Carroll: Palmer, Addai and Giants

Jim Mora said that Jerious Norwood didn't understand the difference between pain and injury. He's not alone; I've heard variations on that theme in sports since I was 13 and it was me who'd just dislocated a finger. Nothings going to change about the macho, pain intolerant sports culture, but perhaps we can understand what the difference actually is between pain and injury. I talked with one of the top neurologists in the country, Dr. Vernon Williams, and asked him what the difference was.

"It's really the result of complex interactions that may begin where the tissue damage has occurred, but involve other things that affect the emotional response to the signal, therefore affecting how the person experiences pain. A person's culture affects pain. A person's attention affects pain. A person's mental understanding of their symptoms affects pain. A person's mood affects pain. And there are other influences. For example, an athlete's pain intensity (how they would describe the severity of pain they are experiencing; their emotional response and the extent to which they are suffering from the tissue injury) will be different because of the emotional context if they are playing in the Super Bowl compared to if they are playing the last game of the season on a non-playoff team. Pain signals will be interpreted differently (and consequently the athletes ability to perform) if he knows that he has a sprain and not a complete tear.

"Our culture's expectation of and celebration of the athlete as "warrior" will affect the emotional and modulating components of the pain pathways in such a way as to enable an athlete to overcome some sensory signals and continue to compete despite h sensory signals from tissue damage. Pain is sensory and emotional and subject to modulation based on a number of factors, including many that have nothing to do with the extent of tissue injury or degree of sensory signals being sent from the site of tissue damage or in many cases perceived damage." In other words, everything affects pain and expecting something more can lead to the type of long-term consequences and short term careers we see in NFL players. Something to keep in mind as we get to the injuries: