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Why Do We Suffer?

Why Do We Suffer?

This is an excellent article on the ins and outs of why we suffer. Written¬†By Christie Aschwanden from Runners World, it’s definitely worth the read.

Why Do We Suffer? Running can hurt.

This is one runner’s quest to understand the bittersweet symphony. By Christie Aschwanden
The wheels were falling off my cart, and all I could do was watch them roll away. This was my third straight August running the Pikes Peak Ascent, and I’d begun the day confident, ready to put hard-won lessons to work. My first year at Pikes, I’d entered on a whim, overconfident and undertrained, and I’d lumbered to the finish line, 13.3 miles and 7,815 feet above the start, thoroughly spanked. The next year, I’d come prepared to expect a finish time akin to a road marathon. I’d upped my mileage and practiced running above 14,000 feet, but still I’d limped home after aggravating an old Achilles injury. Today I was ready for a charmed third try. I was fit, healthy, and confident of a top-10 finish. Maybe I’d even break three hours if all went well.
I’d begun at a moderate pace as planned, but when I reached No Name Creek, where I’d intended to start pushing, my body refused to follow the script. My quads and hamstrings tightened then seized, my chest constricted, my arms went all noodley, and a paralyzing fatigue overtook me. It was nothing less than slow-motion agony.
My confidence evaporated, and a downward spiral of negative thoughts engulfed me. I was wallowing in dread at the many miles I had left to plod when a spectator pumped her fist at me and shouted, “Looking great! You’re in eighth place!”
In an instant, my world changed. The weight in my legs lifted, my breathing relaxed, and my spirit crawled out of its hole. Suddenly I didn’t just look great to my anonymous fan, I actually felt great, too. So great that I picked up the pace and finished the race sixth overall. My time, 3:08:21, wasn’t quite what I’d hoped for, yet I’d turned a disaster into a solid performance.
But how? As I sat at the finish, watching runners trudge up the final switchbacks like a swarm of ants, I wondered what had happened down there. What exactly was that misery I’d experienced early on? What purpose had it served, and why had the pain evaporated with one tidbit of positive information? Is pain and suffering a psychological phenomenon that can be overcome like a bad mood, or is it a danger signal that can’t be ignored?
To better understand the nature of pain, I started talking to scientists. And the short answer, say these experts, is that the discomfort associated with a hard effort is sort of like the check engine light in your car-serious enough to warrant attention, but more of an early warning than a beacon of death. While you run, your brain gauges the factors that determine the pace you can maintain-your fitness level, the heat, your fuel levels, the course profile then adds physiological feedback it receives to devise a feeling of perceived effort, says exercise physiologist Jonathan Dugas, Ph.D., coauthor of the blog Science of Sport. Researchers call this sensation rating of perceived exertion (RPE). You feel it as fatigue in your legs, tightness in your chest, soreness in your muscles, aching in your feet, and heat on your face.
If you try to push yourself to perform beyond your body’s physiological limits, “your brain will always protect you, and it does that by adjusting your RPE,” says Dugas. “It’s your brain’s way of saying, ‘Hey stupid-you can’t keep this up.'” In my case, I was running a strong race, but it required more physical stress than I’d expected, so my brain stepped in to remind me.
The spectator’s positive cue had changed my interpretation of the discomfort I was feeling, says Alan Utter, Ph.D., M.P.H., an exercise physiologist at Appalachian State University in Boone, North Carolina. “Nothing changed physiologically; it was purely psychological,” he says. The news that I could attain a top-10 finish had altered how I viewed my muscle fatigue and other signals that had been driving my pain perception up to that point. Instead of taking my discomfort as a sign I was exploding, I now saw it as a symptom of success. “Your brain received an external cue, and it sent commands down to your muscles to keep going,” Utter says. “This is why coaches holler on sidelines.”
Just as important, the cheering helped me shut down my negative self-talk, says sports psychologist Stephen Walker, Ph.D., editor of Podium Sports Journal. The knowledge that I was running within my goals had refocused my mind from thoughts like I feel crappy to ones like I’m on target. “How you talk to yourself in that situation can really define your race,” he says. “You need to focus on exactly how you want your body and muscles to feel.”
