The Ultimate “Pain Medicine”

Here is a great way to welcome one of our newest members to the gym. Many have already met him. Steven is a professor in psychology and neuroscience at the Georgia Gwinnett College and is highly motivated to pursue research-based fitness. How does that play a role with CrossFit? Well, by CrossFit being an evidence-based fitness methodology, there has to be research behind the evidence and Steven is on the road to scientifically researching all aspects of fitness. So we welcome you Steven and look forward to seeing and reading what you come up with!


Saturday was my first taste of the camaraderie of CF No Excuses and I loved it! Everyone was super friendly, supportive, motivational, and encouraging. This feeling was seconded this (Monday) afternoon in completing the ‘300’ workout. Without the encouragement of Coach Ben and the others my time (20:32) would have even been slower. Thanks! This helped me get through the WOD, WithOut Dying!

This got me thinking about the CF model and it’s relationship with pain. One of the key aspects of CrossFit is that it’s considered a “sport – the sport of fitness”. By being competitive, and supportive at the same time, a sense of camaraderie develops. We post our times on the whiteboard to be competitive, but not to brag. In fact, I post my time in hopes that I and others will defeat it, driving me harder to beat their time and mine! What does this have to do with pain? Well if you can bare to read on, I will try to explain….

Pain is a bio-physiological response, usually in response to cellular death and/or damage. That is, cells are dying (or stretching or bursting or shrinking or… you get the idea) and that cues sensory neurons (nociceptors) responsible for transmitting pain signals to the brain (technically pain is called nociception). The pathway from pain (e.g., putting your hand on a hot burner like I did Sunday morning) to the brain is fast and efficient and multi-faceted. Fast and efficient, as you’d expect since pain, the perception of things hurting or not feeling good and normal, is our biology’s way, our body’s way of saying: “STOP! Now do something different!” When my hand hit the burner this morning a very rapid set of neuronal signals told my brain to automatically pull my hand away. It was a reflex. However, there was other stuff going on at a level that is usually unconscious to us. Our brains where making rapid associations (learning) that burners, when red, are hot and that’s bad and therefore DO NOT put your hand on one again (STUPID!) I’m a slow learner, so chances are I will burn myself again this week.

In this neuronal cascade from hand to brain, as I’ve tried to explain simply above, there are actually several “pathways”, hence the multifaceted part. One of the most important pathways is called the spino-thalamic pathway. This is what brings the signal from the injury to a parts of the brain involved in generating virtually automatic behavioral responses like pulling your hand back and holding it as you wince in pain. The signal is also transmitted to several other parts of the brain including subcortical brain areas that are considered “pain” transducers (these sort of decide whether we pay attention to the pain) and to the cerebral cortex, which is where your brain/self figures out where on your body you are feeling the pain (e.g., hand, back, abs, legs, or everywhere after the ‘300’ workout). Without these pathways you cannot “feel” pain correctly. But, “feeling” pain is not all there is to this story. See, feeling pain is like feeling the “burn”, feeling a cut, feeling the impact of a punch, or feeling the tear of your ACL. Often we “feel” pain, but do not respond immediately to it. For example, think about a little kid who has just fallen and scraped their knee. They usually jump right up, then they look at their knee and see a red liquid (blood) oozing from it, and then the crying begins. This is what we neuroscientists refer to as the “neural alarm system”. The brain’s “Oh Shit!” response. It’s an interpretation of the “feeling” of pain as something important, something that demands our attention and demands that we respond. For the little fella it’s: 1) cry 2) so mom or dad will pick me up and 3) then all things in the universe will be good again! For the chef: it’s wrap my finger so I don’t get blood in the soup! And so forth.

Interestingly, our “feeling” of pain in the physical realm (e.g., getting burned, cut, punched, etc.) is tightly linked, neurologically, to our feeling pain in the social realm (being excluded, ostracized, socially rejected, or made fun of). The kid who doesn’t get picked for dodgeball experiences a sense of pain very similar to what he would feel if he were just kicked with a dodgeball: although all of this pain is associated with the “neural alarm system”, not the physical aspects of pain. See humans have been social critters for, well a long, long time (~4 million years or so)! So, our brains have evolved to be a group organism. We like to be in groups. We like the feeling of team support. We like when our teammates slap our ass. We like camaraderie. And when any of those things are threatened our brain responds using the same exact systems as those used in physical pain in order to motivate us to do something different: this time it’s not to pull your hand from the hot burner, but to make friends, work to get picked for dodgeball, or work to complete that WOD even if you think you’ll meet Pukie, or die! In the same way Tylenol and Ibuprofen reduce physical pain, camaraderie can reduce social pain. Let’s take this thought experiment one step further: if the physical pain and social pain systems are so tightly linked and intertwined, neurologically, then we might assume that medicines that reduce physical pain ought to reduce social pain. Indeed, there is new scientific data suggesting that certain pain killers can actually make someone feel LESS upset about being excluded from a group. Amazing isn’t it! So when your kid is feeling low about being cut from the team, “take 2 Tylenol and call me in the morning”, might actually work! Similarly, the thing that reduces social pain – camaraderie – should be able to reduce physical pain. There is little data on this in the scientific, sports science literature, but I think we see this everyday in CrossFit through a highly cooperative, competitive, friendly, and sporting environment. Camaraderie, being made to feel part of a group that is supporting you, with a larger purpose, can make you push through a WOD (or any challenge you face in life: an exam, a war, an athletic competition) without “feeling” the physical pain!

Written by: Steven Platek

IMPORTANT NOTE-— Steven will be publishing an article in the CrossFit Journal very soon! Be on the lookout for that and go read it!! We will also be posting it when it comes out