Right Coast vs. Left Coast:
Do You Run In Pain or Run to Have Fun?

By Dr. Phil Maffetone

Two runners, two writers, one from The New York Times, the other from the Los Angeles Times. The one on the East or Right Coast wrote about pain; the one on the West or Left Coast blogged about having fun during a half-marathon. Both of their essays came out last week.

This seems like a perfect example of right brain vs. left brain. While I’ve never liked to use an oversimplified model of the brain, there’s enough truth in this notion to make an exception here.

The right side of the brain is more anxious and emotional; and pain is definitely an emotion that can make the bravest person cry like a baby. The New York journalist was obviously someone who relied more on her brain’s right hemisphere.

The left side of the brain is where more rational thinking takes place, and so one would expect that running should be pain-free and enjoyable. The Los Angeles journalist was clearly someone who depended more on her brain’s left hemisphere.

“Personal Best” fitness columnist Gina Kolata, writing in The New York Times (“How to Push Past the Pain, as the Champions Do”), emphasized—actually labored—about how and why running and pain go together. They are kissing athletic cousins. It was a "no pain no gain" article reminiscent of years gone by, encouraging runners to run through the pain like champions.

Too bad that The New York Times isn’t better censored—trusting young athletes to read her article and follow the pain principle by sacrificing their health for faster race times. Because accompanying the Kolata pain piece was a disturbing photo of a gifted, yet emaciated-looking female runner in great discomfort; the image is not for the weak of heart. This kind of news is unfit to print.

Kolata also quoted Mary Wittenberg, president of the New York Road Runners, which puts on the New York City Marathon, to highlight how painful running can be: “You can see it in the saliva-coated faces of the top runners in the New York marathon.”

Kolata’s running coach, former New York Marathon winner from the 1970s, Tom Fleming, confirmed the "no pain no gain" philosophy by telling her what his motto is, and was, during his racing days: “I was totally willing to have the worst pain. I was totally willing to do whatever it takes to win the race.” In other words, he was totally willing to beat the crap out of his body and sacrifice it for a slightly faster time.

It gets worst. I checked one of Kolata’s earlier columns. It dealt with a hamstring injury. Here’s what she wrote: “I don’t know why I got injured. It happened halfway through a seven-mile run. Suddenly, my left hamstring hurt so much I could not continue and could barely walk. But a couple of weeks later I could run again, putting up with a sort of chronic pain. I like to think that injuries will get better if you wait, but my hamstring pain wasn’t improving; sometimes I could hardly walk the rest of a day after a run.”

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I was born in the New York City borough of Brooklyn and spent much of my life in the area, including a complementary sports medicine practice for 20 years just north of the City. Much of that time was spent treating runners who tried adhering to the same "no pain no gain" philosophy and ended up with various injuries and frustration. New York is a great place, but it’s one of the highest stress areas of America. If you live there, you better be willing to cope with stress to survive.

Growing up in the 1960’s in New York meant dreaming about driving off in a Volkswagen bus to California, the flower power state of peace. It took me longer than expected, but eventually I moved to the Los Angeles area to pursue my music career. But then eventually settled in the mountains of Arizona where I now live.

A few months ago I got an email from Rene Lynch, editor and food writer for the Los Angeles Times. She was starting a blog on her training for the Long Beach half- marathon in October 2010, and wanted guidance from me. Her past history of trying to run the race was not good—pain and constant disappointment. Writing in her blog, she wrote “[I was] bedeviled by a nagging, compelling, overwhelming desire to lie on the couch and watch TV instead of working out. I also had a painful foot injury. I used it all as an excuse to take months and months off. Ugh.”

A former runner who has competed in 10 half and full marathons, Rene thought that there must be a better way to train and get through a race—not limping, not wasted, not in pain. That’s when she contacted me. “Running should be fun and healthy,” I emailed back. Not sacrificing your health for a bit more fitness has always been my motto to athletes, including myself. It was a rude awakening I experienced after crossing the New York City Marathon finish line in 1980. I detailed this in my new book, The Big Book of Endurance Training and Racing:

“All went well through the first ten miles. The excitement swept me along at a slightly quicker pace than I’d planned, yet I felt great. As expected, by fifteen miles I felt tired but was able to continue. Within the next couple of miles, however, I began to shiver. Despite drinking plenty of water, I felt dehydrated. And I was craving cotton candy. At eighteen miles, I stopped to check my feet. They were numb, and I wanted to be sure they were still there. ‘My hamstrings are cramping,’ I said out loud. Suddenly, I realized I wasn’t thinking rationally, and all I could remember was my goal to finish the race and prove to myself and others that I was healthy.

“Alarmed by how awful I looked, two paramedics tried to remove me from the course. But I wouldn’t let them. Somehow, I painfully fought my way onward. I have very little memory of those last few miles.

“A finisher’s medal was hung around my neck. I cried with joy over the ultimate success of passing my four-hour endurance test. But the next moment I discovered myself herded into the first-aid tent. It looked like a war zone. There were casualties all around me. Doctors and nurses were running in and out. Sick-looking runners lying on cots groaned in pain. Ambulances came and went. I thought to myself, ‘Are these people really healthy? And am I?’ I realized then that running the marathon had not proven my health at all. I was fit enough to run 26.2 miles. But clearly fitness was something quite different from good health.”

