The type of sport matters: Pain perception of endurance athletes versus strength athletes

Background: Studies assessing athletes’ pain sensitivity yield inconsistent data, which demonstrate either increased pain threshold and tolerance in athletes than controls or similar thresholds. This inconsistency may result from the variability in the type of sport practiced by the athletes and its effect on pain perception. For example, endurance athletes perform continuous intense exercise for prolonged durations, whereas strength athletes perform short bouts of extreme efforts. Consequently, endurance athletes may tolerate and modulate pain better than strength athletes. This hypothesis was tested by comparing pain perception of endurance athletes with that of strength athletes. Methods: Subjects were 19 endurance athletes (triathletes), 17 strength athletes (weightlifters and throwers) and 17 non-athlete controls. Quantitative measurements included heat-pain threshold, heat-pain tolerance, cold pressor pain ratings, temporal summation of pain (TSP) and conditioned pain modulation (CPM). Fear of pain and pain catastrophizing were also assessed. Results: The two athlete groups had lower pain ratings than non-athletes. However, strength athletes had higher heat-pain threshold than endurance athletes, whereas endurance athletes had higher heat-pain tolerance and stronger CPM than strength athletes and lower fear of pain levels. Longer training time correlated with TSP in endurance athletes but with CPM and heat-pain tolerance in strength athletes. Conclusions: Although athletes in general seem less responsive to noxious stimuli than non-athletes, the type of sport differentially affects pain perception; whereas endurance-based sport is associated with improved pain inhibition, strength-based sport is associated with reduced pain sensitivity. These characteristics may be considered when sport is recommended for pain management. Significance: This study shows that different sport types are associated with different characteristics of pain perception and modulation, as well as of thoughts towards pain.