chronic pain is an ailment of the central nervous system.  It is defined as “pain without apparent biological value that has persisted beyond normal tissue healing time” It has been described as a pain that persists beyond the point that healing would be expected to be complete (usually taken as 3-6 months). The pain may be continuous or intermittent. Chronic pain can be experienced by those who do not have any evidence of tissue damage or biological reason for pain (International Association for the Study of Pain, 2007).   This ‘unknown cause’ aspect often results in difficulty in reaching a diagnosis. Running brings the body to the cliff edge of pain and sometimes we fall off to swim in pool of hurt. So why could it be used to reduce pain? The answer may lie in the elusive “runners high”.  This neurobiological reward (runners high) is often reported by runners and is thought to result in habitual running – addictive behaviour, in an effort to get the next fix (Raichlen et al., 2012). Endocannabinoids – the brain’s version of cannabis, and opioids such as endorphins – the brain’s version of morphine are the chemicals which are thought to be released during the runners high. These chemicals have powerful pain relieving capabilities. But unfortunately sufferers of chronic pain conditions may neither be fit enough nor encouraged to reach the exercise intensities that lead to this rewarding sensation of the runners high. But they can be guided and helped to build exercise tolerance until they cross the threshold where they become motivated to exercise by endocannabinoids and endorphins and realise that we possibly have to suffer in order to reduce our pain.


Raichlen DA, Foster AD, Gerdeman GL, Seillier A & Giuffrida A. (2012). Wired to run: exercise-induced endocannabinoid signaling in humans and cursorial mammals with implications for the ‘runner’s high’. J Exp Biol 215, 1331-1336.


Scott V & Gijsbers K. (1981). Pain perception in competitive swimmers. Br Med J (Clin Res Ed) 283, 91-93.


Tanaka M, Shigihara Y & Watanabe Y. (2011). Central inhibition regulates motor output during physical fatigue. Brain Research 1412, 37-43.


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I qualified with an Honours degree in Physiotherapy from Trinity College Dublin in 2004. Since graduating I have worked in St. James Hospital Dublin and have worked in all the areas of speciality within the hospital including cardiorespiratory, orthopaedics, rheumatology, care of the elderly, neurology, burns and plastic surgery among others . I have also completed a post graduate certificate in acupuncture in UCD 2009. The Physiotherapy Department in SJH has strong links with Trinity College Dublin (TCD) and I have supervised undergraduate and postgraduate physiotherapy students on practice placements and also delivered lectures on the undergraduate academic programme in TCD. I have a keen interest in all sports and currently plays with Cill Dara RFC 1st team squad, and Milltown GAA. I have previously worked as Physiotherapist to Co. Carlow Senior GAA Team, Milltown GAA, Leinster Junior Rugby Team and Cill Dara RFC. I am an experienced runner and competed in the Dublin City Marathon in 2002. I continue to participate in running events and multisport disciplines such as Gaelforce West, Gaelforce North and the Motivate Challenge. I have a particular interest in strength and conditioning. I utilise this knowledge of resistance training in the treatment of his clients. I am committed to continuous learning and development in order to ensure the optimal level of care is offered to my clients, and with this in mind I am currently undertaking a certification in Strength and Conditioning (CSCS) with the NSCA.

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