No pain no gain?

Meyken Houppermans, PhD. CrossFit Level 3 Trainer.
Founder and Head Coach
Pain and injuries are common in high intensity sports. The No Pain No Gain approach can make things worse. Pain acceptance and the utilization of your athlete mindset enhances recovery more effective.

Pain is common

Most professional and recreational athletes deal with pain and injuries regularly. With the difference that professional athletes are under constant supervision by health professionals and receive medical and non- medical treatment, compared to recreational atrhletes who sometimes train at the same intensity and volume but without medical supervision.

Professional athletes might look like the healthiest people on earth, but in reality often push their body to the limit, sometimes over the limit, with the eye on the prize.

Recreational athletes are also known to push their limits and have pain and injuries. Many times they do not take matters into their own hands to consult a professional (it is not their day job to be an athlete), making them at higher risk for the development of a chronic injury. On the one hand, they sometimes train like a professional, on the other hand, they do not take care of themselves like a professional. (High intensity sports require high maintainance).

Up- and downside of regular exercise

Working out regularly improves physical and mental health. Pushing through and showing mental toughness can make us do the unthinkable (Mental toughness: what it is and what not). If you want to improve, you need to get out of your comfort zone. Sucking up pain is said to make the difference between the winner and the loser.

But there is also a downside to all this greatness.

No pain no gain?

Sometimes we are so enthusiastic that we ignore signals of the body telling us something is wrong. Sometimes we are mentally not capable of interrupting our workout regime, out of fear of missing out, or gaining weight, or losing everytrhing we've worked so hard for. (Will you lose your fitness when you cannot workout?). Sometimes  ignoring the fact that in our 40’s we need to train different compared to how we trained in our 20s. (Can you do CrossFit at an older age?) Sometimes we havew been taught by coaches to push through no matter what, no pain no gain.

A lot of injuries are the result of overuse and overload, with underlying physical and mental factors. Physical factors are for example: Too much training sessions in a week; too heavy workouts or too much load; bad technique; taxing the same muscles, tendons and ligaments several workouts in a row; lack of recovery; (High intensity sports require high maintainance); or not taking athlete-  specific factors into account such as the athlete's anatomic ratio’s or mobility.

Mental factors refer to behavior and mindset of the athlete and the coach. For example always wanting to be the best; a no-pain-no-gain mindset; picking up the regular workout regime too soon after an injury; not adjusting the workout to the athlete’s capabilities and needs; a huge ego; or experiencing too much peer pressure.

Injuries and pain from overuse and overload correlate with chronic pain.

Athletes' perspective on injury


Athletes have a more positive outlook on their recovery compared to non-  athletes and they have higher outcome expectations. Having an optimistic perspective on sickness, injury and pain, can have a huge impact on physical en mental recovery, in athletes as well as non- athletes. Optimistic people recover faster and better, pessimistic people have a higher risk of dying from diseases.


The downside to this optimism is that athletes (and coaches) can have the tendency to set unrealistic recovery goals or have unrealistic outcome expectations. They tend to go too fast in the recovery process or pick up the regular workout regime too soon. The fact that athletes have a higher pain tolerance compared to non- athletes doesn’t help. Neither does the fact that athletes are known for ignoring pain caused by overuse, such as muscle cramps. They tend to redefine that pain into something they need to fight against.

Fear side

Besides the upside and downside on how athletes perceive pain and deal with it, there is also a so called fear- side to this: Not all athletes are truly optimistic. Some athletes act optimistic out of fear of not being able to overcome the injury. Some injured athletes are overwhelmed with negative feelings and even depression. They might act optimistic, when in reality they feel really pessimistic, scared and anxious. So besides ‘unrealistic’ optimism, pessimism and fear can also be huge obstacles for recovery.

Effective approach

People cope with pain in several different ways, depending on factors such as the type and duration of the pain; previous experiences with pain; and even gender, sociocultural differences and personality.

Pain can cause stress and stress has a negative effect on pain: Stress often comes from the believe that we cannot control the pain, that it is just our destiny, or that e need to avoid all activities related to the pain. People who experience  stress in relation to pain tend to use less effective coping strategies. Such as resting a lot or hoping and praying the pain or injury will go away.


The more effective way of dealing with pain and injury, especially if it’s long lasting or chronical is pain acceptance. This means staying active and not avoid the pain by all means and paying less attention to the pain. We know that, as soon as athletes accept the injury they are confronted with, they are able to cope with the consequences much better and recover sooner.[1]

Three step- approach:

-         Step 1: Reset goals and expectations
Set realistic goals and outcome expectations concerning your recovery. Consult a professional to help you with this. Put your initial training goals on hold. Make your recovery your priority.

-         Step 2: Keep moving smarter, not harder
Whatever you do: keep moving. Whether it is just walking around or sitting on  the couch but moving your upper body. Avoid rest because that’s not going to help you. Be creative and think about what you CAN do, instead of what you  cannot. Maybe you cannot squat anymore thanks to you lower back injury, but you can do split squats or finally have the time to focus on learning a handstand pushup. Consult a professional to help you set up a smart and  challenging new workout-recovery plan.

-         Step 3: Use your athlete mindset to work for you instead of against you
You have a choice: either you do not accept the pain or injury, or you do  accept it. Since not accepting it doesn’t make it go away, but does make you feel really frustrated, you might as well accept it! In that way, you’re using your athlete mindset and your mental toughness to work for you, instead of against you.

Mental toughness is about creating self-efficacy, a positive mindset and positive self- talk, focusing on  positive emotions (and embracing the negative ones!), and behaving likewise.  It’s a positive coping strategy that sets you up for a successful pathway towards your goal and keeps you going instead of quitting. It’s about redefining failure in terms of great attempts and steps to get closer to your goal.

Now that doesn’t mean always being happy or stress free or successful. It’s about how you cope in a healthy manner with stressors, difficult situations and setbacks. It’s how you approach goals and life in general. It’s totally ok to feel shit every once in a while, to cry, to feel angry and to doubt yourself. It’s about how you move on and grow from there.

Mental toughness in terms of self efficacy, positive self- talk, a positive mindset, focusing on positive emotions yet also embracing the negative ones, can have great benefits for your mental and physical health. In shorter run it lowers stress levels and improves the quality of sleep for example. It makes you feel more relaxed, fulfilled and at ease. In the longer run it can reduce the risk of chronical diseases such as depression, cardiovascular diseases and cancer.


An injury or pain sucks, but it’s not your destiny or identity. The way you deal with it greatly influences how and how fast you get back on track. And if you want to do that in an effective way, you need to use your athlete mindset to the best!

Create your own health!©


van Wilgen CP, Verhagen EA. A qualitative study on overuse injuries: the beliefs of athletes and coaches. J Sci Med Sport. 2012 Mar;15(2):116-21. doi: 10.1016/j.jsams.2011.11.253. Epub 2011 Dec 19. PMID: 22188849.; Sarafino, E. (2014). Health Psychology: Biopsychosocial Interactions.