Triathletes and ironman triathletes participate in an extremely intense sport that involves hours of considerable pain, in addition to physical and psychological stress, every day. The basic pain modulation properties of these athletes has not been established and for this reason it is not clear whether they present with unique features that make it possible for them to engage in such efforts. This study’s goal was to investigate the existence of possible alterations in pain perception and modulation of triathletes, in addition to possible underlying factors. 19 triathletes and 17 non-athletes who underwent measurement of pain threshold, pain tolerance, suprathreshold perceived pain intensity, temporal summation of pain, and conditioned pain modulation (CPM) participated in the study. Participants also completed the fear of pain and the pain catastrophizing questionnaires, and rated the amount of perceived stress. Triathletes exhibited higher pain tolerance (P<.0001), lower pain ratings (P<.001), and lower fear of pain values (P<.05) than controls. The magnitude of CPM was significantly greater in triathletes (P<.05), and negatively correlated with fear of pain (P<.05) and with perceived mental stress during training and competition (P<.05).
The study’s findings indicate that triathletes exhibit greater pain tolerance and more efficient pain modulation than controls, which may underlie their perseverance in extreme physical efforts and pain during training/competitions. It is possible that this capability is enhanced or mediated by psychological factors, making it possible to better cope with fear of pain and mental stress.