Experience plays a major role in how we interpret pain, says Utter. The year after my miraculous turnaround at Pikes Peak, I returned again and finished within six seconds of my previous year’s time-and this time it felt easier. My experience illustrates a component of pain perception that Utter calls teleoanticipation. “The pace you set at the beginning of a race and throughout is based on prior experiences,” he says. “Your brain remembers the last marathon that you ran and how you felt and uses that as a benchmark to set your intensity by.”
Teleoanticipation explains why it’s easier to speed up in the final mile of a race than early in a 10-K. “When you only have a mile left, you can usually handle more pain, because you know where your endpoint is,” says Utter. “When that anticipatory response kicks in, you can often pick up the pace.”
Your expectations about pain going into a race come from your training experiences, says Mark Tarnopolsky, M.D., Ph.D., a professor of neuromuscular and mitochondrial disorders at McMaster University Medical Center in Hamilton, Ontario, and an accomplished runner. “You have to train your pain threshold just as you train your lactic threshold,” he says. In fact, the same kinds of intervals that up your lactate threshold also improve your pain tolerance, because they teach your brain what it feels like to approach your limit and keep going, he says. This is both a physical and psychological process-your body adapts to the exercise, while your mind learns to cope with the discomfort and develop confidence that you can handle the pain.
Another way to boost your pain threshold is to join what Michael Atkinson, Ph.D., a runner and sports sociologist at Loughborough University in England, calls a “pain community”-a running club, workout group, or training buddy that pushes you to run harder. A pain community can teach you to handle suffering by guiding you through a set of intense physical rituals, whether they are Tuesday track workouts or a weekly long run, says Atkinson. “One of the biggest things separating runners who can come to enjoy pain and suffering from those that don’t is that they’ve been opened up to the possibility that pain can be a source of pleasure and enjoyment,” says Atkinson. “So often in everyday life, we’re taught that for any kind of physical discomfort or pain-you just run away, you negate it, you try to medicate it, you do everything in your power to avoid any suffering. The more you learn to embrace the process, the better you’ll deal with it over time.”
Andy Jones-Wilkins, a perennial top-10 finisher at the Western States Endurance Run 100-miler, sees his acceptance of pain as a competitive advantage. “The person who knows the suffering is coming, who expects and embraces it, will do better than someone who’s scared of it,” he says.
That may be true, but Utter is convinced that not everyone feels pain the same way. “If you put two different runners on a treadmill at 70 percent of their max, one might say they’re at 6 or 7 on a 10-point perceived exertion scale, and the other might be at a 9.” Fitness levels and training influence how difficult a given effort level feels, but pain tolerance also is an inherent component, says Tarnopolsky. “I see it in the clinic all the time: Some people find the tiniest little thing uncomfortable, and others can tolerate a muscle biopsy with very little anesthetic.” All elite runners have talent, he says, but “when it comes time to separate the top athletes, the differences may be from the neck up.”
“When I am running well, pain is just another feeling, as in: Am I hot or cold? Is it quiet or loud in this room?” says Justin Freeman, a 14:52 5-K runner, former Olympian in cross-country skiing, and coach at the New Hampton School in New Hampshire. “Pain becomes an indicator of whether I have the fitness to continue at a given pace, not something that controls me.”
Many successful runners say their very best performances seem to transcend pain, says Ric Rojas, a former USATF cross-country national champion who is now a private coach in Boulder, Colorado. “It’s a common misconception that peak performance requires you to feel maximum pain and suffering,” Rojas says. “Top athletes will tell you their peak performance hits a sweet spot. They don’t feel pain and suffering as much as the exhilaration of the running experience.” In interviews with runners after an Olympic Marathon, “the words pain and suffering very rarely come up,” Rojas says. “What comes up is I relaxed, I focused, I stayed calm.”
But why seek that pain at all? “It’s an amazing thing for people outside of running to get their heads around: Why would you put yourself through something you know is going to hurt?” says Atkinson. “A lot of runners say, ‘That’s part of the allure.’ Pain is not just a necessary evil; it’s a fundamental part of the process,” he says. “It’s part of the reason you go out there. You want to feel your lungs burn a little, to feel your quadriceps get fatigued. It’s part of feeling that you’re alive out there on a run.”
For many runners, the urge to suffer represents a turning away from society’s obsession with numbing pain or medicating every discomfort. “Many people are coming to running at a point in our cultural history where they’re saying, ‘I’m not satisfied with this anesthetized way of living,'” says Atkinson.
