Are athletes special people?   November 28th, 2016

​Of course they are. We all have witnessed them and their exceptional performances during last summers’ Olympic games, the once-every-four-year alibi for sports fanatics to avoid bodily movement while watching their favourites giving the best of themselves. Michael Phelps won his 23th Olympic gold medal, Almaz Ayana smashed the 10.000m world record by 14 seconds, and Usain Bolt won his third 100m crown in three Olympic Games. Earlier this summer in Paris, the yellow jersey pointed out Chris Froome to be the best cyclist in France for the third time, and footballers showed to be incredible athletes as well as highly skilful ball players. Peak sprints of 32 km/h were clocked during the UEFA EURO 2016 games, and some ran more than 12 km during one match.

So, we agree, we have seen exceptional performances, but that does not answer our question. Are athletes special people? Some show exceptional exercise related physiological parameters. Cyclists and cross country skiers show measures of VO2max rising above 85 ml/kg/min (an average healthy young male typically does not exceed 55 ml/kg/min). Some endurance athletes have a lung capacity of 7 liter and ventilate as much as 200 liter in one minute. The fastest sprinters of the world reach maximal power values of above 2500 watts during their medal races. Absolutely exceptional, but is all this the result of nature and talent, or nurture and hard work?

And what about their pain physiology? Running a marathon hurts.  Throwing the javelin with an injured elbow may hurt, but did not prevent Belgian athlete Nafi Thiam to win Olympic gold. Sometimes an injury makes it physically impossible to proceed. Samir Ait Said will probably confirm this, but his expression (see picture) shows limited pain experience. Or was the picture taken at just the right moment, from just the right perspective?

Evidence indeed rises that athletes are exceptional when it comes to pain physiology and perception. Tesarz et al. concluded in a review in 2012 that regular physical activity is associated with specific alterations in pain perception. Athletes generally possess elevated pain tolerance whereas literature on pain thresholds in athletes is less uniform. It is postulated that pain tolerance is strongly modulated by psychological and psychosocial factors. As athletes are systematically exposed to painful situations inherent to their sports activity, they are ‘trained’ to be efficient pain-copers. Furthermore, several studies using conditioned pain modulation as an indicator of endogenic capabilities of pain inhibition show more efficient pain modulation in athletes (Geva and Defrin 2013; Flood et al. 2016).

So, are athletes special people? We can at least conclude that they show exceptional performances using their almost-superhuman capabilities, including those related to pain perception. Therefore athletes are role models for many ‘less-divine’ humans when it comes to pain and injury management. We acknowledge for example the positive effects of regular exercise and the possibility to train pain-coping skills. But the flip side of this coin shows that patients can get confused while observing their role models. Controversial methods aiming a better recovery, dietary supplements to energize maximally and ‘that-unique-therapist-with-special-capabilities’ are some examples of externally focused behaviour in athletes on their incessant quest for the winning 1%. Thereby they seem to forget about their before mentioned almost-superhuman capabilities, which is probably a reason to lose some of their winning percentages.   

Kevin Kuppens

Kevin is a physiotherapist and researcher with a special focus on shoulder pain and chronicity in athletes and performing artists.

2016  Pain in Motion

References and further reading:

Tesarz J, Schuster AK, Hartmann M, Gerhardt A, Eich W. Pain perception in  athletes compared to normally active controls : A systematic review with meta-analysis. Pain [Internet]. International Association for the Study of Pain; 2012;153(6):1253–62.

Geva N, Defrin R. Enhanced pain modulation among triathletes : A possible explanation for their exceptional capabilities. Pain [Internet]. International Association for the Study of Pain; 2013

Flood A, Waddington G, Thompson K, Cathcart S. Increased conditioned pain modulation in athletes. J Sports Sci [Internet]. Routledge; 2016 Jul 25 [cited 2016 Aug 9];1–7.