Rene Lynch finished the Long Beach half-marathon—pain-free, and all smiles. Here’s what she blogged: “For me, it was, by far, the easiest, most enjoyable, relaxed race I've ever run. “I felt like the gun went off, and next thing I knew, I was at Mile 11. I felt so great that when the race split off for the marathoners, I ever-so-briefly considered trying to do the whole thing. And then I came to my senses and stuck to the half-marathon course.

“But it was so easy that I'm going to try to do the Rock and Roll Marathon this coming Sunday if I can get registered at the last minute. Yes, that would be back-to-back half marathons, both done at the easy heart rate of 135 beats per minute that Dr. Phil prescribed for someone at my age and fitness level.

“Now, note that I haven't yet told you what my time was. There are a few reasons for that. One, I'm incredibly slow, and keeping my heart rate in check made me even slower, but Dr. Phil said to focus first on aerobic conditioning, and the speed would come. He brought me this far; I'm just going to trust in the rest.”

Congratulations Rene!

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It’s unfortunate that runners of the Kolata/Fleming masochistic mindset often don’t truly understand what pain is and where it comes from. If only they could experience the pleasure of healthy training. Then racing wouldn’t have to be so brutal; and injuries could be safely kept at bay.

Like with other endurance athletes, most pain that runners experience in the course of training and competition is due to some imbalance in the body. This kind of pain tells one that there’s a bad problem in the body that needs to be fixed. This “bad” pain is informing a runner that something is wrong. And, if the pain persists, is worsening, or causes undue distress, the runner should stop, and maybe drop out.

More importantly, runners should avoid even entering a race if their body is injured. Most runners already know of their pain-producing injury before the race start.
In May of 1984, I attended the men’s U.S. Olympic marathon trials in Buffalo, New York with an athlete I had trained who qualified for the event. I was standing near the starting line looking at the small pack of elite runners—178 of them, which looked like a small town road race—and when the gun went off, everyone took off fast. The lone exception was a runner who was hobbling, limping in severe pain unable to bear weight on his left leg. He was attempting to run but his slow limping gait only caused excruciating pain. I couldn’t bear watching, and walked out on to the course. All the other runners were long gone. As I approached him, he looked at me and said with a sad voice, “I was hoping for a miracle—I got injured a few weeks ago and have been unable to run.” I put my arm around him and helped him off the course.

It’s not like runners have not known about pain—and how to relieve it. I remember riding to the start of the New York City marathon in the early morning in 1980, on a bus rented by the Taconic Road Runners. I was shocked that, halfway there, people started passing around bottles of painkillers. It was reminiscent of Greenwich Village in the 1960s—please pass the drugs! Even though I was running, I passed on them. My comments about their dangers were ignored—“tradition is hard to break,” someone said.

This is really how runners think they’re coping with the pain experienced in a marathon. Got drugs? But what they don’t know, or won’t admit to in most cases, is that the cause of the pain is not a deficiency in aspirin or other non-steroidal anti-inflammatory drugs (NSAIDS) but some physical bodily imbalance. The most common problem is some type of muscle imbalance causing a joint, ligament, or other muscle to hurt. In many cases the problem is chronic and a chemical imbalance has also developed—hence, inflammation. Add the stress of race day and the fact that the majority of runners start too fast, beyond their athletic ability, combined with the stress of a partially broken body, and the result is increased pain.

Trying to numb pain with a drug, or listening to the “no pain no gain” mantra of “push through it” just makes matters worse. Physical ailments become more chronic, chemical problems worsen and risk of future, more serious damage rises. In many cases, going through this is too much of a strain, and millions have chosen to retire from sports and revert to being couch potatoes. In fact, runners have the highest dropout of any participatory sport.

Common drugs taken by athletes to mask pain include Advil, Aleve and aspirin. These NSAIDS suppress pain but don’t correct any of a runner’s problems. They may temporarily reduce some inflammation—in muscles and joints—while at the same time prevent the production of the body’s own natural anti-inflammatory chemicals necessary for recovery of a race.

More serious is that, if one is dehydrated, which most runners finishing a long event are, using NSAIDS can seriously affect liver function, and in some cases cause liver failure.

Despite these real health problems, companies that make these drugs have often sponsored marathons and other long endurance events, offering free over-the-counter drugs to all participants

The other type of pain a marathon, half-marathon, or 10K runner feels during a race, less so in training, is what I call race pain. It’s a “good” pain, the feeling the brain gets from the body when it goes just beyond our comfort zone during physical activity. This is not a sharp pain. It doesn’t cause one’s hamstrings to go into spasm or the hip joint to blow up with inflammation. It’s a more general pain associated with peak performance. All experienced athletes have felt this, and virtually everyone can deal with it, some better than others giving them the ability to push a bit harder.

Left Coast writer Rene Lynch wanted to avoid the experience of bad pain of muscle and joint problems—real injuries—and so she modified her approach. I suggested she train at a specific heart rate for easy training as well as have proper walking warm up and cool down procedures (this also meant no stretching.) It was really so simple that she later wondered how it could be this easy.

Right Coast writer Gina Kolata seems to be in love with bad pain. Some of her past articles inform readers of her ongoing quest seeking various recommendations or therapists in the hope of trying to find the magic-bullet treatment for her many ailments. She associates competitive sports with bad pain, confusing the commonality of injury as if it were normal. But with proper training, balanced food intake and the right lifestyle, she could help achieve the ultimate athletic feat—reaching her athletic potential without her body breaking down in the process.

So what will it be runners? Pain or pleasure? It’s your choice.