Prevalence of Pain in Athletic Populations- A Frightening Static

As a company in the business of human performance, KYMIRA have a vested interested in helping athletes perform, recover and manage pain more effectively. As part of our research into athletic pain, we’ve investigated the size of the problem and written this article about the rates and nature of the issues athletes are facing…

Prevalence of Pain in Athletic Populations- A Frightening Static

Prevalence of Pain in Athletic Populations- A Frightening Static

-

For decades there has been an acceptance of a disproportionate amount of pain amongst athletes and the generally active.

We don't have to look far for the clues about athletic pain and injury rates – every single professional sporting organisation will employ at least a physiotherapist on their staff. In the upper echelons of professional sport where the budgets are larger, this progresses into an entire medial department including multiple doctors and specialists in various form on injury management.

Of course a livelihood where extreme physical exertion isn't just desired, it's expected is largely responsible for such levels of injury and discomfort. Throw into the mix a less-than-optimum travel and training schedule and the problem increases in orders of magnitude. A fatigued athlete is more susceptible to injury than a fully recovered one.

Culturally, athletes exist in a world where pushing beyond one's limits is encouraged. Outdated training maxims such as ‘no pain, no gain' and ‘rest is rust' are still commonplace in sport.

As a company in the business of human performance, KYMIRA have a vested interested in helping athletes perform, recover and manage pain more effectively. As part of our research into athletic pain, we've investigated the size of the problem and written this article about the rates and nature of the issues athletes are facing…

Time to read: 7 minutes

Level: Intermediate

Key Points:

  • Rates of pain- are they higher in the athletic population?
  • The nature of athletic pain.
  • How is pain being treated in sport?
  • Are there non-medical solutions to pain available?
  • Can infrared clothing be used as an effective pain reliever for athletic populations

For decades there has been an acceptance of a disproportionate amount of pain amongst athletes and the generally active.

Rates of Pain- are they Higher in the Athletic Population?

The proportion of the general population reporting any kind of day to day pain varies depending on the research method and the study design, but overall estimates from research suggest a figure of between 35% to 51.3% of us suffer with a level of general pain.

When we investigate further and look for incidence of disabling pain, research returns a figure of 10.4% to 14.3%. [1]

The obvious flaw in this study is that this assesses the whole population in terms of age ranges, whereas athletic populations are generally younger and therefore statistically less likely to be suffering from pain in normal circumstances.

When we dig into the general population data further we see a figure of 14.3% of 18-25 year olds suffering from pain and up to 30% in the 19-39 year old category. If we blend these figures we can take an educated assessment of 22% of 18-39 year olds suffering from pain and we will use that as a basis for comparison with athletic populations, as it's a fairer representation of the age profile of the athletes.

In a cross-sectional study titled ‘PREVALENCE OF PAIN AND QUALITY OF LIFE IN HIGH-PERFORMANCE ATHLETES' [2], researchers assessed levels of pain of 86 athletes from 4 different sports, all with different levels of impact, training and competition requirements (Judo, Swimming, Skydiving and Volleyball).

The results showed the incidence of pain amongst the athletic populations was significantly higher than in general populations – 100% of the judo participants, 86% of the skydivers, 67% of the volleyball players and 45% of the swimmers experience pain. Taken as a whole, the mean percentage of athletes experiencing pain is a huge 74.5%.

The Nature of Athletic Pain

Such is the variety of sports that the types of pain and injury experienced in athletic populations vary enormously and the data doesn't always lead to expected conclusions.

One would assume that incidences of pain would be higher in sports with high impact forces such as Wrestling, American Football and Rugby, but the reality is that causation of injury is far more nuanced and less obvious than first thought. Overtraining, under recovery, inappropriate body positions during training and competition and the loading of the joints can all affect joint pain.

In a systematic review on the prevalence of neck pain [3], researchers discovered that whilst the athletes competing in sports such as American Football and Wrestling suffered from disproportionate levels of neck pain relative to the general population (73% of Wrestlers in the study reported experiencing neck pain), there were some surprising results – 65% of Ice Hockey players experienced neck pain, which was the second highest figure in the sports assessed.

Most surprisingly was the number of triathletes (a non-contact sport) suffering from neck pain – 48%. This has been attributed to neck position during the cycling element of the sport, highlighting the impact that positioning and overuse can have on joints.

The knock on effect of athletic pain is more significant than in other aspects of life because in many cases it prevents normal functioning and day-to-day activity. Missed training days through injury have a direct impact on sports performance, skill acquisition, fitness levels and ultimately results, so the prevention and eradication of athletic pain isn't just a desirable outcome, it's an active target.

