How to Deal with Running Pain Like a Pro

My favorite quote about the suffering that runners experience during races (and hard workouts) is from legendary ultrarunner Scott Jurek: “Pain only hurts.” In other words, as intense as it may be, the discomfort we experience when running to our limit does no harm beyond being uncomfortable. Sure, it might feel like you’re dying, but you’re not. Some runners, including the pros (who wouldn’t be pros otherwise), have a higher tolerance for this sort of discomfort than others do. Those who maintain a pain-only-hurts attitude toward their suffering have the highest tolerance for it—and consequently get the most out of the physical fitness they bring to each race.

What does it mean to have a pain-only-hurts attitude? At its core, it’s about not making race discomfort out to be more than it really is. To say that pain only hurts is to accept the pain as a necessary part of the racing experience instead of wishing it away as though it were an indication that something has gone wrong. Former 5,000-meter American record holder Bob Kennedy said it well: “One thing about racing is that it hurts. You better accept that from the beginning or you’re not going anywhere.”

Accepting discomfort does not lessen it, but it does make it more tolerable, hence less of a drag on performance. Research has shown that people who are trained to accept exercise-related discomfort experience lower perceived effort levels and perform better in endurance tests. A 2011 study by scientists at the Catholic University of America, for example, found that high school runners trained in mindfulness techniques (a practice that involves acceptance of internal states and external circumstances) significantly lowered their mile times.

Two good ways to increase your acceptance of race discomfort are bracing and detachment. Bracing entails actively girding your mind for suffering before a race. Tell yourself, This is going to hurt, and be OK with that. Never allow yourself to be unpleasantly surprised by how much you hurt during competition. Detachment entails separating your thoughts and emotions from your perceptions so that the latter don’t control the former. Realize that you don’t have to think negative thoughts and experience unpleasant emotions just because your esophagus is on fire and your legs feel like concrete. Instead of thinking, I hate this at such moments, think, I’ve been here before and gotten through it. This is nothing new.

Psychologists refer to this type of process as metacognition, which can be loosely defined as thinking about your thoughts and feelings. The better you are at observing your own consciousness, the more you can control it. It should come as no surprise to learn that elite runners rely heavily on metacognition when racing. In 2015, sports psychologist Noel Brick of Ulster University teamed up with a pair of colleagues to interview ten elite runners about what went on in their heads during competition. A majority of these athletes described not merely feeling intense discomfort in races but also using the sensation as information. In a discussion of their findings published in Psychology of Sport and Exercise, Brick and his coauthors remarked, “While many athletes reported awareness of exertional pain during running, this awareness was primarily used as a signal to engage an appropriate cognitive strategy.” In essence, the runners asked themselves, “Given how I’m feeling right now, what is the best thought I can think or the best action I can take to maximize my performance?” Among the most commonly cited responses to discomfort were adjusting pace, trying to relax, and “chunking” distance or time (i.e., mentally dividing a run into smaller segments to make the distance seem more manageable).

The researchers noted that while certain specific metacognitive strategies were widely practiced among these elite runners, others were idiosyncratic. What matters most is not the specific thing you think or do in response to discomfort but that you cultivate a habit of monitoring (rather than just feeling) your discomfort so you can choose the best response for you.

As a coach, I’ve found that different metacognitive strategies are useful to different athletes. When I find myself deep in the pain cave in races, my self-talk becomes rather harsh (Man up! Don’t be a wimp!). It works for me, but when I share this strategy with my athletes, some of them look at me like I need to be locked up.

In fact, though, my little midrace drill-sergeant routine is nothing more than an idiosyncratic way of exercising what’s known as inhibitory control, which all runners exercise in one way or another. Inhibitory control is the ability to resist immediate impulses (such as the desire to slow down or quit for the sake of escaping discomfort) and stay focused on a less immediate goal (such as completing a race in the least time possible). The better you get at vetoing your urges to take your foot off the gas in races, the better you will perform. In a 2015 study, Italian researchers found that a standard test of inhibitory control was a strong predictor of subsequent race performance in a group of ultrarunners.

Other research has shown that inhibitory control can be strengthened through deliberate practice, and there are lots of ways to do this. In everyday life, just about any form of deferred gratification you can think of will strengthen the underlying mechanism, which is centered in a part of the brain called the anterior cingulate cortex. An example from my own life is creating a daily to-do list and tackling the item I dread most first, the item I’m most looking forward to last. In training, things like exercising to failure (e.g., holding a wall squat as long as you can) and the aforementioned mental trick of chunking distance or time when you’re running hard will have the same effect.

Metacognition is also useful for emotional self-regulation. Individuals who are adept at regulating their emotions are said to have a high level of emotional intelligence, and guess what? Research has shown that EI, too, correlates with running performance. A study led by Enrico Rubaltelli of the University of Padova and published in Personality and Individual Differences in 2018 found that individual scores on a test of EI predicted half-marathon performance better than prior racing experience and even training volume in a group of recreational runners.

Emotional intelligence, too, can be increased through deliberate practice. Mindfulness training is one proven means of enhancing the capacity for emotional self-regulation. But there are other ways. A lot of runners, including many professionals, use the training and racing context itself to work on this skill. Simply recognizing that you always have a degree of freedom to choose your emotions is half the battle; from this point, it is relatively easy to choose specific emotions that are more helpful than reflexive fear. If your shoe spontaneously falls apart during a marathon, for instance (as happened to Eliud Kipchoge during the 2015 Berlin Marathon), you don’t have to panic; you can keep calm and press on (as Kipchoge did, ultimately winning the race).

You may find it easier to control your emotions during a race if you preselect a desired emotional state before it even starts. Some elite runners like to race angry and intentionally work themselves into a lather prior to competing. There is scientific evidence that anger can indeed be performance enhancing for certain runners. Others have had success racing in a state of gratitude, especially when returning from a setback. Ryan Hall made a conscious choice to race the 2010 Boston Marathon with joy, and it helped him achieve a fourth-place, 2:08:40 performance. The fact that the fastest American-born marathoner in history chose to race happy is all the proof we need that having fun and performing at the highest level are not mutually incompatible.

Excerpted from Run Like a Pro (Even if You’re Slow): Elite Tools and Tips for Runners at Every Level, by Matt Fitzgerald and Ben Rosario, published by Berkley, an imprint of Penguin Publishing Group, a division of Penguin Random House, LLC. Copyright © 2022 by Matt Fitzgerald and Ben Rosario.