Pain is a part of life for everyone – and a part of sports for all athletes.

Whether it’s pain due to injury, fatigued muscles, or disability, pain can get in the way of training and competing at the level you know you’re capable of.

Para-athletes are more likely to experience pain more frequently than non-disabled athletes. Disabilities may involve tissue damage, structural differences, muscle tension, differences in coordination leading to more falls, and can affect organ function. Unlike pain due to overtraining, this kind of pain is chronic and athletes may live with it their whole lives. Athletes who are amputees or have limb differences may experience phantom limb pain - when neural pathways fire even though the nerve endings are no longer there.

Another type of pain is “nociplastic” pain – a type of pain that has no basis in tissue damage, but is caused by chronic stress and perfectionism. Essentially the body starts to create pain as a fear response, often using known neural pathways from previous tissue damage. Phantom limb pain is one example of this, but anyone can experience it. This kind of pain is real, can be debilitating and often confusing as more and more doctors find nothing wrong. Perfectionism is highly correlated with nociplastic pain – something many athletes working at an elite level will be familiar with!

Most pain is actually on a continuum between these two types. Ever experienced pain due to a fall which becomes worse in moments of stress? Or dissipates when you’re doing something you love and forget about it for a moment?

Pain – no matter the origin – can get in the way of training consistently, but can also affect sleep quality, confidence, identity, your social life and overall quality of life.

As well as pain being more common in para-athletes, it is also less predictable. Many para-athletes experience a fear of flare ups and of Post-Exertional Malaise (PEM) – extreme fatigue that sets in after doing something that is physically or mentally challenging. This fear makes sense – you don’t want to push yourself in training to a point where you can’t train again for a week! But this fear often leads to avoidance and over-caution, interfering with sustainable training. On the other side of the coin is the athlete who jumps at the opportunity to train when they are pain free, and ends up pushing too hard and putting themselves out of action for a few days.

Disabled people who experience chronic (long-term) or recurrent pain, such as muscle tension or structural differences, may experience a feedback loop between the body and nervous system. A body in long-term pain can become hyper-vigilant, which increases sensitivity over time.

For some disabled athletes, hospital visits are a part of life. While these help long-term, they can actually increase pain in the short-term – being prodded and poked by doctors and nurses, having blood drawn and spending long days going from specialist to specialist. Our bodies can also have a fear response to the situation which can add significantly to pain and fatigue.

All of this paints a picture in which para-athletes are balancing and managing pain, fatigue and cognitive load. “Pushing through” pain without adequate tools can erode trust in the body and in sport environments.

It is in this reality that these athletes are having to train consistently, make performance decisions, balance the rest of their life with their training, and compete or perform on set dates they have no control over.

This creates a unique barrier to performance that requires a unique solution. In my next post, we’ll look at why Cognitive Behavioural Hypnotherapy combined with Somatics and Mindfulness, can be a pain management tool that can help you step away from pain and towards training and performing more consistently.

Ready to see what this could do for you? Book a free first session with me here.