The type of sport matters: Pain perception of endurance athletes versus strength athletes.

BACKGROUND: Studies assessing athletes' pain sensitivity yield inconsistent data, which demonstrate either increased pain threshold and tolerance in athletes than controls or similar thresholds. This inconsistency may result from the variability in the type of sport practiced by the athletes and its effect on pain perception. For example, endurance athletes perform continuous intense exercise for prolonged durations, whereas strength athletes perform short bouts of extreme efforts. Consequently, endurance athletes may tolerate and modulate pain better than strength athletes. This hypothesis was tested by comparing pain perception of endurance athletes with that of strength athletes. METHODS: Subjects were 19 endurance athletes (triathletes), 17 strength athletes (weightlifters and throwers) and 17 non-athlete controls. Quantitative measurements included heat-pain threshold, heat-pain tolerance, cold pressor pain ratings, temporal summation of pain (TSP) and conditioned pain modulation (CPM). Fear of pain and pain catastrophizing were also assessed. RESULTS: The two athlete groups had lower pain ratings than non-athletes. However, strength athletes had higher heat-pain threshold than endurance athletes, whereas endurance athletes had higher heat-pain tolerance and stronger CPM than strength athletes and lower fear of pain levels. Longer training time correlated with TSP in endurance athletes but with CPM and heat-pain tolerance in strength athletes. CONCLUSIONS: Although athletes in general seem less responsive to noxious stimuli than non-athletes, the type of sport differentially affects pain perception; whereas endurance-based sport is associated with improved pain inhibition, strength-based sport is associated with reduced pain sensitivity. These characteristics may be considered when sport is recommended for pain management. SIGNIFICANCE: This study shows that different sport types are associated with different characteristics of pain perception and modulation, as well as of thoughts towards pain.

Gait metric profile of 157 patients suffering from anterior knee pain. A controlled study.

PURPOSE: Gait metric alterations have been previously reported in patients suffering from anterior knee pain (AKP). Characterization of simple and measureable gait parameters in these patients may be valuable for assessing disease severity as well as for follow-up. Previous gait studies in this population have been comprised of relatively small cohorts and the findings of these studies are not uniform. The objective of the present study was to examine spatio-temporal gait parameters in patients with AKP in comparison to symptom-free controls. Furthermore, the study aimed to examine the relationship between self-reported disease severity and the magnitude of gait abnormalities. METHODS: 157 patients with AKP were identified and compared to 31 healthy controls. Patients were evaluated with a spatiotemporal gait analysis via a computerized mat, the Western Ontario and McMaster Osteoarthritis Index (WOMAC) questionnaire and the Short Form (SF)-36 health surveys. RESULTS: AKP patients walked with significantly lower velocity (15.9%) and cadence (5.9%), shorter step length (9.5%), stride length (9.6%), and showed significant differences in all gait cycle phases (P<0.05 for all). Study group reported higher levels of pain (96%), functional limitation (94%), and poorer perception of mental quality of life (30%) (P<0.05 for all). CONCLUSION: Significant differences were found between the spatiotemporal gait profile of AKP patients and symptom-free matched controls. In addition, an association was found between subjective disease severity and gait abnormalities. These findings suggest the usefulness of gait parameters, alongside with the use of self-evaluation questionnaires, in identifying deviations of these patients from healthy population.