Long-distance races can also serve as rites of passage, says Atkinson. “You go into a race with a sense of self, and in the process of encountering this really uncomfortable pain and suffering, you’re forced to look in the mirror and find out, What defines me? Am I a person who perseveres? Am I able to endure?” he says. “You may emerge at the end as a qualitatively different person, and that’s something you carry over to the rest of your life.”
My first marathon, a high-altitude trail race in 2000 in Breckenridge, Colorado, was such a journey. My selfdoubts arose at the starting line when the race director declared that “the course is probably more like 27 or 27.5 miles,” adding that the stretch to the finish was all downhill, as if that offered some consolation.
After a long, strenuous climb, the race meandered for miles along breathtaking singletrack above treeline, then careened down an endless track of slick, knee-grinding talus that chewed my quads into tartare. But this was lifethere was no way out but the path before me. So I plodded on and when the trail emerged at the road down to town and, presumably, the finish line, a triumphant burst of joy overtook me. Just one short downhill and I was there. Then I looked up. The runners ahead were ascending a ski hill on the other side of the road.
That unanticipated rise between me and the finish was a bunny slope in the winter, but right now it looked like Mount Everest. A kid on a mountain bike passed me, and I briefly considered stealing his ride and coasting down the hill. Yet I hadn’t come this far to quit now, so I put my head down, took a deep breath, and gave myself over to the pain. This was what it felt like to be alive, right there, right then, in that place, and I embraced every sensation. As I ran, I got a painful introduction to parts of my body I had never noticed before-an aching muscle attachment in my hip, a cranky outer knob on my ankle joint, a sore, burning pad on my forefoot. Still, I ran up that damn hill. My first steps felt unbearable, but the next ones a little less so. By halfway up the slope, I realizedI can handle this. As I look back now on those last grueling miles, it’s not the pain that I recall most vividly. Instead, I remember my capacity to endure it.
Where It Hurts
Ten ways a runner can feel the burn-and then deal with it
OUCH: You’re parched, your mouth is full of cotton balls, and your heart races. SCIENCE: Plain and simple: You’ve lost too much fluid. CURE: Drink! Water is best to quench the thirst, but drink what you crave.
Hitting the Red Zone
OUCH: Your muscles burn–and basically everything’s on fire. SCIENCE: Many call this “going anaerobic,” but there’s little evidence that the pain arises from too little oxygen (or too much lactic acid). Rather, your brain recognizes that you’re too close to your physiological limit and forces you to slow down. CURE: Ease up soon-or it’s game over.
Leg Cramps
OUCH: Your muscles are seizing up big time. SCIENCE: Electrical impulses in the muscles have gone haywire, causing rapid contractions. CURE: Stop and stretch. Scientists are unsure of exactly what causes cramps, but it’s not as simple as electrolyte imbalances or dehydration.
Shin Splints
OUCH: Your shins are beyond sore. SCIENCE: Pain is likely due to overtraining, wearing worn shoes, or running on uneven surfaces. CURE: Walk it out. Avoid relapses with stretching and strengthening exercises.
Hitting the Wall
OUCH: You’re out of energy. SCIENCE: You’ve depleted your liver’s supply of glycogen, and it can’t maintain blood glucose. CURE: Begin long runs with full glycogen stores and down carbs when runs top 75 minutes. Aim for 30 to 60 grams per hour.
OUCH: Your brain’s in a fog, and you may feel light-headed and dizzy. SCIENCE: You are hypoglycemic; your liver has run low on glycogen and can’t maintain blood glucose levels. CURE: A steady flow of carbs. Bonus: It will help blunt pain perception, too.
Side stitch
OUCH: A stabbing pain pierces your side. SCIENCE: Theories abound. The most popular: It’s a cramp in your diaphragm muscle. CURE: Focus on breathing with your diaphragm by pushing your stomach in as you exhale and out as you inhale.
OUCH: It feels like a burning wound. SCIENCE: Friction between skin and skin (or skin and clothing) rubs you raw. CURE: Avoid clothing with stitching in chafe-prone areas and apply lube to potential hot spots.
Leg lock
OUCH: Your muscles feel like they’re filled with cement. SCIENCE: You’ve run in the red zone too long and damaged some muscle fibers. Your brain is slowing down your muscles to protect you from permanent damage. CURE: The damage is done–just slow down.
OUCH: Your feet sting and burn. SCIENCE: Friction between your foot and your shoe or sock rubs skin raw. Moisture makes it worse. CURE: Try preventive taping, or lube problem areas and keep feet dry. Wear socks made of moisture-wicking material, or thin, double-layer socks.
Outsmart Pain
How to mentally fight suffering

