The Tribune

By Dr Kent Bazard

IN the world of youth sports, pain is often misunderstood — brushed off as a badge of honour, feared as a sign of weakness, or misread as proof of serious injury. But not all pain is created equal. And for young athletes trying to balance school, sports and growth, understanding pain can make all the difference between recovery and regret.

What Is Pain — Really?

Most people think pain means something is broken. But science tells us that pain is far more complex. Pain is not just a reaction to tissue damage — it’s a signal generated by the brain, interpreting danger based on a variety of inputs.

Sometimes the signal is accurate, like a twisted ankle. But other times, pain lingers even after healing, or shows up in places that haven’t been injured. This is why two athletes can have the same injury, but very different pain experiences.

Two Types of Pain 

in Sports Medicine

Doctors typically classify pain into two main categories:

1. Input-Dominated Pain

This is the type of pain most people are familiar with. It comes from actual tissue damage — muscle strains, ligament sprains, bruises, or bone injuries. It’s usually short-term and improves with appropriate rest and rehab.

2. Centrally 

Dominated Pain

This type is less about the injured tissue and more about how the nervous system and brain process pain signals. It can stick around long after the body has healed and is often made worse by stress, anxiety, poor sleep, or even negative language (like being told your spine is “worn out”).

When left unaddressed, input-dominated pain can evolve into centrally dominated pain — creating a cycle of chronic discomfort and missed time from sport.

When the Pain Isn’t 

Where the Problem Is

Pain can also be misleading. An athlete may feel hamstring tightness, but the root cause could be nerve tension from the lower back. 

A sore shoulder could be driven by neck dysfunction. This is called referred pain, and it highlights the importance of whole-body assessments — not just treating where it hurts.

How Pain 

Changes 

Movement

When young athletes are in pain, their bodies naturally try to protect the area. This leads to changes in movement — limping, guarding, or overusing other muscles. Over time, these compensations can create new injuries or slow recovery. This is why effective rehab focuses not just on pain relief, but also on restoring normal movement patterns and retraining the nervous system.

Tools for Safe 

and Smart Pain 

Management

Managing pain properly doesn’t mean avoiding all discomfort — it means recognising the difference between harmful and helpful pain. 

Here are key principles:

Assessment First: Accurate diagnosis is crucial. This includes ruling out serious injuries, evaluating nerve involvement, and considering central pain features.

Pain Education: Teaching young athletes how pain works reduces fear and speeds recovery.

Movement Therapy: Graded exercise, starting below pain thresholds, helps rewire protective patterns and restore confidence.

Positive Language: Words matter. Avoid labels like “torn,” “worn out,” or “degenerating,” especially with youth. Instead, use empowering phrases that promote healing.

Supportive Environment: Sleep, hydration, stress management, and mental health support all play a role in recovery from pain.

When to Seek 

Medical Advice

While most minor sports-related pain can be managed with proper guidance, there are red flags that warrant medical evaluation:

• Pain that persists or worsens over time

• Pain accompanied by weakness, numbness, or tingling

• Pain that disrupts sleep or daily activity

• Pain following a traumatic injury (e.g., fall, impact)

• Pain with swelling, fever, or unexplained fatigue

The Takeaway

Pain is not the enemy — fear, guesswork, and misinformation are. By helping youth athletes understand that pain is a communication tool, not a verdict, we can guide them toward recovery that is not only faster, but smarter.

It’s time we stop telling young athletes to “push through the pain” — and instead, teach them how to listen to it, learn from it, and come back stronger.

• Dr Kent Bazard, sports medicine physician at Empire Sports Medicine, specializes in ensuring athletes reach their peak performance safely. With extensive experience and a passion for sports health, Dr. Bazard provides insights and guidance for athletes of all ages - men and women.