Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Scandinavian Journal of Pain

Official Journal of the Scandinavian Association for the Study of Pain

Editor-in-Chief: Werner, Mads

CiteScore 2018: 0.85

SCImago Journal Rank (SJR) 2018: 0.494
Source Normalized Impact per Paper (SNIP) 2018: 0.427

See all formats and pricing
More options …
Volume 16, Issue 1


A longitudinal exploration of pain tolerance and participation in contact sports

Claire Thornton
  • Corresponding author
  • Northumbria University, Newcastle upon Tyne, NE1 8ST, UK
  • University of Derby, Kedleston Road, Derby, DE22 1GB, UK
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ David Sheffield / Andrew Baird
Published Online: 2017-07-01 | DOI: https://doi.org/10.1016/j.sjpain.2017.02.007



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.


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.


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 nonparticipating 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.


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.


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.

Keywords: Tolerance; Learning; Adherence; Bothersomeness; Pain


  • [1]

    Hall EG, Davies S. Gender differences in perceived intensity and affect of pain between athletes and non athletes. Percept Mot Skills 1991;73:779–86.CrossrefGoogle Scholar

  • [2]

    Sullivan MJL, Tripp DA, Rogers WM, Stanish W. Catastrophizing and pain perception in sport participants. J Appl Sport Psychol 2000;12:151–67.CrossrefGoogle Scholar

  • [3]

    Tesarz J, Schuster AK, Hartmann M, Gerhardt A, Eich W. Pain perception in athletes compared to normally active controls: a systematic review with meta-analysis. Pain 2012;153:1253–62.Web of SciencePubMedCrossrefGoogle Scholar

  • [4]

    Ryan ED, Foster R. Athletic participation and perceptual augmentation and reduction. J Pers Soc Psychol 1967;6:472–6.PubMedCrossrefGoogle Scholar

  • [5]

    Ryan ED, Kovacic CR. Pain tolerance and athletic participation. Percept Mot Skills 1966;22:383–90.CrossrefGoogle Scholar

  • [6]

    Raudenbush B, Canter RJ, Corley N, Grayhem R, Coon J, Lilley S, Meyer B, Wilson I. Pain threshold and tolerance differences among intercollegiate athletes: Implications of past sports injuries and willingness to compete among sports teams. N Am J Psychol 2012;14:85–91.Google Scholar

  • [7]

    Tesarz J, Gerhardt A, Schommer K, Treede R, Eich W. Alterations in endogenous pain modulation in endurance athletes: an experimental study using quantitative sensory testing and the cold-pressor task. Pain 2013;154:1022–9.CrossrefPubMedWeb of ScienceGoogle Scholar

  • [8]

    Scott V, Gijsbers K. Pain perception in competitive swimmers. BMJ 1981;283:91–3.CrossrefGoogle Scholar

  • [9]

    Tajet-Foxell B, Rose FD. Pain and pain tolerance in professional ballet dancers. Br J Sports Med 1995;29:31–4.CrossrefPubMedGoogle Scholar

  • [10]

    Ord P, Gijsbers K. Pain thresholds and tolerances of competitive rowers and their use of spontaneous self-generated pain coping strategies. Percept Motor Skills 2003;97:1219–22.CrossrefGoogle Scholar

  • [11]

    Rhudy JL. Does endogenous pain inhibition make a better athlete, or does intense athletics improve endogenous pain inhibition? Pain 2013;154: 2241–2.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [12]

    Geva N, Defrin R. Enhanced pain modulation among triathletes: a possible explanation for their exceptional capabilities. Pain 2013;154:2317–23.PubMedCrossrefWeb of ScienceGoogle Scholar

  • [13]

    Crombez G, Eccleston C, Baeyens F, Eelen P. Habituation and the interference of pain with task performance. Pain 1997;70:149–54.CrossrefPubMedGoogle Scholar

  • [14]

    Smith BW, Tooley EM, Montague EQ, Robinson AE, Cosper CJ, Mullins PG. The role of resilience and purpose in life in habituation to heat and cold pain. J Pain 2009;10:493–500.Web of SciencePubMedCrossrefGoogle Scholar

