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How to deal with pain

Consultant Clinical Health Psychologist Dr Anna Mandeville tells us how to cope with pain.

One of the most annoying things an athlete may have to manage during short or long term injury is pain. Acute pain from injury is actually designed to be frightening, acting as a protective mechanism for the body. When we experience pain, it’s never just the sensation, but thoughts and feelings too. If we fall on the track and think a ligament has gone, we’re likely to feel anxious and the pain will feel worse. FMRI scanners show that as well as our sensory cortex lighting up when we are injured, the fear centres of our brain do, too. Using topical analgesics (creams, sprays and gels) can help to manage this.


If an athlete experiences a temporary flare of pain during recovery, and his first thoughts are negative, a spiral is set off where there are negative predictions of the future, and the pain is amplified.

However, if we accept setbacks as an inevitability, we can build resilience. A key way is to train our thinking. Thoughts are not facts. When we can observe and record our thoughts, we can then learn to challenge them. Techniques such as consciously pacing yourself – telling yourself to drop the effort to 20 per cent, say – can help to replace negative thoughts with useful ones.


With acute injury, it’s important to use a variety of approaches to reduce the chances of that pain becoming chronic. Studies show that if acute pain is kept under
control, using appropriate physio and medication, there’s less chance of it becoming chronic. Being stoic and trying to keep medications down isn’t actually for the best.

Many people have been unhelpfully told chronic pain is psychological as no damaged tissues can be seen. It is definitely physical, and pain science tells us the body carries pain signals in various ways. It’s helpful for chronic pain sufferers to know it’s not all in their mind, and there are ways of managing the physical pain.

If you do experience a physical pain, a topical analgesic can be effective. There are a range of options, including pain relief gels such as Deep Relief, which helps with muscular and joint pain, but also has the benefits of bypassing the negative effects on the stomach which oral tablets have. I would also advise seeing a GP if you have any concerns about physical pain.

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Once armed with ways of working with any pain, and you have made good gains with your rehabilitation, getting back into a team may be the next step. Being reconnected with the team climate will help you feel reconnected with people. Reaching manageable goals and getting good feedback is extremely beneficial.


You can continue your rehab work even in your mind by using imagery. Research shows that the brain makes connections associated with better performance when you’re mentally rehearsing your game, and this helps you to improve. Getting very physically relaxed and making a full sensory picture of your perfect game makes a difference.

Our brains are wired into having worry routines as a protective instinct, so using relaxation and visualisation can stimulate the restful parasympathetic nervous system to aid recuperation.


When you’re ready to get back into it, use behavioural approaches to build confidence. Work with your team leader and coach to start with quick wins (short stints on the field to get positive feedback). Getting back in the zone is all it takes for our bodies to take over and do what it does best. It’s our minds that are the meddlesome ones – don’t let your thoughts defeat you.

Illustration: Dale Edwin Murray


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