  1. Believe you can handle the hurt

Like most runners, you probably realize when pain is coming, so plan for how you’ll react. If you know that your legs will burn the last mile, anticipate this feeling and turn it into a cue that the finish is near and you’re on target. Your physiology sets limits on how fast you can go, but self-confidence can nudge your brain into allowing you closer to that limit before it cranks the pain to make you stop, says exercise physiologist Jonathan Dugas.

  1. Try relaxing.

Seriously, If you’re hurting, don’t fight it-relax and listen to what your body is telling you. “Digging deeper will just get you deeper in a hole,” says coach Ric Rojas. Instead, try relaxing muscle groups you’re not using to save energy and run more efficiently, says William Gayton, Ph.D., a sports psychologist at the University of Southern Maine. “Your forehead muscles don’t need to be tense.”

  1. Challenge negative self-talk

Seize your power to reframe your pain. “If you find yourself focusing on how tired you are, you might turn that around and say, ‘So what? Tiredness is normal, it comes in waves, and it’s not going to last forever,'” says Gayton. “The thought my legs are killing me might be countered by telling yourself, That’s a good sign. I must be really working it. Keep it up!”

  1. Divide and conquer

You can tolerate more pain when an endpoint is near, says exercise physiologist Alan Utter. Use this phenomenon to your advantage by breaking a race into manageable chunks, focusing on intermediate landmarks. Tell yourself you just need to tolerate the pain until the top of the next hill instead of focusing on the far-off finish. Train Smarter, Hurt Less
Four ways to prep your body to handle anything

  1. Prep for pain

Before you tackle a tough race, acquaint yourself with the types of pain you might feel. You may be surprised how racing downhill can pound your quads into hamburger if you ease up on descents in normal training. Your brain is more apt to hit the brakes if you encounter an unexpected difficulty than one it has planned for, says Dugas. Training for painful ups and downs (and headwinds and heat waves) will push your body to adapt.

  1. Train at race pace

If you want to run faster, you need to teach your body and brain what that feels like before the race, Dugas says. Whether you’re training for a 5-K or 26.2, running mile repeats at that pace helps your body adapt to the workload and your brain recognize what your pace should feel like. Then, when race day comes, your mind will be more apt to trust your body to keep pace without blowing up.

  1. Push your limits

You probably already know how interval training can improve your performance. This is partly because it raises your pain tolerance, too. Runners who begin interval-training programs lower their running times more quickly than physiological adaptations can take place, implying that there’s something going on in the brain, too, says Dugas. Exactly what happens remains unclear, but repeatedly pushing yourself near your limit may train the brain to activate the muscles in a more optimal manner, Dugas speculates. Another theory holds that intervals give your mind a clearer sense of what your body can tolerate. When you hammer yourself in interval sessions, you teach the brain, “Okay, I can handle this,” says Dugas.

  1. Find an accomplice

There’s nothing like having a buddy breathing down your neck to help you approach your pain threshold. “Training groups can push you and take you to heights that you didn’t think were possible,” says Atkinson. “You learn your body can do some astonishing things.”

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