253. Pain Tolerance in Runners

[00:00:00] You're listening to episode 253 of the Marathon Running Podcast. In this episode, we're going to talk about pain tolerance and pain threshold. This is the Marathon Running Podcast by Letty and Ryan from We Got The Runs. Join us in our running community for weekly content that is motivational, educational, and inspirational.

[00:00:27] And let the Marathon Running Podcast take you from the starting line to the finish line and beyond. Hey, runners, and welcome to episode 252. My name is Letty. My name is Ryan. And we are back for another wonderful episode on anything that can help you train better and perform better during your marathon. Ryan, how have you been? I'm doing well. How about you?

[00:00:55] Doing well myself. Just hanging out here, talking to you. So what's the topic for today? So today we are going to talk about another scientific aspect, but also because of it, mental aspect, we're going to talk about pain threshold and pain tolerance.

[00:01:13] And we're talking about all that because once you understand that, that level of understanding will hopefully help you while you are running your marathon, while you are pushing through the hard miles to keep pushing rather than stopping. Yes, these are the interesting ones to me. I love the ones that are scientific based or based on research because I end up learning a lot sometimes.

[00:01:38] Some little things or little tips here and there that you might not think logically make sense to improve performance. So it's kind of fun. I agree with you. And you know how I always say mental, mental shows or mental, mental topics are my favorite when it comes to the podcast. And then I always used to say, oh, my mind is so weak and I want to learn, learn, learn, learn. And I feel like over the last few years, I've learned so much that I don't feel that my mind is that weak anymore.

[00:02:07] Yeah, I think it's always hard to quantify the mental aspect of running or any sports athletics. But when I think this is one that that you can kind of appreciate or understand a little bit better than some others. Typically, you when you start feeling pain or you start feeling that urge to just stop, it comes way before the physical symptoms. I know that sometimes if people pass beyond like their physical abilities, you know, you start vomiting, you start doing other stuff.

[00:02:36] Maybe with running, you pass out or other things. But for most most people, you psychologically kind of get to the point where you stop before you get to the physical points of actually stopping. That being said, though, you can really get yourself into physical harm by pushing too far. So you should obviously not go too far as well either.

[00:03:01] If you're one of the people that stops really early and you could maybe push it further, it might be good for you. But if you're one of the people that just pushes through and passes out or, you know, gets to the physical aspects of it too fast, then you got to be careful. Yes. And that's our legal slash medical disclaimer from our team here. Do not do that. And if you do that, do not sue us.

[00:03:26] No, just have a good support group or have good coaches or other people that can, you know, help help you understand the cues that your body is giving you and listen to your body. But also know that, you know, you might be able to push beyond a bit. I think it's relative also to to other sports. One of the big ones that I think of is just free diving. Free diving is one that you have to resist the urge to breathe.

[00:03:56] Your body increases like carbon dioxide concentration, which is, I think, from my understanding, the primary cause of, you know, your trigger to want to breathe. And a lot of the free divers learn how to overcome that in order to dive longer. And the human body is actually really good at lasting a lot longer than most people hold their breath. However, you also hear free divers that end up dying.

[00:04:26] And passing out shallow water blackout because they held it too long. But back on topic to running. Yes, back on topic to running. In order to tackle this episode, we asked no one else but Hugo van der Bruck, who has been on a couple of weeks ago. He is an amazing runner that used to run elite for the Netherlands. His PR is a 212 and that was before any of those amazing running shoes existed.

[00:04:54] He now lives in Kenya where he has a Kenyan run camp and coaches runners of all levels. I will link all his information in the show notes because I think he's a very interesting individual. And he's learning with and from the best down there in Kenya. And he is really well versed when it comes to the psychiatry and all the mind stuff of running.

[00:05:18] When he was 22 years old, he had a running psychologist that worked with him and helped him obviously accomplish his goals. And so he knows so much when it comes to that. And he keeps up to date by reading tons of studies. So I felt like he was a wonderful guest for that. So you want to get into it? Sure. So without any further ado, we're now going to play our conversation with Hugo. All right. So I'm back on with Hugo. Hugo, thank you so much for joining me again.

