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Back to discussing pain management in powerlifting (the previous article being “No pain, no gain – the dark side of pain in powerlifting or any sport” , I bring two new items for us to chew on: first, the results of a survey I did with competitive powerlifters about their own pain management strategies. Second, scientific evidence that pain is actually our greatest enemy since it inhibits maximum strength effort. Since powerlifting is only about maximum strength effort, then pain is really a problem.

Let’s start with the last item. What the experimental studies suggest is that the amount of muscle pain, as measured by nociceptive activity, is related to motor unit firing and velocity decrease. In other words, pain centrally inhibits muscle contraction (Graven-Nielsen et al. 2002 and Farina et al. 2004). More specifically, pain centrally inhibits maximal voluntary contraction (Graven-Nielsen et al. 2002).

No wonder that unlike bodybuilders, powerlifters are no fans of the “no pain, no gain” philosophy. While lighter, hypertrophy oriented training deals with what is known as delayed onset muscle soreness (DOMS), a moderate and manageable pain, strength athletes manage injury related pain. I always ask my athletes if what they are feeling is “good pain” or “bad pain”. If it is “bad pain”, than stop and let’s figure out what’s going on.

Most of us, competitive athletes, manage “bad pain”. Please take a look at the (hopefully partial) results of the survey bellow:

Pain management in powerlifting

In spite of the small “n” (58 respondents), they are mostly experienced competitive athletes: 48.2% have 6 or more years of competitive experience. Almost 70% of these very experienced lifters manage diagnosed injuries. That means they have already been to the doctor, they have been told they are hurt and, like we all do, obviously ignored the dumb recommendation of stop training or competing and went on with their lifting. Painfully.

These lifters who painfully ignore lifter-refractory physicians’ advice have to handle pain most of the time. More than a half of the respondents (60.3%) manage pain in situations not necessarily related to the workout or competition and a non-negligible 24.1% feel pain every day, many times each day.

We’re talking about tough, mature (69% over 30 years old) guys (86.2% male). How do these typical, almost stereotype powerlifters manage their pain? Unfortunately, in ways that are not the best for their health or sports longevity. Most will take anti-inflammatory drugs (51.7%).

Non-steroid anti-inflammatory drugs not only won’t help healing, but may actually hinder the process, as the literature seems to suggest for fractures and muscle injury (Gerstenfeld et al 2006 and Reynolds et al 1995). But they do help with the discomfort of the soreness. Anecdotal evidence (personal communication from lifters) indicates that AIs were/are taken after particularly heavy workout sessions like a supplement, as a “post-workout” formula.

An important proportion of the respondents (43.1%) takes over-the-counter pain killers, many of which are actually non-steroid anti-inflammatory drugs.

What about the rest? Less than 10% declared taking opiates. That is good news. As discussed in the previous article , opiate pain killers can become a serious problem in sports.

The other good news is that more than 30% of the respondents employ non-pharmacological and potentially not harmful methods of pain management, such as chiropractic/ostheopathic treatment, acupuncture and myofascial release.

The degree to which this survey actually reflects the reality of high performance powerlifters cannot be positively ascertained. However, it is a first indication that pain management is a very real problem for us, that many of us are not dealing with it in the best possible way and that there is room for discussion and education on the subject.

Our community is still insufficiently educated about the non-pharmacological alternatives to pain management and also to injury prevention. It is also true that many of us don’ give a damn – or at least claim not to give a damn – about it: “powerlifting involves injury – live with it”. Isn’t that what we usually say?

However, knowing that that “live with it” injury related pain may prevent us from breaking a record because of the central inhibitory mechanism it triggers, how many of us wouldn’t go out of our way to quench it? Or at least keep it under very good control?

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If you wish to add your answer to the survey, please follow the link:

Pain management in powerlifting

 

Read more:

Inhibition of maximal voluntary contraction force by experimental muscle pain: A centrally mediated mechanism

Effect of Experimental Muscle Pain on Motor Unit Firing Rate and Conduction Velocity

Non-steroidal antiinflammatory drugs fail to enhance healing of acute hamstring injuries treated with physiotherapy

Differential inhibition of fracture healing by non-selective and cyclooxygenase-2 selective non-steroidal anti-inflammatory drugs

Quadriceps inhibition following arthroscopy in patients with anterior knee pain

Pain inhibition of shoulder strength in patients with impingement syndrome.

Effect of Experimental Muscle Pain on Motor Unit Firing Rate and Conduction Velocity