Running with Pain

Sharyn O’Halloran

The motto “no pain, no gain” drives athletes to push through the intense discomfort of strenuous physical exertion to the nirvana of endorphin induced bliss on the other side.  But many times, the pain doesn’t stop.  No matter how much grinning and bearing you do, the pain becomes chronic and may even intensify.  It is at these times that you need to re-evaluate your training program and seek the advice of a health expert.

Women, unfortunately, have difficultly following this common sense advice for two conflicting reasons. First, women are slower to seek medical attention for an injury than are men.  They will wait until the pain becomes simply unbearable (I know, I’m one.) Second, when women do seek medical attention, doctors are less likely to treat the pain itself than males with the same aliment.  Female pain, unlike male pain, is viewed as psychological not physiological.  In both cases, a women’s pain goes untreated.

What is the pain gap?

Women and men experience pain differently.  Studies repeatedly show that across all disease categories women feel more acute pain.  A Stanford University study examined gender-related differences in pain intensity as reported on 1-to-10 scale, in which a zero stands for “no pain” and 10 for “worst imaginable.”  The research found statistically significant higher pain scores for female patients across all categories. Moreover, the reported differences were clinically significant: a pain-score improvement of one point is what clinical researchers view as indicating that a pain medication is working.

A recent article in the Wall Street Journal summarized over 15 years of clinical studies, reaffirming the findings that women are both more likely to develop chronic painful conditions and to report greater pain than men with the same condition. Women also express more acute pain than men even after the same surgeries, such as wisdom tooth extraction, gall bladder removal, hernia repair and hip and knee surgery.

In addition, women repeatedly exhibit lower thresholds (report pain at lower levels of stimulus intensity) and tolerance (can’t bear intense painful stimulation as long) for various types of pain.  For example, while men and women have comparable thresholds for cold and ischemic (decreased blood flow) pain, women have lower pain thresholds for pressure-induced pain than men. Similarly, women tolerate less heat and cold pain than men, but tolerance for ischemic pain is comparable between men and women.

Why the difference?

While hormones play a role, part of the problem is behavioral. Women usually wait longer to seek medical intervention like surgery. In contrast, men tend to seek surgery before their pain becomes extreme. The surgery itself is equally beneficial for both sexes, but because a woman typically has more advanced disease by the time she gets surgery, the result often isn’t as good.

A 2008 Canadian study also shows that medical professionals respond differently to female and male pain.  Even when women  seek medical help, they are less likely to be treated.  For example, the odds of a surgeon recommending knee replacement were 22 times higher for a male patient than a female. Moreover, when expressing symptomatic pain, women are more likely to be sedated while men are more likely to receive pain medication.

What to do?

1)   Know Your Pain—Log when your pain occurs.  If it is episodic or happens during the monthly cycle, hormones could be at play. If it happens during long runs, changing your workout to accommodate these fluctuations could help mitigate some of the pain.  If it is chronic, seek medical advice.  Knowing when and under what conditions your pain is expressed will help with diagnosis and treatment.

2)   The Obvious is Not Always Obvious—I always assume I know the cause of my pain.  I have an amazing track record: I am always wrong.  While symptoms may be felt like a tight hamstring, the cause may have nothing to do with the hamstring.  In my case, a chronically tight hamstring that would not respond to stretching and downtime was not caused by a muscle pull but by musculoskeletal misalignment.  Go figure.

3)   Seek Medical Advice Early—Don’t wait.  If an injury is not responding to topical remedies seek medical advice early on.  I muscled through my pain and completed a marathon and ultra-marathon under excruciating circumstances.  I probably did more damage than good.

4)   Mix-it-Up –Imbalances in muscular strength and flexibility are typical byproducts of extensive endurance training and a recipe for injury.  Cross training  will help maintain your endurance and strength even while you allow yourself to heal.  Weight training and water aerobics, along with a consistent stretching routine, provide the best defense against repeat injury.

5)   Persistence—The same determination that makes you an endurance athlete is going to get you the health results you want. My podiatrist thinks I have a crush on him because I visit so often.  That may be true, although I don’t date married men, but I insist that he gets my orthotic insoles correct.  Otherwise, there is another good-looking podiatrist just down the block.


 Copyright © 2014 All rights reserved.

Women, Running and Stress Management

Sharyn O’Halloran

In a previous post, I discussed the statistics on Why Women Run?  The key finding was that women run to stay fit and healthy just like men.   Unlike their male counterparts, however, women also see running as a way to reduce stress. These findings reflect changing demographics as well as how women experience the physical symptoms of stress.