  • [15]

    Dar R, Ariely D, Frenk H. The effect of past injury on pain threshold and tolerance. Pain 1995;60:189–93.PubMedCrossrefGoogle Scholar

  • [16]

    Sheiner E, Sheiner EK, Shoham-Vardi I. The relationship between parity and labor pain. Obstet Gynecol Int J 1998;63:287–8.CrossrefGoogle Scholar

  • [17]

    Saisto T, Kaaja R, Ylikorkala O, Halmesmak E. Reduced pain tolerance during and after pregnancy in women suffering from fear of labor. Pain 2001;93:123–7.CrossrefPubMedGoogle Scholar

  • [18]

    Byerly PN, Worrell T, Gahimer J, Domholdt E. Rehabilitation compliance in an athletic training environment. J Athl Train 1994;29:352–5.Google Scholar

  • [19]

    Buckworth J, Dishman RK, O’Connor PJ, Tomporowski PD. Exercise psychology. Champaign, IL: Human Kinetics; 2013. p. 341–2.Google Scholar

  • [20]

    Bingel U, Schoell E, Herken W, Buchel C, May A. Habituation to painful stimulation involves the antinociceptive system. Pain 2007;131:21–30.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [21]

    Rennefeld C, Wiech K, Schoell ED, Lorenz J, Bingel U. Habituation to pain: further support for a central component. Pain 2009;148:503–8.Web of ScienceGoogle Scholar

  • [22]

    Clark-Carter D. Quantitative psychological research: a student’s handbook. Hove: Psychology Press; 2008.Google Scholar

  • [23]

    Bourgeois AE, Meyers MC, LeUnes AD. The sport inventory for pain: empirical and confirmatory factorial validity. J Sport Behav 2009;32:19–35.Google Scholar

  • [24]

    Meyers MC, Bourgeois AE, Stewart S, LeUnes A. Predicting pain response in athletes: development and assessment of the sports inventory for pain. J Sport Exerc Psychol 1992;14:249–61.CrossrefGoogle Scholar

  • [25]

    Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med 2001;8:1153–7.CrossrefPubMedGoogle Scholar

  • [26]

    Manning EL, Fillingim RB. The influence of athletic status and gender on experimental pain responses. J Pain 2002;3:421–8.PubMedCrossrefGoogle Scholar

  • [27]

    Bae Y, Lee S. Analgesic effects of transcutaneous electrical nerve stimulation and interferential current on experimental ischemic pain models: frequencies of 50 Hz and 100 Hz. J Phys Ther Sci 2014;26:1945–8.PubMedWeb of ScienceCrossrefGoogle Scholar

  • [28]

    Field A. Discovering statistics using SPSS. 3rd ed. London: Sage; 2009.Google Scholar

  • [29]

    Bhalang K, Sigurdsson A, Slade GD, Maixner W. Associations among four modalities of experimental pain in women. J Pain 2005;6:604–11.CrossrefPubMedGoogle Scholar

  • [30]

    Addison T, Kremer J, Bell R. Understanding the psychology of pain in sport. Irish J Psychol 1998;19:486–503.CrossrefGoogle Scholar

  • [31]

    Rainville P, Feine JS, Bushnell C, Duncan GH. A psychophysical comparison of sensory and affective responses to four modalities of experimental pain. Somatosens Mot Res 1992;9:265–77.CrossrefPubMedGoogle Scholar

  • [32]

    Janal MN, Glusman M, Kuhl JP, Clark WC. On the absence of correlation between noxious heat, cold, electrical and ischemic stimulation. Pain 1994;58:403–11.CrossrefPubMedGoogle Scholar

  • [33]

    Jaremko ME, Silbert L, Mann T. The differential ability of athletes and non-athletes to cope with two types of pain: a radical behavioural model. Psychol Rec 1981;31:265–75.CrossrefGoogle Scholar

  • [34]

    Bandura A, O’Leary A, Barr Taylor C, Gauthier J, Gossard D. Perceived self-efficacy and pain control: opioid and nonopioid mechanisms. J Pers Soc Psychol 1987;53:563–71.CrossrefPubMedGoogle Scholar