How is Pain being treated in Sport?

One of issues in pain control in athletes has been highlighted in the 2017 report ‘Pain in elite athletes—neurophysiological, biomechanical and psychosocial considerations: a narrative review' [4]. The research shows that a knowledge gap exists when it comes to pain in sports, because most sports clinicians are not trained pain specialists, but most pain specialists aren't sports clinicians, meaning more nuanced cases are often dealt with in a possibly sub-optimal fashion.

The treatment of pain is relevant here because there are approximately six different types of pain associated with sport, each with their own origin and treatment that a non-expert medic may not appreciate.

At an elite level sports teams and athletes will employ a full team of clinicians from a variety of specialist areas such as sports medicine, physiotherapy, strength and conditioning, massage, nutrition and in some cases chiropractic. These medical professionals are tasked with ensuring the athletes stay as pain free and fit as possible, but it will require effective diagnosis and treatment by the team of specialists to be as effective as possible.

They'll use a variety of treatment options from pharmacology to non-medical.

According to the ‘International Olympic Committee consensus statement on pain management in elite athletes' [5], the treatment options vary depending on the diagnosis, but essentially the pain medications fall under the following categories…

  • Oral non-steroidal anti-inflammatory drugs (NSAIDs)
  • Injectable NSAIDs
  • Other non-opioid analgesics
  • Opioid analgesics
  • Injectable and transdermal anaesthetics
  • Other medications and over-the-counter supplements

There's a potential issue for athletes here when it comes to banned substances, because the sands are constantly shifting when it comes to the guidelines around medications. Previously legal substances can become illegal with a change in rules, so it relies on the medical departments being abreast of the most up to date legislation.

When a single mistake can result in a lifetime ban, athletes and medical departments have to be right up to date with current legislation which is a headache in itself!

There are non-pharmacological solutions to pain of course, which will depend on the severity of the problem and the budgets available to the athlete. These interventions may include…

  • Surgery
  • Massage
  • Manual therapy
  • Strength and Conditioning Plans

Are there Non-Medical Solutions to Pain Available?

Thankfully there are ways we can help to manage pain without resorting to medical interventions. Infrared fabrics have been shown across multiple studies to help ease pain in subjects suffering from a variety of conditions.

Research shows that infrared fabrics stimulate Nitric Oxide production. Nitric Oxide activates a chemical called Cyclic Guanosine Monophosphate (cGMP). This is the chemical activated when we take an opiate painkiller so will have a mild analgesic affect.

The vasodilating effect of infrared is also a powerful ally when it comes to circulatory and movement issues.

By improving blood flow to stiff or sore tissues we improve mobility, flexibility and reduce the pain. There are numerous studies that highlight the benefits of infrared and pain relief, such as ‘Infrared therapy for chronic low back pain: A randomized, controlled trial' [6] which showed an improvement of the pain experienced by the patient and importantly, no side effects.

The anti-inflammatory effects of infrared clothing are also an effective pain reliever. Research shows that the infrared clothing reduces feeling of pain, DOMS and is effective at decreasing production of free radicals and inflammatory mediators, easing pain in athletes [7]

Can Infrared Clothing be used as an effective pain reliever for the Athletic Population?

The question we at KYMIRA are investigating in particular is what are the more passive approaches to pain management that are being used in sport of all levels, especially in those athletes who don't have the budgets to fund entire medical teams?

The answer points to use of infrared for a number of reasons such as…

  • Cost effective – far cheaper than a medical department!
  • Passive – can be worn 24/7 and takes no effort
  • Doesn't violate any anti-doping legislation
  • Causes no side effects
  • Infrared stimulates recovery and performance as well as ease pain
  • Portable – don't need to take any equipment with you
  • Multi-use – you can wear it thousands of times and it remains effective
  • Variable – comes in all garments that cover different areas of the body

When you consider the multitude of factors that an athlete has to content with such as rules and regulations, budgets, travel, portability etc, infrared comes out as a firm choice every time when it comes to pain relieving options for athletes.

If we refer back to the start of the article where we explained that 74.5% of athletes suffer from some form of consistent pain, it becomes clear that we need better, more effective pain relief that doesn't come from a pharmacological or medical setting. Athletes simply can't constantly pop pills or rely on medical intervention to keep them at a bearable level of pain.

We believe here at KYMIRA, we have the answer. To view the KYMIRA infrared clothing range, click here.