[00:05:50] Thank you for having me, Leti. I'm happy to be there. Yes. And just do a quick reminder because we had you on. I think this is going to air a few weeks, maybe a month after your first podcast with us. So just do a quick reminder of who you are and how you're an expert in the field of coaching runners.

[00:06:35] Sure. I have a guest house here, two guest houses actually, where we accommodate runners from all over the world. And yeah, I'm especially interested in this subject of, you know, mindset and how to become mentally strong and how to basically control your performance. Perfect. Perfect. You summed it up great.

[00:06:58] And I guess with that, we'll hop right into today's topic, which is going to be pain threshold and pain tolerance. Something very interesting. But before we talk about that, maybe tell us what the difference is between pain threshold and pain tolerance. And why does that matter for athletes? Right. Right.

[00:07:17] So, yeah, this is something that, of course, scientists come up with and to kind of distinguish between the first moment you experience something as pain and the amount of pain you're able to tolerate. Right. Right. So, your pain threshold is, so let's say now you have something that kind of increases in pain from number scale of 1 to 100. Maybe from 1 to 15, you wouldn't call it pain.

[00:07:45] You would just say that you feel something. But at some point, you would say, now I experience this as pain. I can handle it. But yeah, it does feel a bit painful. So, that's your pain threshold. And then pain tolerance is the maximum amount of pain you're willing to handle or to persevere. Right. So, that's the difference between the two. Okay.

[00:08:09] And with that, why do you think that active people and athletes generally have a higher pain tolerance than inactive individuals? Well, I think for a couple of reasons. I think, first of all, there's a little bit self-selection there. I think people who have a really low pain threshold are not so likely to choose running as a sport. Right. So, people who choose running, they know like at some point it gets a bit harder.

[00:08:39] And yeah, people with a very low threshold will stop running, I guess. You know, it's not something they really enjoy doing. But I think even more than that, the biggest thing is just that every training session that you do is both a physical workout and a mental workout. Because every time you run, you're actually training your brain that it's okay what you're doing. You're not, you know, in the danger zone. You're not going to die. You're not going to get a heart attack. You'll be okay.

[00:09:09] Right. So, you're able to, because of the training that you do, you teach yourself to handle the pain. Research shows not necessarily that it's because of training, but it does show that runners have a higher pain tolerance. And ultra runners have an even higher pain tolerance than regular runners.

[00:09:28] So, for example, there is some research that has been done with ultra runners and just, you know, active people who were asked to put their hand in a very cold ice bath. And I think the maximum amount, the maximum length of time they were supposed to keep their hand in the ice bath was two minutes.

[00:09:49] But the scientists just told them, just put your hand in the ice water and tell us every 20 seconds how painful it is. And when it's too painful for you, you remove your hand. Right. And they had to score the pain on, I think it was a scale of one to 10. So, from the regular people, most people were not able to hold their hands in the water for more than two minutes.

[00:10:17] They all pulled out their hand before that and said, now I've reached the maximum amount of pain, like a score of 10. Whereas the ultra runners, without exception, were able to hold their hand in the water for the full two minutes. And when they were then asked how painful it is, they would say it's a score of five or six. Right. So, of course, this is a very objective measurement because it's the same for everyone in a physical way.

[00:10:44] But it's interesting that in a mental way, those ultra runners, they probably compare that with the pain that they have in a race, which is so much higher than putting your hand in ice water. So, yeah, they would say this is an average pain and they could probably still continue for many, many more minutes holding their hand inside. Wow, that's crazy. Let me take a step back and go back to pain threshold just to clarify that further.

[00:11:09] Which one of the two or both do you think is static? Is it possible to change pain threshold as well? There's not so much research done in that area. Yeah, pain tolerance is the main one that you want to change. Pain threshold, probably you can change it a little bit, but not that much.