  • [35]

    Gedney JJ, Logan H. Pain related recall predicts future pain report. Pain 2006;121:69–76.PubMedCrossrefGoogle Scholar

  • [36]

    Lee JE, Watson D, Frey Law LA. Lower order pain-related constructs are more predictive of cold pressor pain ratings than higher-order personality traits. J Pain 2010;7:681–91.Web of ScienceGoogle Scholar

  • [37]

    Taylor J, Taylor S. Pain education and management in the rehabilitation from sports injury. Sport Psychol 1998;12:68–88.CrossrefGoogle Scholar

  • [38]

    Maeoka H, Hiyamizu M, Matsuo A, Morioka S. The influence of repeated pain stimulation on the emotional aspect of pain: a preliminary study in healthy volunteers. J Pain Res 2015;8:431–6.Web of ScienceGoogle Scholar

  • [39]

    Pen LJ, Fisher CA. Athletes and pain tolerance. Sports Med 1994;18:319–29.CrossrefPubMedGoogle Scholar

  • [40]

    DeRoche T, Woodman T, Yannick S, Brewer BW, Le Scanff C. Athletes’ inclination to play through pain: a coping perspective. Anxiety Stress Coping 2011;24:579–87.Web of ScienceCrossrefGoogle Scholar

  • [41]

    Kress JL, Statler T. A naturalistic investigation of former Olympic cyclists’ cognitive strategies for coping with exertion pain during performance. J Sport Behav 2007;30:428–52.Google Scholar

  • [42]

    Johnson MH, Stewart J, Humphries SA, Chamove AS. Marathon runners’ reaction to potassium iontophoretic experimental pain: pain tolerance, pain threshold, coping and self-efficacy. Eur J Pain 2011;16:767–74.Web of SciencePubMedGoogle Scholar

  • [43]

    Driediger M, Hall C, Callow N. Imagery use by injured athletes: a qualitative analysis. J Sports Sci 2006;24:261–71.CrossrefPubMedGoogle Scholar

  • [44]

    Baker SL, Kirsch I. Cognitive mediators of pain perception and tolerance. J Pers Soc Psychol 1991;61:504–10.PubMedCrossrefGoogle Scholar

  • [45]

    Egan S. Acute-pain tolerance among athletes. Can J Sport Sci 1987;12:175–8.Google Scholar

About the article

Northumbria University, Newcastle upon Tyne, NE18ST, UK.

Received: 2016-11-16

Revised: 2017-02-01

Accepted: 2017-02-21

Published Online: 2017-07-01

Published in Print: 2017-07-01

Ethical issues: All participants provided informed consent to participate and the study was approved by the University Research Ethics Committee. The study was not registered.

Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Conflict of interest: There are no conflicts of interest.

Citation Information: Scandinavian Journal of Pain, Volume 16, Issue 1, Pages 36–44, ISSN (Online) 1877-8879, ISSN (Print) 1877-8860, DOI: https://doi.org/10.1016/j.sjpain.2017.02.007.

Export Citation

© 2017 Scandinavian Association for the Study of Pain.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Manuel Castro-Sánchez, Amador J. Lara-Sánchez, Félix Zurita-Ortega, and Ramón Chacón-Cuberos
Sustainability, 2019, Volume 11, Number 16, Page 4256
Kevin Kuppens, Stef Feijen, Nathalie Roussel, Jo Nijs, Patrick Cras, Paul van Wilgen, and Filip Struyf
Physical Therapy in Sport, 2019, Volume 37, Page 150
Claire Thornton, David Sheffield, and Andrew Baird
European Journal of Pain, 2019, Volume 23, Number 5, Page 1020
Tal Assa, Nirit Geva, Yoni Zarkh, and Ruth Defrin
European Journal of Pain, 2018
David J. Spindler, Mark S. Allen, Stewart A. Vella, and Christian Swann
Journal of Sports Sciences, 2018, Page 1

Comments (0)

Please log in or register to comment.
Log in