Elon research about how athletes perceive pain generates international attention

Nicole Razor '16, a member of the Elon women's basketball team, and Exercise Science Professor Eric Hall looked into how an athlete's perception of pain before an injury factored into how they experienced pain when injured. 

Sidelined by hip problems during her junior year, Nicole Razor ’16 knows the challenges that come with overcoming an injury. A psychology major, the former Elon women’s basketball player also knows how a person’s mindset can play in confronting physical challenges. 

Those two areas converged last year as Razor and Eric Hall, professor of exercise science at Elon, pursued research into how an athlete’s fear of pain and injury can impact how they perceive that pain when it happens, with their findings presented this spring at the American College of Sports Medicine annual meeting

“As a psychology major and someone who loves the game of basketball, I tied those two together with an interest in sports psychology,” Razor said. “For me, this research just shows how much the mind and the body are connected.”

The research co-authored by Hall and Razor has now generated international attention, with the study cited in a July article by Canadian Running magazine titled, “Your perception of pain might be making your muscles hurt more.”

“Learning to differentiate between the routine aches and soreness that come with training, and the painful issues that could become chronic is an important skill learned through experience,” the article notes after citing the research. 

Hall said Razor approached him about her interest in the psychology of injury, having already been dealing with some of those challenges herself. Hall, who specializes in neuroscience, said the psychology of injury had been an interest of his, but not one that he had devoted significant time to. 

“With her injuries, it was a merging of her personal experience and academic interests,” Hall said. 

Knowing that they could not intentionally inflict injuries on athletes, they decided to focus on muscle soreness — the kind that has a delayed onset after an athlete gets back to activity after being inactive. The research focused on Elon athletes on the men’s and women’s basketball, football and baseball teams as its study population. 

The July 4 break for Elon athletes going through conditioning training presented a good opportunity to induce muscle soreness after determining how those athletes thought about pain and injury, using tools such as the Athlete Fear Avoidance Questionnaire and Pain Catastrophizing Scale, Hall and Razor said.

Surveys that gauged the level of pain athletes were experiencing after returning to conditioning workouts revealed a correlation between the level of pain reported and their level of anxiety or fear of pain an athleted had prior to experiencing it. 

“Basically, how you perceive pain determines how you experience pain when you have an injury,” Razor said. 

Hall said the findings could help pave the way for new strategies in how to better prepare athletes for pain and injury they might have in the future. 

“You obviously can’t change how they experience muscle soreness, but you might be able to help change how they approach it,” Hall said. 

Razor starts graduate school at Anderson University in Anderson, S.C., this fall, and is staying involved with college athletics as a graduate assistant to Anderson’s women’s basketball team. She expects being able to use her findings to help the players she will be working with. 

Both see opportunities for future exposure for their research, with the possibility of publication within journals such as the Journal of Athletic training or other sports health journals. 

“This project is very applicable to her future goals both as a coach and as a sports psychologist,” Hall said.