[00:11:33] And I think also the research does show that it's especially pain tolerance where runners excel in a way that they score a lot higher. So, they do experience the pain, but they can just handle it a lot better and they don't rate it as very, very painful. Right? But they would still say, yeah, I can feel that it's pain. Right?

[00:11:58] So, that's the pain threshold between runners and non-runners. There's not a huge difference there. The biggest difference is in pain tolerance. So, they both feel something as painful, but the runners are just able to resist that pain for much longer. And you believe that is due to training, right? Mostly, yes. Like I said, there is a little bit of self-selection there.

[00:12:27] Because people who are naturally able to handle pain are more likely to choose an endurance sport. Because enduring, you know, yeah, that's where the name endurance sport maybe comes from. But it's you're enduring against tiredness, against pain. And so, all endurance sports have that mental component, of course, where you reach a certain point, especially in a race where you're kind of suffering. And that doesn't count, of course, for all training sessions.

[00:12:56] But I think most runners are doing one or two sessions a week that are quite hard. So, if your pain tolerance is really low and your pain threshold also, this is probably something you don't enjoy doing. Right? So, I think there's a little bit of self-selection there. But it's definitely true. I mean, we know from research as well that the training that we do increases our pain tolerance. Perfect.

[00:13:25] And I guess with that, I want to hop into the next question. My next question is, when it comes to the mental and physical connection of this, do you think that higher pain tolerance is more mental, physical or a mix of both? I think it's mostly mental in a way. I mean, there's always, of course, a physical component as well. But I think this is mostly a mental thing.

[00:13:52] And it's how you're able to focus on something else than the pain. One, that has to do with mental tools that we discussed last time. Also, things like self-talk, meditation, relaxation exercises, visualization. Those kind of things help you to focus on what you're actually doing instead of being focused on the pain.

[00:14:20] But secondly, the more you go through that pain, the more you're able to handle it. And I always think that when you're training often, you kind of remove that emotional component of pain. So what I see with people who are new to running, when they start running and it gets hard, they kind of get emotional about it. It's like, oh, they tell me it's so tough, it's so painful.

[00:14:48] And it's like they're getting, of course, negative thoughts in their mind, you know, about, yeah, I want to quit. I can't handle this any longer. And the more runners are used to do hard workouts and to do hard stuff and to go through the pain, the more they're able to kind of remove that emotional component from it. So they feel the pain and they're like, yeah, that's part of the deal. That's what I'm doing. That's my job, you know.

[00:15:16] That's what, okay, even if it's not a job that makes money, but that's what you chose to do. So they go through it, at least to a certain extent. And, yeah, another research that I found quite interesting is with swimmers, where you have three groups of swimmers. The first group is basically amateur swimmers or recreational swimmers. The second group was club level swimmers.

[00:15:43] So they are like serious swimmers, but at a level like maybe they're at the top of their own club. And then the third group was elite swimmers, national level swimmers. So they let them do a test like where they had to. I think they've wrapped a band around their arm and they had to squeeze their hand into a fist and press really hard, which at some point would get quite painful. Right.

[00:16:11] And then they would test like how long they could continue and they would score basically their pain tolerance based on how long they were able to handle this test. And the first thing that was quite interesting was that the better the swimmer, the higher the pain tolerance. And there was a very big difference. Like the club swimmers would score maybe 80. The amateurs would score 40 or 50.

[00:16:40] And the elites would score like 150 or 170. Right. So it was like a much, much higher score. So the elite swimmers, sorry, they scored like almost double of what the club level swimmers would do. Whereas the club level swimmers are also seriously training. They were still training hard. Right. Because they were like the best in their club.

[00:17:02] And then when they asked those swimmers, how would you compare the pain that you felt during the test with the pain during a competition? The club swimmers would say, yeah, the pain that I felt during the test was so painful. It was harder than what I've ever experienced in a race. Whereas the elite level swimmers said it was quite painful. But in races, I feel even higher than this.