References

[1] https://bmjopen.bmj.com/content/6/6/e010364

[2] https://bjsm.bmj.com/content/48/7/633.3

[3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6284113/

[4] https://cor-kinetic.com/wp-content/uploads/2018/01/pain-in-elite-athletes—neurophysiological-biomechanical-and-psychosocial-considerations-a-narrative-review.pdf

[5] https://bjsm.bmj.com/content/51/17/1245

[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2539004/

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4993144/

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A fatigued athlete is more susceptible to injury than a fully recovered one.\nCulturally, athletes exist in a world where pushing beyond one’s limits is encouraged. Outdated training maxims such as ‘no pain, no gain’ and ‘rest is rust’ are still commonplace in sport.\nAs a company in the business of human performance, KYMIRA have a vested interested in helping athletes perform, recover and manage pain more effectively. As part of our research into athletic pain, we’ve investigated the size of the problem and written this article about the rates and nature of the issues athletes are facing…\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nTime to read: 7 minutes\nLevel: Intermediate\nKey Points:\n\nRates of pain- are they higher in the athletic population? \nThe nature of athletic pain.\nHow is pain being treated in sport? \nAre there non-medical solutions to pain available? \n\nCan infrared clothing be used as an effective pain reliever for athletic populations\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nFor decades there has been an acceptance of a disproportionate amount of pain amongst athletes and the generally active. \n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\nRates of Pain- are they Higher in the Athletic Population? \n\n\n\n\n\n\n\nThe proportion of the general population reporting any kind of day to day pain varies depending on the research method and the study design, but overall estimates from research suggest a figure of between 35% to 51.3% of us suffer with a level of general pain.\nWhen we investigate further and look for incidence of disabling pain, research returns a figure of 10.4% to 14.3%. [1]\nThe obvious flaw in this study is that this assesses the whole population in terms of age ranges, whereas athletic populations are generally younger and therefore statistically less likely to be suffering from pain in normal circumstances.\nWhen we dig into the general population data further we see a figure of 14.3% of 18-25 year olds suffering from pain and up to 30% in the 19-39 year old category. If we blend these figures we can take an educated assessment of 22% of 18-39 year olds suffering from pain and we will use that as a basis for comparison with athletic populations, as it’s a fairer representation of the age profile of the athletes.\nIn a cross-sectional study titled ‘PREVALENCE OF PAIN AND QUALITY OF LIFE IN HIGH-PERFORMANCE ATHLETES’ [2], researchers assessed levels of pain of 86 athletes from 4 different sports, all with different levels of impact, training and competition requirements (Judo, Swimming, Skydiving and Volleyball).\nThe results showed the incidence of pain amongst the athletic populations was significantly higher than in general populations – 100% of the judo participants, 86% of the skydivers, 67% of the volleyball players and 45% of the swimmers experience pain. Taken as a whole, the mean percentage of athletes experiencing pain is a huge 74.5%.\n\n\n\n\n\n\n\n\n\n\n\n\nThe Nature of Athletic Pain\n\n\n\n\n\n\n\nSuch is the variety of sports that the types of pain and injury experienced in athletic populations vary enormously and the data doesn’t always lead to expected conclusions.\nOne would assume that incidences of pain would be higher in sports with high impact forces such as Wrestling, American Football and Rugby, but the reality is that causation of injury is far more nuanced and less obvious than first thought. Overtraining, under recovery, inappropriate body positions during training and competition and the loading of the joints can all affect joint pain.\nIn a systematic review on the prevalence of neck pain [3], researchers discovered that whilst the athletes competing in sports such as American Football and Wrestling suffered from disproportionate levels of neck pain relative to the general population (73% of Wrestlers in the study reported experiencing neck pain), there were some surprising results – 65% of Ice Hockey players experienced neck pain, which was the second highest figure in the sports assessed.\nMost surprisingly was the number of triathletes (a non-contact sport) suffering from neck pain – 48%. This has been attributed to neck position during the cycling element of the sport, highlighting the impact that positioning and overuse can have on joints.\nThe knock on effect of athletic pain is more significant than in other aspects of life because in many cases it prevents normal functioning and day-to-day activity. Missed training days through injury have a direct impact on sports performance, skill acquisition, fitness levels and ultimately results, so the prevention and eradication of athletic pain isn’t just a desirable outcome, it’s an active target.\n\n\n\n\n\n\n\n\n\n\n\n\nHow is Pain being treated in Sport?