How to Master Pain Management During Athletic Training

By: Jamie O. Edwards, MD

Female athlete manages shoulder pain with massage

Pain is important. Nobody wants to experience it, but pain does have a purpose. Pain is the body’s way of communicating a potential problem or injury. Recently BBC News reported on one of only two known people to have a rare genetic mutation that prevents them from feeling pain. In the story, the patient explained why her lack of pain is problematic. “It would be nice to have a warning when something’s wrong—I didn’t know my hip was gone until it was really gone; I physically couldn’t walk with my arthritis.”

When you are an elite athlete, you depend on pain. “An athlete’s ability to tolerate pain is essential to success. Pain provides valuable information about your body and how it is performing. To maximize its usefulness it is important to understand what kind of pain should be listened to and what type is helpful or safe to work through,” writes the Association for Applied Sport Psychology.

While recognizing the purpose of pain, it is equally important to know how to manage it. Athletic trainers are skilled at categorizing types of pain and determining the appropriate course of action. The more athletes understand their pain and what it’s communicating, the better they will be able to manage pain and master their sport.

Not All Pain is the Same

From fatigue to sore muscles to sudden, shooting pain, athletes experience an array of discomfort. It is a common adage that athletes are comfortable being uncomfortable. But when pain is ignored, it can be dangerous. You shouldn’t always tough it out, especially in the instance of an injury. Treat the injury first and foremost. Stay active only under the advisory of your physician. For example, if you injure your shoulder, you might still be able to do leg squats and stretches. Talk to your doctor about alternative strategies to maintain fitness and flexibility as you heal.

A common mistake athletes make is to treat all pain like it’s the same type of pain. By ignoring your body, you’re at risk of causing further damage. It may seem obvious, but an injury is not the same thing as muscle fatigue or pain that is otherwise considered par for the course. This needs to be emphasized because many athletes fear a disruption in their training to such a degree that they frequently push through injury, avoid treatment, and sometimes ignore the recommendation of their physicians. What they don’t realize is that they risk permanent injury and jeopardize or complicate recovery when injuries are compounded by neglect.

There are numerous stories about professional athletes who played through pain and injury, only to damage their careers. One of the most notable stories is of hockey player Pat LaFontaine of the New York Rangers. He played in the NHL for 15 years. After sustaining numerous traumatic brain injuries, the league refused to clear LaFontaine to return to the ice. Despite this, The Rangers ultimately allowed LaFontaine to play through another season, which resulted in yet another concussion. LaFontaine never played hockey again and now copes with the long-term effects of post-concussion syndrome.

LaFontaine would not have been able to reverse the effects of his concussions, but he could have mitigated further consequences had he followed the advice of the league and his doctors.

In lesser cases, especially when pain isn’t caused by trauma, it can be more difficult to know when it’s time to pull back from sports temporarily or permanently. Remember, you’re not in this alone. Your doctor and athletic trainer will help you listen to your body and set a therapy solution specific to your case.

Pain, Sports & Opioids

The pain management toolbox often includes medications such as steroid injections and opioids. Medications mask the pain; they don’t solve the underlying problem causing the pain. In the case of opioids, what once seemed like an easy pain solution, now is the cause of a national crisis of abuse and misuse. Increasingly doctors are hesitant to prescribe opioids no matter the circumstances.

As we learn more about the risks, benefits, and consequences of masking pain with drugs, we also learn about effective alternatives. In a white paper titled Beyond Opioids: How Physical Therapy Can Transform Pain Management to Improve Health, published by the American Physical Therapy Association (APTA), the need for a multidisciplinary approach to pain management is outlined. “The best way to prevent opioid abuse and addiction? Prevent exposure to opioids in the first place when they are not the optimal or appropriate choice for an individual patient,” states the APTA.

As an athlete, you have many options for pain management. MedlinePlus published a list of pain medication alternatives including:

  • Acupuncture
  • Biofeedback
  • Electrical stimulation
  • Massage therapy
  • Meditation
  • Physical therapy
  • Psychotherapy
  • Relaxation therapy
  • Surgery

Each option is different and may not be suited to your individual pain. For example, reported that the US Open of Surfing now has an acupuncturist on staff to help surfers specifically with shoulder, back and hip pain. Acupuncture might not be right for every athlete, but it has been proven effective and can eliminate the need for opioids. If you’re interested in it or any other protocol, talk to your athletic trainer, doctor or physical therapist to make sure the method of pain management is safe and effective for your needs.