Pain responses in athletes: the role of contact sports

High contact athletes differ from low or non-contact athletes in their responses to pain. The mechanisms for this have not been widely investigated and most sports-related pain research has not differentiated between the three sources of pain: contact, injury and exertion. This thesis aimed to explore differences between contact and non-contact athletes, in these three sources of pain. The first aim of the thesis was to develop an understanding of the pain experiences of
different athlete groups, examining the proposed mechanisms of learning, attrition and individual differences. The first study addressed this by conducting semi-structured interviews
with high, low/medium and non-contact athletes. Template analysis indicated that high contact athletes viewed pain differently to low/medium or non-contact athletes. High contact athletes described pain as something to be overcome, often celebrated contact pain and were more able to differentiate between potentially harmful and benign injury pain. The second study also addressed aim one, but directly compared high contact athletes to low/medium contact athletes
based on the mechanisms of personality and learning. Learning was explored by measuring direct coping and pain bothersomeness while personality was measured using a short inventory based on the Big Five personality traits. High contact athletes found pain less bothersome, had
higher direct coping than the other athletes and were less agreeable. Study three was a longitudinal exploration of pain responses over a contact sport athletic season, examining the
mechanisms of learning and attrition. Cluster analysis placed athletes into participating or nonparticipating groups. Results showed that participating athletes were more tolerant of ischemic and cold pain at the end of the season (eight months follow-up) compared to those who disengaged from the sport; they also became more tolerant of ischemic pain at eight months follow-up compared to at the start of the season. Participating athletes also had higher direct
coping for contact pain and found pain less bothersome than non-participating athletes. The final study further explored the role of experience in sport by examining novice and
experienced high contact athletes’ and non-contact athletes’ responses to experimental pain. Athletes completed a simple motor task while being exposed to pressure pain. During the pain condition, challenge and threat states were manipulated to examine the role of task instructions. Results indicated that experienced high contact athletes had higher pain tolerance than the other groups, reported pain as less intense and had higher direct coping than the other athletes. Both groups of high contact athletes performed better in pain than non-contact athletes and were able to maintain their performance in pain. They also reported pain to be less bothersome and were challenged when in pain even if they received threat instructions. Taken together the results of this thesis indicate that learning to cope with pain is the most plausible explanation for high contact athletes’ lower pain bothersomeness, higher pain tolerance and performance in pain. It is proposed that experience of pain and having a direct coping style are important determinants of performance in contact sports and should be targeted by coaches.