The Psychology of Pain in Running: Cognitive Training to Distinguish “Good Pain” from “Bad Pain”

Introduction

“No Pain, No Gain” is the most widely circulated motto in the sports world, but it is also one of the most misunderstood and misused phrases.

There is indeed “meaningful discomfort” in running—muscle burning, heavy breathing, lactate accumulation—these are the necessary costs of training adaptation. But there are also “dangerous pain signals,” and ignoring them can cost you weeks or even months of time off from injury.

The problem is that under fatigue and adrenaline, these two types of pain are often difficult to tell apart. Developing a wise awareness of pain is a mental skill that runners must deliberately cultivate.

Good Pain vs. Bad Pain: A Complete Comparison Table

How the Brain Perceives Pain: The Influence of Psychological Factors

Modern neuroscience research has revealed an important fact: pain is not entirely an objective signal sent by peripheral nerves; it is a subjective experience “constructed” by the brain based on multiple factors.

Psychological factors that influence pain perception include:

• Anxiety and fear: Fear of injury amplifies pain perception (fear-avoidance model)
• Attentional focus: The more you focus on pain, the stronger it feels
• Contextual interpretation: The same muscle burning sensation feels more tolerable during a race than during training
• Past injury memory: If you have been injured in the same area before, discomfort there is more quickly interpreted as “dangerous”
• Self-efficacy: Runners who believe they can cope with pain actually have higher tolerance

Cognitive Training: Developing Wise Pain Awareness

Method 1: Body Scan Practice

During each training session, perform a quick 30-second body scan at regular intervals:

1. Start from the soles of your feet and scan upward one area at a time to the top of your head
2. For each area, ask: “What do I feel here?”
3. For any discomfort, ask: “Is this a muscle sensation, or a joint/bone/tendon sensation?”
4. Ask: “Is this sensation increasing, decreasing, or staying the same?”

The purpose of this practice is not to make you stop, but to build a “fine-grained ability to discriminate” body signals, rather than only being able to roughly feel “everything hurts” when fatigued.

Method 2: Pain Diary

In your training log, record every discomfort you experience:

• Location (the more precise, the better)
• Nature (burning, tightness, stabbing, heaviness…)
• Intensity (1 to 10)
• Triggering context (after how many kilometers of running, when climbing…)
• Condition after stopping (does it ease immediately?)

Tracking this data allows you to identify patterns—which discomfort is a normal training response and which is a persistent signal that needs attention.

Method 3: The Three-Question Test Before “Keep Going”

When noticeable pain appears during a run, before deciding whether to continue, ask yourself three questions:

1. Is this sensation causing me to change my running form? (If yes, stop)
2. Has this sensation shown a trend of worsening over the past 10 minutes? (If yes, stop)
3. Does this sensation improve significantly after 1 minute of rest? (If no, stop)

The 5 “Bad Pain” Warning Signs Runners Most Often Overlook

1. Sharp pain on the outside of the knee: May be iliotibial band syndrome (IT Band Syndrome); ignoring it often leads to long-term time off
2. Severe morning pain in the heel or arch: A typical signal of plantar fasciitis
3. Tenderness on the front of the shin: May be an early signal of a tibial stress fracture
4. Morning stiffness and tenderness to touch in the Achilles tendon: An early sign of Achilles tendinitis
5. Localized sharp pain below the kneecap on one side: Patellar tendinitis; continued neglect can develop into a chronic problem

Conclusion

Learning to listen to the language of your body is the greatest guarantee of longevity in a running career. Veteran runners who can compete year after year are usually not those who never feel pain, but those who have learned to discern the meaning of pain and make wise judgments between “worth continuing” and “need to stop.”

“Good pain” is your companion in progress; “bad pain” is your body’s guardian. Both deserve your attention and respect.

Related Reading

• Pain Tolerance Training: Pain Management Strategies in Running
• Pain Tolerance Training: Cognitive Reframing of Late-Run Discomfort
• Injury Prevention for Teenage Runners: Distinguishing Growing Pains from Training Injuries
• Pain Perception in Sports: Can Pain Tolerance Be Trained? A Complete Breakdown from Science to Practice