[00:17:30] So even though they scored like almost double of the club swimmers, they still said the pain that they would feel in competition is, you know, higher. It's more painful than this test. Right. So that shows you how much more they're able to hurt themselves, basically. And so then the first thing you say is like, okay, so this is also a genetic thing maybe because the club swimmers are training hard.

[00:17:55] The elite swimmers are obviously training a little bit harder, but they're all, you know, going to the pool almost every day and they're doing hard sessions. But then when they compare the elite swimmers throughout the season, they saw that when they were off season, they would score a lot lower, like 80. And then when they were, you know, starting to build up, they would score 110, 120. And then when they were in really hard training and having competitions, they would score like 150, 170.

[00:18:25] So you could see their pain tolerance like fluctuate throughout the year almost as a function of how hard the training was that they were doing. That's quite impressive. And I wonder how much all of this has to do with an elite's mindset and willingness to even go to that place.

[00:18:47] Because I read somewhere or heard somewhere that embracing the pain is something that elites expect as they go there. Oh, yes. Yes, yes, definitely. It's, yeah, it's something that people talk about and they prepare for. Yes, yes, definitely. Yeah, I was an elite runner myself.

[00:19:10] So I, yeah, and you're with elite, you know, Kenyans and Americans and, you know, people that you meet during races. And it's definitely one of the subjects that people say that they prepare themselves mentally for the pain. And, you know, sometimes someone says like, today I feel like I'm ready to die. And it sounds funny, you know, like seriously.

[00:19:35] But what we mean as runners is like you just feel mentally so strong sometimes that you feel like nothing can hurt me. Like I can push through that pain no matter how hard it is. And, yeah, I've had those days myself. I remember when I ran my one of my quickest half marathon times. It was a race in the Netherlands where it was snowy and like there was lots of snow on the roads and was like not perfect conditions at all. But I just woke up the day and I felt like I'm totally ready to die.

[00:20:03] And, yeah, I had, you know, one of the best races of my life. And people talk about that and it's something they prepare for also mentally. Like so another thing that those swimmers were saying also like they were training harder, training harder during, of course, peak season when they were, you know, in the last phase of getting ready for the big competitions, the big swimming competitions. But they were also doing more mental training.

[00:20:28] So like off season, they would just do some training, physical training and that's it. But then as soon as the races started to approach, they started to doing more visualization exercises, more relaxation exercises. The average elite athlete spends around one and a half to two hours a week doing mental training. Right. That's also some other research that shows that when they interviewed about 250 elite athletes from different sports.

[00:20:56] So, and yeah, that's maybe one and a half to two hours on average per week. But that would be more in the weeks approaching competitions. Wow. Yeah. So, so that's crazy. But to go back to what you were saying about this, when you were an elite runner and you would feel the pain, did you obviously feel the pain? But were you also happy that you were in that pain cave?

[00:21:22] Did you feel like, okay, now I know I'm there or because for us average runners, when we get to that painful place, it's almost like fear, right? Because you're like, oh, I don't know if I can handle this. I don't know if I can tolerate this for long enough. Maybe I should just back up so I can even just finish the race. I don't want to die out there. So tell me what was going on in your mind. Yeah. And I totally understand amateur runners as well.

[00:21:51] I'm an amateur runner myself now, right? And I've been doing mostly easy runs for the last maybe one and a half year because I had, as soon as I started training harder, I got a calf issue. But, yeah, I've been doing consistent strength training since September and that helped me to start doing workouts again. So I think from between December, half of December and now, let's say in the last two months, I've been doing four or five hard workouts. Not that much, but still.

[00:22:20] And I feel exactly what amateur runners feel, you know, because I do my first workout and it gets hard. And I'm like, oh, man, this is tough. I didn't feel this for one and a half year, right? And actually, today, just this morning, I went out with a group of six Kenyans, four ladies and two male pacers. And I, we went on, what was it, a 12K? So it's about eight mile tempo run. And about halfway, I was actually thinking, I don't know if I can finish this. It was hot.

