In their new book Ouch: Why Pain Hurts, and Why it Doesn’t Have To sociologist Margee Kerr and writer Linda Rodriguez McRobbie make the case for leaning into pain and claim that if you can remove your fear of it there are potentially transformative realms on the other side.

Running 26 miles on swelling feet, pulling on an oar until your hands bleed, trading punches and kicks in the ring – the kinds of things that we label “sport” could just as easily be called “torture”. And yet, we do it. A lot.

We’re all familiar with the health benefits of regular exercise, but what motivates people to go so far beyond the recommended 20 minutes of cardio three times a week and into a place a little more… painful?

Before we go any further, however, we have to be clear: Pain can be and often is a real signal that something is wrong. Pain is, in part, an evolutionary response to tissue damage or the potential for tissue damage, a highly sophisticated and fast-acting mechanism that keeps us from touching hot stoves and off a sprained ankle. That certain sensory inputs are experienced as pain and that pain is read as aversive, or something we don’t want to do again, is an important part of staying alive and healthy. So though it is sometimes appropriate to “push through the pain”, it’s more important to hear what your body is trying to tell you, especially if that is that you need to stop.

The good news is that confronting pain in exercise can not only help you become better at understanding what your body is saying and what to do about it, but also comes with its own benefits.

Pain can help us feel good

A lot of us are familiar with the “runners’ high”, known clinically as “acute exercise induced analgesia” – that happy, pain-free, even euphoric state that some people report after a serious effort. This feel-good neurochemical cocktail – which isn’t just for runners, of course – is what happens when the discomfort of physical exertion increases circulation of our endogenous opioids and cannabinoids, our built-in painkillers, along with a handful of other neurochemicals that are associated with positive feelings. Working together in varying degrees, these reduce anxiety and pain, while also increasing our sense of feeling good, sometimes even great.

So neurochemically, a little pain can go a long way. But wait, there’s more: Pushing our physical limits is expensive, metabolically speaking, and forces us to reprioritise where our limited resources are going. Studies show that during exercise, activity decreases in areas of the brain associated with executive function – the system responsible for things like planning and organising. This is how exercise can help us “out of our heads” and press mute on our sometimes less-than-helpful inner dialogues. All those cycling ruminations and anxieties – relationships, work, money, groceries, the future – are quieted, leaving us feeling more grounded in our bodies and in the present moment.

How we decide to think about an experience powerfully defines that experience. There are, of course, limits to our ‘believing is experiencing’ – we can’t decide that our arm is not broken and ta-da, it’s not.

It can help us learn to listen to our body

It can be really hard to learn the distinction between momentary discomfort and dangerous pain, especially if our first response to any discomfort is to avoid or suppress. In many areas of our lives, from our willingness to engage with people whose opinions we disagree with to the temperature of our homes, our tolerance for discomfort is diminishing. Sport, however, is the one area where we seem to expect and allow for discomfort, part of the “no pain, no gain” trade off.

That’s useful because we can use sport as an opportunity to learn how to ‘practice’ managing pain. Exercise introduces us to new sensations and requires us to pay more attention to what’s happening in our body, ultimately helping us distinguish between ‘good’ pain (muscles stretching and being used, for example) and dangerous pain (that “pop” you just heard). Being able to tune in to our sensations is a skill, and part of practicing what’s called interoceptive awareness, our ability to accurately assess what’s going on inside ourselves. Cultivating interoceptive awareness is crucial to managing pain in the moment, as well as dealing with ordinary, and extraordinary, stress. When you have a good idea of what your body is saying and why it’s saying it, then you can make better choices about what to do next.

Great! So how do we do it? 

Even with the help of our endogenous painkillers, it’s not easy to push through pain. Cramps happen, muscle ache happens, fatigue, joint pain, all of those things are real and they hurt. But they aren’t always reliable indicators that you should pack it in. We think of this kind of discomfort as ‘the wall’, and when you hit it, it can feel pretty solid. Some of this wall is our own nervous system trying to keep us from potentially hurting ourselves; some of it is reinforced by our perceptions of our own limits. So how do athletes keep running or lifting or cycling or dancing through that wall?

How we decide to think about an experience powerfully defines that experience. There are, of course, limits to our ‘believing is experiencing’ – we can’t decide that our arm is not broken and ta-da, it’s not. But, as many athletes have discovered, we can have far more control in shaping the meaning of sensation than most of us might think. In practice, this means that we can use cognitive tools to push through those moments when pain comes. Studies demonstrate that athletes at all levels reframe their painful sensations as something manageable, describing that ache in their legs as they keep pedalling as just a “vibration”, telling themselves that burning in their arms as they push through the water feels good, that it’s part of the process, or reminding themselves that pain is just perception, that it’s not “real”. Many athletes report talking to themselves, repeating mantras as simple as “you can do it”, setting short-term goals (“Just to that tree. Now that tree. Now that tree.”), or reminding themselves of the bigger reason they’re doing this – what they want, who they want to be. These kinds of techniques recast pain and fatigue as endurable, and, by enduring it, as part of the individual’s success as an athlete.

It’s all about context and control

At the core of these cognitive strategies is what people in the military and endurance athletes call “embracing the suck”. By accepting that painful sensations are often part of the experience, we gain a sense of control over them; maintaining a sense of agency can significantly impact our experience of pain, even just having the choice to keep our eyes open or closed can reduce our perception of pain. Part of this is because retaining a sense of agency through a painful episode can reduce the uncertainty and therefore the fear of pain; one study found that ultra-runners were able to hold their hands in ice-cold water significantly longer than controls, in large part because they were less anxious about the pain. They knew it would end when they wanted it to and when we know we have the choice to stop, we can push a little further and explore the boundaries of pain.

This aspect of pain demonstrates a really important point about it, whether or not something is experienced as aversive pain depends on context. Running through electrified wires, swimming through ice and mud, crawling under a field of barbed wire sounds absolutely awful, but in the context of the Tough Mudder obstacle course race, where promise of pain is part of the pitch, it counts as fun. Extra fun if you’re wearing a tutu. Pain experienced in pursuit of a goal or as part of a bonding exercise, pain that is under our control or associated with accomplishment and reward, that’s good pain.

A little pain is good for us

Pain is, in the right context, an opportunity. It’s a chance to remind yourself that you’re a body in pain now, but that doesn’t mean you will be later (well, at least until the DOMS sets in). It can feel really good to be able to do things that other people can’t or won’t, to do things that you thought you couldn’t. It feels good to meet pain and adversity and know that you’ll survive it. And the more we practise the skill of surprising ourselves with our own resilience, the better we will be at it.

Ouch: Why Pain Hurts, and Why it Doesn’t Have To by Margee Kerr and Linda Rodriguez McRobbie (Bloomsbury Sigma) is published in hardback on the 21st January 2021. Available at Bloomsbury.com and at all good bookshops.