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School of Health

Resilience in Motion: What Ultra-Endurance Athletes Reveal About Coping with Pain

I’ve had the privilege of working alongside my esteemed colleague, Dr. Carole Paley—currently based at Leeds University—for many years. Together, we’ve explored the outer boundaries of conventional pain research, publishing on topics ranging from medieval pain to salutogenesis, mindfulness to acupuncture, and metabolic syndrome to cancer-induced bone pain.

This week, we’re excited to share our latest contribution: a review article titled "Human Resilience and Pain Coping Strategies: A Review of the Literature Giving Insights from Elite Ultra‑Endurance Athletes," published in Sports Science, Medicine and Society—available here.

Professor Mark Johnson

So what’s it about?

Elite ultra-endurance athletes push their bodies and minds to the limit, enduring intense pain, fatigue, and harsh environments. Our article explores how they manage such extreme discomfort—and what we can learn from them. These athletes combine physical conditioning with psychological resilience, using strategies like mindfulness, emotional regulation, and body awareness to stay focused and keep going. Interestingly, many of the same techniques are used by people living with chronic pain. Both groups benefit from accepting pain, reframing it, and using mental strategies to cope. But there’s a key difference: ultra-endurance athletes often see pain as part of the reward, a sign of progress and achievement, rather than something purely negative. This mindset shift, along with a strong sense of control, helps them perform under extreme stress.

We believe that understanding how elite athletes mentally manage extreme pain can offer real value for people living with chronic pain. By drawing on strategies like mindfulness, cognitive reframing, and resilience training, individuals can feel more in control, build tolerance, and improve their overall well-being.

Resilience in Motion isn’t just what athletes embody—it’s a mindset that could transform how we live with and manage pain.

Dr Carole A. Paley PhD presents a research talk titled "Human resilience and pain coping strategies: insights from the experiences of elite ultra-endurance athletes" at a lecture hosted by the University of Leeds and Leeds Beckett University. A presentation slide with university logos is displayed in the background.

Professor Mark Johnson

Professor / School of Health

Mark Johnson is Professor of Pain and Analgesia. Mark is an international expert on the science of pain and its management and the world leader on transcutaneous electrical nerve stimulation (TENS). He has published over 300 peer reviewed articles.

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