Typically, women runners are around 40.  Sixty percent are married and 77.8 percent are college educated.  Moreover, they are affluent; 70.8 percent earn a household income over $75,000.  Many of these women have come late to running, usually starting in their 30s, and have run for an average of 9.6 years.  Female runners participate in about 7 races per year with about half completing a marathon at least once in their lifetime.

Indeed, the number of women who finish events has risen from a little over a million in 1990 to over 8.6 million female participants in 2012.

FinishersGraph_1990to2012-2Women now represent 56 percent of all running event finishers, a two-fold increase over the last two decades.

This rise in women’s participation in competitive running events has coincided with rising stress levels among women, especially married women, who struggle to balance both work and family.  For instance, in a recent study, women were more likely than men (28 percent vs. 20 percent) to report having a great deal of stress (8, 9 or 10 on a 10-point scale).  Almost half of all women (49 percent) surveyed said their stress has increased over the past five years,


compared to four in 10 (39 percent) men.  Women are more likely to report physical and emotional symptoms of stress than men, such as having had a headache (41 percent vs. 30 percent), having felt as though they could cry (44 percent vs. 15 percent), or having had an upset stomach or indigestion (32 percent vs. 21 percent) in the past month.  Married women report higher levels of stress than single women, with one-third (33 percent) reporting that they have experienced a great deal of stress in the past month.

Clearly, running can be an important tool to manage stress.  It can also help alleviate many of the physical and emotional symptoms of stress.  A recent study published in the Journal of Neuroscience , showed that  gene markers associated with anxiousness increased noticeably in mice that didn’t run, while mice that were forced to run before being exposed to stress, a dunk in cold water, failed to show a significant uptick of those same gene markers.

So even if your not forced to take a cold-water plunge, go for a run.  You will feel and look better.


Click to access gender-stress.pdf

Copyright © 2014 All rights reserved.

New York Road Runners Fosters Commitment to Running

Sharyn O’Halloran

Last week’s post on How to Stay Motivated to Run, discussed the importance of joining a local running club to maintain a consistent training schedule. Here is a closers look at both the individual and social benefits to getting involved.

Established more than half a century ago, the Road Runners Club of America provides an outlet for individuals to embrace the sport of running and motivation to individuals to get them running and keep them running as they develop a lifelong commitment to better health. The club hosts numerous races throughout the nation, ranging from 5K fun runs to marathons and even ultra-marathons. The New York Road Runners, to which I belong, boast thousands of members participating annually in world-class events such as the TCS New York City Marathon. The 2013 NYC marathon was the largest ever, with some 55,000 runners from all other the world.

The nonprofit Road Runners combines donations from individuals and corporations with the income from its events to promote the advancement of running. The club works to inspire people of all ages to run but places special emphasis on youth programs. The New York Road Runners club sponsors numerous educational programs and activities that serves more than 200,000 children throughout New York City, as well as nationally and internationally.

I have trained with the NYRR for a number of marathons and ultimately ran my first 60K (37.28 mile) race with the club in 2013. My participation in these events has also raised money for a number of charitable organizations, including the Legal Aid Society and Community Impact at Columbia University.

Helping yourself stay fit can also help others.

Copyright © 2014 All rights reserved.

How to Stay Motivated to Run

Sharyn O’Halloran

Staying motivated to run long distances while juggling constant demands from work and family is very hard. Here are a few tricks that I have found along the way.

1) Compete in Local Races— Join a running club that sponsors local events. I belong to the New York Road Runners, which hosts racing events almost every weekend throughout the year. Competing in a race forces me to stay on my training program.

2) Virtual Coach— When I am training for a long distance event, and even if I am not, I always sign up with a Virtual Coach. Each night I get an email telling me what my workout program is for the next day. I don’t have to think about it. I just do what the coach says (more or less).

3) Cross-Training— Running high volume miles consistently week-after-week can take its toll and, frankly, it can get boring. To mix it up, I weight train, ride bike and participate in body sculpting classes for core strengthening. Over the course of a week, I complete my long runs, while getting a full-body workout.

4) Stretching and Yoga—One of the best ways to ward off injury is to incorporate a stretching routine into your daily workout. This could be done in the morning or night. I usually go through a set of classic runners stretches for hip flexors, hamstring and quads. I also like to include some basic yoga poses to both stretch and strengthen core muscles.

5) Virtual Training Partner—I find it impossible to coordinate my training sessions with another equally busy person. Instead, as a commitment device, I have a friend that I email before and after my long runs and before and after racing events. Being answerable to another human being, even if virtually, pushes me to complete the task, especially when I am tired and hurting.

Copyright © 2014 All rights reserved.