Athletes and pain tolerance

Effect of Mindfulness Based Stress Reduction (MBSR) in Increasing Pain Tolerance and Improving the Mental Health of Injured Athletes

Literature indicates that injured athletes face both physical and psychological distress after they have been injured. In this study, a Mindfulness Based Stress Reduction (MBSR) was utilised as an intervention for use during the period of recovery with injured athletes and, to the best of our knowledge, this is the first study using MBSR as an intervention for this purpose. Objective: The aim of this research was to investigate the role of MBSR practise in reducing the perception of pain and decreasing anxiety/stress, as well as increasing pain tolerance and mindfulness. An additional aim was to increase positive mood and decrease negative mood in injured athletes. Methods: The participants comprised of twenty athletes (male = 14; female = 6; age range = 21-36 years) who had severe injuries, preventing their participation in sport for more than 3 months. Prior to their injury, the participants had trained regularly with their University teams and participated in official university championships. Both groups followed their normal physiotherapy treatment, but in addition, the intervention group practised mindfulness meditation for 8 weeks (one 90-min session/week). A Cold Pressor Test (CPT) was used to assess pain tolerance. In contrast, the perception of pain was measured using a Visual Analogue Scale. Other measurements used were the Mindful Attention Awareness Scale (MAAS), Depression Anxiety and Stress Scale (DASS), and Profile of Mood States (POMS). Results: Our results demonstrated an increase in pain tolerance for the intervention group and an increase in mindful awareness for injured athletes. Moreover, our findings observed a promising change in positive mood for both groups. Regarding the Stress/Anxiety scores, our findings showed a notable decrease across sessions; however, no significant changes were observed in other main and interaction effects in both groups. Conclusion: Injured athletes can benefit from using mindfulness as part of the sport rehabilitation process to increase their pain tolerance and awareness. Further research is required to assess whether increasing pain tolerance could help in the therapeutic process.

A longitudinal exploration of pain tolerance and participation in contact sports

BACKGROUND/AIMS

Athletes who choose to engage in contact sports do so with the knowledge that participation will bring pain in the form of contact with others, injury, and from exertion. Whilst athletes who play contact sports have been shown to have higher pain tolerance than those who do not, it is unclear whether this is a result of habituation over time, or as a result of individual differences at the outset. The aim was to compare pain responses over an athletic season in athletes who participated in contact sport and those who disengaged from it.

METHODS

One hundred and two new contact athletes completed measures of cold and ischaemic pain tolerance, perceived pain intensity, pain bothersomeness, pain coping styles and attendance at the start, middle (4 months) and end (8 months) of their season. The athletes were drawn from martial arts, rugby and American football. Cluster analysis placed 47 athletes into a participating category and 55 into a non-participating cluster.

RESULTS

Participating athletes had higher ischaemic pain tolerance at the start (r=0.27, p=0.05), middle (r=0.41, p<0.0001) and end of the season (r=0.57, p<0.0001) compared to non-participating athletes. In addition participating athletes were more tolerant to cold pain at the end of the season (r=0.39, p<0.0001), compared to non-participating athletes. Participating athletes also exhibited higher direct coping, catastrophized less about injury pain and also found contact pain to be less bothersome physically and psychologically compared to non-participating athletes. Participating athletes were more tolerant of ischaemic pain at the end of the season compared to the start (r=0.28, p=0.04). Conversely non-participating athletes became significantly less tolerant to both pain stimuli by the end of the season (cold pressor; r=0.54, p<0.0001; ischaemia; r=0.43, p=0.006). Pain intensity as measured by a visual analogue scale did not change over the season for both groups.

CONCLUSIONS

Those who cease participation in contact sports become less pain tolerant of experimental pain, possibly a result of catastrophizing. The results suggest that athletes who commit to contact sports find pain less bothersome over time, possibly as a result of experience and learning to cope with pain. Athletes who continue to participate in contact sports have a higher pain tolerance, report less bothersomeness and have higher direct coping than those who drop out. In addition, tolerance to ischaemic pain increased over the season for participating athletes.

IMPLICATIONS

Having a low pain tolerance should not prevent athletes from taking part in contact sports, as pain becomes less bothersome in athletes who adhere to such activities. Participating in contact sports may result in maintained cold pain tolerance, increased ischaemic pain tolerance, reduced catastrophizing and better coping skills. Coaches can therefore work with athletes to develop pain coping strategies to aid adherence to contact sports.

Prevalence of Knee Osteoarthritis in 100 Athletically Active Veteran Soccer Players Compared With a Matched Group of 100 Military Personnel

BACKGROUND

Although knee injuries in professional soccer (football) have been extensively studied, the prevalence of knee osteoarthritis (OA) in veteran players is not well documented.

PURPOSE

To investigate the prevalence of knee OA in retired professional soccer players in comparison with a group of athletically active military personnel.

STUDY DESIGN

Cross-sectional study; Level of evidence, 3.

