Sports Medicine

, Volume 48, Issue 3, pp 525–537 | Cite as

Endurance Performance is Influenced by Perceptions of Pain and Temperature: Theory, Applications and Safety Considerations

  • Christopher John Stevens
  • Alexis R. Mauger
  • Peter Hassmèn
  • Lee Taylor
Review Article


Models of endurance performance now recognise input from the brain, including an athlete’s ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use.


Compliance with Ethical Standards


No sources of funding were used to assist with the preparation of this article.

Conflict of interest

Christopher Stevens, Alexis Mauger, Peter Hassmen and Lee Taylor declare that they have no conflicts of interest relevant to the content of this review.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2017

Authors and Affiliations

  1. 1.School of Health and Human SciencesSouthern Cross UniversityCoffs HarbourAustralia
  2. 2.Endurance Research Group, School of Sport and Exercise SciencesUniversity of KentKentUK
  3. 3.ASPETAR, Qatar Orthopaedic and Sports Medicine HospitalAthlete Health and Performance Research CentreDohaQatar
  4. 4.School of Sport, Exercise and Health SciencesLoughborough UniversityLoughboroughUK

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