Pain sensitivity increases more in younger runners during an ultra-marathon

Abstract

Objectives: Ultra-endurance research interest has increased in parallel with an increased worldwide participation in these extreme activities. Pain-related data for the growing population of ultra-endurance athletes, however, is insufficient. More data is especially needed regarding the variation in the aging populations of these athletes. We have previously shown that peripheral and central pain sensitivity increases during an ultra-marathon. To further clarify these changes in pain sensitivity during ultra-endurance competition we investigated these variations in two age populations: Younger runners ≤ 39-year-old (younger) and an older group of runners being ≥ 40 years of age (older).

Methods: Subjects were recruited from ultra-marathon competitions held over a three-year period in Florida, USA. All courses were flat with either hard macadam surface or soft sandy trails; run in hot, humid weather conditions. Pressure pain threshold (PPT) was measured with a pressure algometer on the distal, dominant arm before and immediately after an ultra-marathon. Conditioned pain modulation (CPM) was also measured pre and post, immediately after the PPT by placing the non-dominant hand in a cold-water bath maintained at 13.5 ± 1.5 °C. The difference between the pre and post measurements for both PPT and CPM were calculated and referred to as ΔPPT and ΔCPM, respectively for analysis. Data were analyzed with a Mixed 2 × 2 (Within X Between) MANOVA.

Results: Both PPT and CPM decreased during the ultra-marathons (p<0.05) in the younger group of runners. In the older runners there was not a statistically significant decrease in PPT during the ultramarathons whereas CPM did significantly decrease statistically (p=0.031). The ΔPPT was less in the older group compared to the younger group (p=0.018). The difference between the younger and older groups ΔCPM approached statistical significance at p=0.093.

Conclusions: This statistical evidence suggests that the overall increase in peripheral and possibly central pain sensitivity was different between our age groups. Pain sensitivity during the ultra-marathon increased more in our younger group of runners than in our older group. This study suggests that there is an unidentified factor in an older population of ultra-marathon runners that results in an attenuated increase in pain sensitivity during an ultra-endurance activity. These factors may include a decreased innate immune response, lower fitness level, lower exertion during the ultra-marathon, variation in endorphin, enkephalin, endocannabinoid and psychological factors in the older age runners.

Keywords: conditioned pain modulation; hyperalgesia; innate immunity; pain; pressure pain threshold; ultra-endurance exercise.