METHODS

A group of 100 veteran Greek soccer players aged 35 to 55 years (mean [±SD] age, 46.90 ± 5.9 years) were examined for knee OA and were administered the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. A matched group of 100 athletically active military personnel served as a comparison group.

RESULTS

The sonographic prevalence of OA was significantly higher in the veteran soccer group (52%) than in the military group (33%) (n = 200; P = .010). This difference remained significant even after excluding participants with a history of knee surgery (44.1% vs 25.3%, respectively) (n = 151; P = .010). Femoral cartilage thickness was similar between the 2 groups (P = .473), while altered knee alignment had no effect on the prevalence of OA (P = .740). With the exception of perceived pain being more prevalent in the military group, there were no other statistically significant differences between the 2 groups in KOOS values.

CONCLUSION

Veteran soccer players had a higher sonographic prevalence of knee OA but better pain scores than a matched group of athletically active military personnel.

The Injury/Illness Performance Project (IIPP): A Novel Epidemiological Approach for Recording the Consequences of Sports Injuries and Illnesses

Background. Describing the frequency, severity, and causes of sports injuries and illnesses reliably is important for quantifying the risk to athletes and providing direction for prevention initiatives. Methods. Time-loss and/or medical-attention definitions have long been used in sports injury/illness epidemiology research, but the limitations to these definitions mean that some events are incorrectly classified or omitted completely, where athletes continue to train and compete at high levels but experience restrictions in their performance. Introducing a graded definition of performance-restriction may provide a solution to this issue. Results. Results from the Great Britain injury/illness performance project (IIPP) are presented using a performance-restriction adaptation of the accepted surveillance consensus methodologies. The IIPP involved 322 Olympic athletes (males: 172; female: 150) from 10 Great Britain Olympic sports between September 2009 and August 2012. Of all injuries (n = 565), 216 were classified as causing time-loss, 346 as causing performance-restriction, and 3 were unclassified. For athlete illnesses (n = 378), the majority (P < 0.01) resulted in time-loss (270) compared with performance-restriction (101) (7 unclassified). Conclusions. Successful implementation of prevention strategies relies on the correct characterisation of injury/illness risk factors. Including a performance-restriction classification could provide a deeper understanding of injuries/illnesses and better informed prevention initiatives.

Play Hurt, Live Hurt: Living with and Managing Osteoarthritis from the Perspective of Ex-professional Footballers

Personal accounts of living with osteoarthritis (OA) are rare and qualitative research has focused mainly on the experiences of women. As yet no studies have focused solely on the experience of men living with OA. The primary focus of this study was the experience of living with OA from the perspective of ex-professional footballers in the UK using semi-structured interviews with interpretative phenomenological analysis. Participants identified the cause of their OA to be associated with aspects of their playing career. Living with OA involved pain, surgery, medication and restricted mobility. Feelings of frustration were often associated with disruption to work, social and leisure activities. Participants' experiences and memories of playing professional football were important in helping them manage the threat of the disease. The findings have provided an insight into the experience of ex-professional footballers as they seek to accommodate to a life of pain, disability and functional impairment.

Hip passive range of motion and frequency of radiographic hip osteoarthritis in former elite handball players

OBJECTIVE

To establish the relation between handball playing, passive hip range of motion (ROM), and the development of radiological hip osteoarthritis (OA) in former elite handball players. Two related issues are addressed: (a) the relation between long term elite handball playing and the incidence of hip OA; (b) the relations between hip ROM, OA, and pain.

METHODS

Data on 20 former elite handball players and 39 control subjects were collected. A questionnaire yielded personal details, loading patterns during physical activity, and previous lower limb joint injury. Bilateral radiographs were analysed to diagnose and classify hip OA. Passive hip ROM was measured bilaterally with a goniometer.

RESULTS

A close relation was found between long term elite handball practice and the incidence of hip OA: 60% of the handball players were diagnosed with OA in at least one of the hip joints compared with 13% of the control subjects. Passive ROM measured in the handball players was significantly lower for hip flexion and medial rotation and higher for abduction, extension, and lateral rotation than the control values. The handball players with OA reported less pain in the hip joints during daily activities than the control subjects with OA.

CONCLUSION

The risk of developing premature hip OA seems high for retired handball players and significantly greater than for the general population. Pain and discomfort represent two difficult diagnostic challenges to the sports physician, as the repetitive nature of movements that are specific to handball can lead to alterations that are rarely seen in the general population.

Cognitive strategy and ability in endurance activities

The purpose of this study was to ascertain whether elite athletes utilize associative strategies and, on the other hand, if nonelite athletes prefer to use dissociative strategies. 60 athletes were interviewed and the Schomer's 1986 method of measurement was used to measure association and dissociation. Analysis showed no significant differences in the total associative and dissociative scores among the three different abilities. However, a significant difference was found concerning the use of dissociative strategy between men and women.