[00:22:50] It was like 11 o'clock and the sun was burning on my face. And I was like, maybe I should back it off a bit because it's getting really tough. And then immediately something clicked in my mind. I was like, no, this is because I'm not used to the pain, right? So, like, I've not been doing hard workouts for one and a half years. Now I've reached the point that it's getting hard for me, but it shouldn't be hard. But it's hard because it's hard in my mind, right? So I was just determined to let that session help me get mentally stronger.

[00:23:18] And it will only help me that much if I don't back off and kind of give in to that feeling, right? So I was like, just focus on the workout. And it's a little bit true what you said that you're kind of happy to be in that pain cave. But it's slightly different because you actually try to not to focus on the pain. You try to focus on, you know, your breathing or just stay behind this person.

[00:23:44] Focus on, you know, pushing hard. Let your legs hit the ground. Or you can have some thoughts that can, how do you say, distract you from the pain, right? So some people like to listen to music because it distracts them. Typically, elite runners don't do that. Mostly elite runners are what you call on task.

[00:24:09] So instead of going off task, which is like, so there's two ways of kind of getting rid of that pain, right? So one way is being off task is like, listen to a podcast or, you know, listen to music, something that distracts you. Typically, what elite runners do, they are on task. So they focus so much on just their job, basically what they're doing on that moment.

[00:24:32] So they try as much as they can to focus their attention on the now, right here, right now, and not listen to that pain, right? So, yeah. So that's what I did today also. And in the end, it worked. And I finished with like my fastest kilometer that I've run in the last two years. So I was like, okay, that was kind of a small victory over myself. And I know that this experience and pushing through this pain helps me so that the next session I do, it won't feel that painful, right?

[00:25:00] So, yeah, it's rather than being really happy or in that pain cave, you try to be there in that pain cave as long as you can, but without focusing on the pain. That's super interesting. And yeah, congrats on your fastest kilometer. I'm sure it's way off your PR, but with what you said with the off task, on task, I find that very interesting. So what, in your opinion, should an amateur runner do?

[00:25:29] Obviously, we run for pleasure and, you know, it is nice to have your hype songs during your marathon. But if we are trying to get faster, do you think it would make more sense to get rid of the headphones and try to be more on task? And then with that, if you do that, you know, the power of music and having the 80 beats per minute or 90 beat per minute that I feel like influences my cadence a lot. What do you have?

[00:26:00] Right, right. So that's a very good question, actually, Leti, because I was of the assumption when I finished my own running career and I started coaching, I was kind of of the assumption that everyone should be on task because this is what I had learned from a sports psychologist. And that's what I do and what I had been doing during my career. And it worked like successfully for me in a way that I always had good races.

[00:26:25] I mean, I wasn't the best runner out there, but I was always able to give so much more in a race than I was in training that it really worked for me. So it was kind of, I made the mistake to assume that everyone should do the same, like everyone should try to be on task during a race. But during my coaching career, I realized that it doesn't work for everyone. And for lots of amateur runners, it actually works better to be off task.

[00:26:54] So off task meaning like for some people, it just works really well to have music to listen to and they have that beat in their head. And even if they don't listen to music, but they just have a song in their head, right? So sometimes you have those songs that are sticking your head and you just, you know, keep playing that song in your own head. So that can also work. Some people, you know, look at the birds and the audience and, you know, think about home or something and that works for them.

[00:27:23] So who am I to say like, no, you shouldn't do that. You have to be on task. I think being on task has huge potential. And if you wanted to be on task, I would say start with positive self-talk. So positive self-talk is slightly different from just talking to yourself during a race or doing a hard workout. It's when you have really prepared yourself to say certain words or phrases.

[00:27:52] So it turns out like 95% of the runners talk to themselves during a race because they've interviewed runners and they ask them, do you talk to yourself? And that's what 95% of the runner says. But for the majority of them, it's not in a controlled way. So and then it doesn't really help you. It only helps you when you do it in a controlled way. So, for example, you might say, OK, at the beginning of the race, I will tell myself this is your day. You can do it. You are strong.