\n\n\n\n\n\n\n\nOne of issues in pain control in athletes has been highlighted in the 2017 report ‘Pain in elite athletes—neurophysiological, biomechanical and psychosocial considerations: a narrative review’ [4]. The research shows that a knowledge gap exists when it comes to pain in sports, because most sports clinicians are not trained pain specialists, but most pain specialists aren’t sports clinicians, meaning more nuanced cases are often dealt with in a possibly sub-optimal fashion.\nThe treatment of pain is relevant here because there are approximately six different types of pain associated with sport, each with their own origin and treatment that a non-expert medic may not appreciate.\nAt an elite level sports teams and athletes will employ a full team of clinicians from a variety of specialist areas such as sports medicine, physiotherapy, strength and conditioning, massage, nutrition and in some cases chiropractic. These medical professionals are tasked with ensuring the athletes stay as pain free and fit as possible, but it will require effective diagnosis and treatment by the team of specialists to be as effective as possible.\nThey’ll use a variety of treatment options from pharmacology to non-medical.\nAccording to the ‘International Olympic Committee consensus statement on pain management in elite athletes’ [5], the treatment options vary depending on the diagnosis, but essentially the pain medications fall under the following categories…\n\nOral non-steroidal anti-inflammatory drugs (NSAIDs)\nInjectable NSAIDs\nOther non-opioid analgesics\nOpioid analgesics\nInjectable and transdermal anaesthetics\n\nOther medications and over-the-counter supplements\n\nThere’s a potential issue for athletes here when it comes to banned substances, because the sands are constantly shifting when it comes to the guidelines around medications. Previously legal substances can become illegal with a change in rules, so it relies on the medical departments being abreast of the most up to date legislation.\nWhen a single mistake can result in a lifetime ban, athletes and medical departments have to be right up to date with current legislation which is a headache in itself!\nThere are non-pharmacological solutions to pain of course, which will depend on the severity of the problem and the budgets available to the athlete. These interventions may include…\n\nSurgery\nMassage\nManual therapy\nStrength and Conditioning Plans\n\n\n\n\n\n\n\n\n\n\n\n\n\nAre there Non-Medical Solutions to Pain Available?\n\n\n\n\n\n\n\nThankfully there are ways we can help to manage pain without resorting to medical interventions. Infrared fabrics have been shown across multiple studies to help ease pain in subjects suffering from a variety of conditions.\nResearch shows that infrared fabrics stimulate Nitric Oxide production. Nitric Oxide activates a chemical called Cyclic Guanosine Monophosphate (cGMP). This is the chemical activated when we take an opiate painkiller so will have a mild analgesic affect.\nThe vasodilating effect of infrared is also a powerful ally when it comes to circulatory and movement issues.\nBy improving blood flow to stiff or sore tissues we improve mobility, flexibility and reduce the pain. There are numerous studies that highlight the benefits of infrared and pain relief, such as ‘Infrared therapy for chronic low back pain: A randomized, controlled trial’ [6] which showed an improvement of the pain experienced by the patient and importantly, no side effects.\nThe anti-inflammatory effects of infrared clothing are also an effective pain reliever. Research shows that the infrared clothing reduces feeling of pain, DOMS and is effective at decreasing production of free radicals and inflammatory mediators, easing pain in athletes [7]\n\n\n\n\n\n\n\nCan Infrared Clothing be used as an effective pain reliever for the Athletic Population? \n\n\n\n\n\n\n\nThe question we at KYMIRA are investigating in particular is what are the more passive approaches to pain management that are being used in sport of all levels, especially in those athletes who don’t have the budgets to fund entire medical teams?\nThe answer points to use of infrared for a number of reasons such as…\n\nCost effective – far cheaper than a medical department!\nPassive – can be worn 24\/7 and takes no effort\nDoesn’t violate any anti-doping legislation\nCauses no side effects\nInfrared stimulates recovery and performance as well as ease pain\nPortable – don’t need to take any equipment with you\nMulti-use – you can wear it thousands of times and it remains effective\nVariable – comes in all garments that cover different areas of the body\n\nWhen you consider the multitude of factors that an athlete has to content with such as rules and regulations, budgets, travel, portability etc, infrared comes out as a firm choice every time when it comes to pain relieving options for athletes.\nIf we refer back to the start of the article where we explained that 74.5% of athletes suffer from some form of consistent pain, it becomes clear that we need better, more effective pain relief that doesn’t come from a pharmacological or medical setting. Athletes simply can’t constantly pop pills or rely on medical intervention to keep them at a bearable level of pain.\nWe believe here at KYMIRA, we have the answer. 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