Sam thinks about pain, endurance, and performance (Book review in progress)

I’ve been thinking a lot about pain lately as I emerge from the knee pain fog that took over lots of my life this fall/winter. At its worst I just couldn’t think about philosophy, work, relationships, or my kids while walking. That’s the usual stuff that fills my brain but my knee hurt too much to think. I used to think of my walks as productive time.

I enjoyed the freedom to think as I walked and often claimed I thought more clearly when walking. Like my standing desk, but better. Instead with my knee pain, I had to focus on breathing through the pain, paying attention to my gait to not make it worse. I’d count steps not with a tracker but in my head to help me make it to my office. The walk was 1.3 km and often I’d stop along the way and check messages, take photos of horses, and catch my breath and regroup.

See Pondering pain and its absence.

Thank you knee brace!

There is nothing the world could do to accommodate this pain. I’ve wondered about how to think about injuries and disability and my knee. See this post on getting past the usual talk of injuries and healing. It’s not that simple. It’s not just a matter of inclusion/exclusion either. See Andrea Zanin’s post on pain and the what the social model of disability leaves out.

Now I think of myself as someone who is good with pain. And I’ve been thinking about what I mean by that.

I think that of myself I suppose because other people tell me that. That’s part of the story. I gave birth to three kids without pain medication. I’m not claiming I could handle difficult births without drugs but run of the mill uncomplicated easy births didn’t seem to need drugs for me. I hear it too from physiotherapists who make your body move in painful ways as part of the injury recovery process. I do exercises even though they hurt. And once, when a dentist couldn’t get the freezing to work for a root canal, I asked him how long the painful part would take. Not long, he said. Just do it, I replied. And yes it really hurt but I lived to tell and we’re still friends.

I’m also reading a really wonderful book about endurance and I especially enjoyed the chapter on pain. I’ve liked Alex Hutchinson’s work for years. His column Sweat Science is one of my fave things to read and share on the Fit is a Feminist Issue Facebook page. I also follow his work in The Globe and Mail. It’s not particularly feminist but it is evidence based reporting on fitness. That’s rare. His book Endure: Mind, Body and the Curiously Elastic Limits of Human Performance is well worth reading. Chapter Five is about pain and endurance athletes.

Of course, I’m also drawn to the chapter because it’s about cycling, the sport of pain. Cyclists have lots to say about pain. Lance Armstrong, “Pain is temporary. It may last a minute, or an hour, or a day, or a year, but eventually it will subside and something else will take its place. If I quit, however, it lasts forever.” Hutchinson goes for Jens Voigt, of “shut up, legs” fame. Among reasonably equally fit and talented cyclists a bike race is about the willingness to suffer. She who suffers the most wins the race. And the ability to suffer was Voigt’s claim to fame.

Hutchinson details some of Voigt’s successes including his career capping attempt at the record for The Hour. Voigt succeeded but he only held it briefly.

What’s the hour? Says Voigt, “The beauty of it lies in its simplicity. It’s one bike, one rider, one gear. There are no tactics, no teammates, no bonus seconds at the finals. The hour record is just about how much pain you can handle! It’s the hour of truth.” p. 85

What’s so tough about it? Hutchinson explains that for a trained athlete sixty minutes of all out exercise sits in the excruciating gap between lactate threshold and critical power. In other words riders need to find the highest metabolic rate that is also steady state. Done right, writes Hutchinson, the hour is the longest bout of painful high intensity exercise you can endure. p. 97

I haven’t done anything like the hour but I have done various distance time trials in a velodrome with a coach yelling “suffer” at me. If I finished and could walk away with a smile, clearly I hadn’t worked hard and suffered enough! Going fast on a track bike hurts. It’s not about bike fit or about things you can fix. It’s about working your body that hard. There’s definitely pain involved. Rowing was similar.

Hutchinson also reports on various tests of endurance athletes and pain. It’s true that athletes can take more pain than the average person. It’s not that they perceive pain differently. In the tests that Hutchinson reports on both athletes and non athletes report pain starting at about the same point. The tests involve non fun things like holding your hand in ice water or having a blood pressure cuff squeezed well past the point of comfort. But notably, for a given test, where the average person says “stop” at point n, the athlete is still going strong at 2n.

The gap between athletes and non athletes is striking. But so too is the gap between athletes in season and off season. It also makes a difference how you get in shape. Athletes who train using high intensity methods, repeated all out sprint drills for instance, develop a high tolerance for withstanding pain than no athletes who train at a moderate pace.

I’m going to his Guelph launch on Wednesday night. See BOOK LAUNCH: Endure! Award-winning journalist Alex Hutchinson launches his book, Endure! on Wed. May 30th at 7pm in the ebar. And I’m going to give him a copy of our book and hope he spreads the word.

Past posts on pain:

Greetings from the Pain Cave

Three great articles on the psychology of pain and of pushing yourself

Are athletes masochists?

Why are painful workouts so much fun? (And other questions about suffering and athletic performance)

Here’s a cycling t-shirt I love but I don’t feel the same way about knee suffering as I do about really hard ride suffering:

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