[00:28:21] You know, a few of those kind of words. And that can help you to be on task and to avoid thinking about the pain. Maybe halfway the race, you might tell yourself now it's getting tough, but you are tougher. I'm just making up some words, right? So whatever you say can work. You have to try it out for yourself. And at the end of the race, you might say, get ready for the launch. You know, get ready to accelerate. Or this is the moment of truth.

[00:28:50] Or now it's time to push hard, right? So you have certain words or phrases for two or three or four different parts of the race. And you tell that to yourself. And what that actually, what most runners that do that, what they say is that it kind of chases away the negative thoughts. And it chases away that fear of pain, right? Because you have very experienced runners who feel like, okay, there's not so much I can improve anymore.

[00:29:18] But then they start doing the self-talk and they still have a jump in their performance because of that. It's quite interesting how it can work for people. So, yeah, I think like one of the things is that you can't really have two thoughts in your head, right? So if I, if that's why they always say like, if you jump over, you know, a river or how do you call it? A pond, you know, you shouldn't tell yourself don't fall in the water.

[00:29:45] Because if you, if you tell yourself don't fall inside, what are you thinking about? You think about falling inside, right? So you should never think something negative or something like don't do this because your, your brain doesn't understand. Don't do this, right? Don't think of a pink elephant. Of course you think about the pink elephant. So you, you tell yourself what you do want to think about, right?

[00:30:12] So you can tell yourself, you know, this is your day or you can tell yourself, relax your shoulders. So those are all cues for yourself to what you can focus on. And then those negative thoughts that you might have when the pain comes are much less likely to kind of come in and control you. And if they do come in, you just replace them with one of your phrases. This is great. That's another great tip.

[00:30:40] You know, I feel like every time I talk to you, there is some tips that just come out and then I try to write them down. And I'm really glad. Thank you for sharing that all with me. And hopefully we can have you back on again sometime soon where we talk about mental state and subliminal cues and all that. Because there's so much with this whole mindset. So thank you, Hugo. Yeah, you're welcome. It's also interesting for me to know that I hope you can start to practice with it and the listeners also.

[00:31:09] And I especially want to say don't get demotivated when it doesn't work immediately. Because it's very common that you still have like, you know, negative thoughts like you're running and you feel the pain and you're like, oh my God, it's so hard. I should slow down. Well, you actually feel like you should be able to handle it. Right. So you don't get demotivated. Just continue and just say, okay, there's that negative thought. It's normal to have that coming in.

[00:31:37] Let's try to replace it with something positive. Right. So you just have to kind of also persevere with that. And it's the same for all the other tools. There's no magic in there that you try it once or twice and you run a huge personal best. It's something you have to train. You have to train your brain the same way you train your body. Yeah, yeah.

[00:32:02] And you've inspired me to maybe take the headphones off for just a few runs and just see what goes on in there. So thank you. Yeah, yeah, yeah. That would be good, actually. Yeah. Thank you, Hugo, so much for coming on and telling us everything that we learned today. Again, Ryan, super interesting, right? Yeah, I love those scientific-based podcasts. Yes.

[00:32:30] And I love hearing about the studies, too, because they bring everything so much to life. So I'm really grateful for that. So, again, thank you so much. Everything will be linked in our show notes. And that's it for today. That's all we have. In our next episode, we're going to have a recap of the LA Marathon that took place on March 16, 2025. One of my favorite races. So stay tuned for that. And hopefully we'll also already have a YouTube video recapping all of that.

[00:33:00] Those are your favorite ones. Yes. I love expos and races and all that stuff. And I fell in love with vlogging while in Kenya, as you know, if you watched my videos. I know, Ryan, you are a couple of videos behind still for Kenya. But hopefully you're watching all the other videos on our shoe reviews, etc. I mean, I know you are because you're helping me produce them. Of course. All right. So again, stay tuned for next week's episode. And with that... Have a good week at running.

[00:33:30] Thanks for tuning in. For more information and marathon running news, please head to www.marathonrunningpodcast.com and we'll be back next week.