PAIN

Each athlete’s individual experience of the pain of exertion during training and competition was explored using detailed open- ended, semi-structured interviews, which were recorded and tran- scribed verbatim by the researchers. The transcripts were then interpreted using a Hermeneutic Phenomenological approach to enable the researchers to gain a better insight into the mind of these elite athletes and to understand their ‘lived’ experience exactly as that athlete lived it.

Questions asked included: ■ Tell me the story of the best race you have ever run/cycled (prompts given included, how did it feel, did it hurt, when did it hurt, why do you think it hurt?)

■ Tell me the story of the race that you were the most unhappy with? (same prompts used as above)

■ During training and competition there will be times when you experience pain due to the extreme exertion you are putting your body under, tell me what it feels like to be in so much pain (describe the pain), why do you push yourself in this way?

■ If I were to ask you to put a meaning to the pain, what mean- ing would that be?

■ What type of person do you think you are? Are you shaped by how hard you race and train?

WHAT DID WE FIND? These in-depth interviews produced rich, descriptive and eloquent renderings of the experiences these athletes had. From these tran- scriptions essential themes were sifted out and the essence of the experience ie. ‘that what makes a thing what it is’ was discovered. The interviews also gave an insight into who the athletes were, what made them ‘tick’ and how their sport influenced their ‘being in the world’, the so called ‘ontological’ aspect of themselves.

Unsurprisingly we discovered that physical pain is part of the game with athletes expressing the pain descriptively such as ‘it was agony, ‘my lungs feel like they are going to explode’ and repetitive comments of ‘it’s physical (the pain) in an all over thing’. However, the most surprising comments referred to the deep psychological pain that the athletes experienced from the start to the finish of their performance and on occasions consid- erably longer. Emotions such as apprehension were reported as feeling ‘really nervous’, ‘get really scared’, some of these feelings were heightened by the occasion such as being ‘quite agitated’, ‘fired up’ and on one occasion ‘if anyone came near I would just kick their heads in, I was just so fired up’. A similar comment was made by the multiple Tour de France winning cyclist Lance Armstrong in his book, ‘Its not about the bike. My journey back to life’ (1) he said ‘I would bite somebody’s head off to win a race’. These were all emotions contributing to the athletes’ collective mental state.

Comments during competition about the mental pain took the form of: ‘the mental pain is worse I think, absolutely worse, the physical pain I can tolerate’ and ‘it hurts mainly in my mind’, ‘it is the mental anguish that really gets you’. One specific occasion, which many athletes will relate to, is the mental pain experienced when your body is telling you to slow down and your mind is say- ing, just keep going. One of the athletes described this as the constant feeling of being torn apart, body and mind in turmoil. Mental pain after training or competition usually took the form of

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disappointment for not achieving a goal or failing due to injury. One athlete just felt that ‘I had been let down by my body’ the disappointment at not being able to fulfil a longed for and poten- tially achievable goal due to injury was not only physically but mentally excruciating.

Again unsurprisingly the common theme among the athletes was a spirit of competitiveness. ‘I wanted to win, to do well’, ‘you do push yourself further and further’. The fear of failure prevails all the way through and a concern about letting people down ‘I felt I was representing my country’. It became very evident that rela- tionships were very important to these athletes, the need to impress, and the need to please ‘if you don’t do it you feel you are letting her (girlfriend) down’, and ‘sometimes you do it as much for them as you do for yourself’. These statements applied to significant others, such as partners, coaches or parents. One athlete stated that ‘you are getting a peer reward for self-abuse from taking part in the sport, it is a positive thing’. Another ath- lete said that ‘they enjoyed the pain, without being weird’ and the general feeling was that the more pain these athletes experi- enced, the more they can handle it. It was also felt, that although the pain may be almost intolerable during a race or training, there was always the knowledge that the physical pain would go away once the event or training session ended, ‘the pain is always a crescendo when you cross the finish line, but you know that as soon as you get to the finish that is it’. However, although the physical pain may disappear, there is always the possibility of the mental pain to deal with, depending upon the result.

There was a general feeling that you really needed to be an athlete to understand the experience, that people, the public in general, with no experience of pushing themselves out of their comfort zone, could not understand or imagine what the experi- ence must be like, ‘people who don’t run just don’t understand it’, and ‘you have to do a race and be a sports person to really get it, it is weird’. If and how does this experience affect their lives? Well there was a feeling that the experience shaped them, moulded them into who they are. They found that they could cope with rejection more easily and handle difficult life situations more effectively. The whole ‘pain’ experience became more of a life changing event than initially thought, not just the transitory experience during training or competition, the knock on effect permeated into their lives, both sporting and private. During their experience of pain the athletes did question ‘why am I doing this?’ on a regular basis.

WHY ARE OUR FINDINGS IMPORTANT TO ENDURANCE ATHLETES? If it hurts when you slog up a hill or fail to make a new PB you can take heart from the fact that you are not alone! Physical and emotional pain is part of the game. After all, there would be noth- ing to endure if long distance races were simply a walk in the park. As our subjects clearly reported, part of the sense of achievement comes from knowing it is going to hurt and doing it anyway. While dropping out of a race may stop the physical pain, the emotional pain may far outweigh the short term relief.

However it might be helpful to reflect on the following points: - ■ Pain in endurance sport could be thought of in terms of “performance-related pain” compared with illness or injury-

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