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There is a paucity of research examining exercise-induced pain (EIP) management in elite endurance sports. The purpose of this study was therefore to investigate how elite endurance athletes experience and manage EIP to help inform the work of Mental Performance Consultants. Individual semi-structured interviews were conducted with 12 female and three male athletes ( M age = 23.73,  SD  = 2.31) competing in track and field (i.e., 600–1,500 m;  n  = 5), swimming (i.e., 200–400 m;  n  = 5), and canoe kayak (i.e., 500–1,000 m;  n  = 5). Given the centrality of self-regulation in elite sports and in the management of internal states (e.g., EIP), the social cognitive model of self-regulation was used to guide this study and to derive practical implications. The template analysis generated (a) two themes (i.e., sensations, beliefs) and six subthemes (e.g., tightness, progressive) related to the experience of EIP as well as (b) three themes (i.e., preparation, execution, evaluation) and 17 subthemes (e.g., accept and commit to EIP, direct attention away from EIP, reflect using a training journal) related to the management of EIP. Findings suggest that the experience of EIP is highly cognitive and generally perceived as detrimental to performance if not effectively managed. Athletes used several psychological strategies to prepare to experience EIP, reduce the aversive effects of EIP while performing, and learn from their EIP management strategies to improve their coping capacity. Importantly, combining self-regulation and mindfulness strategies appears to be valuable to successfully manage EIP. Lay summary:  This study examined how elite track and field, swimming, and canoe kayak athletes experience and manage exercise-induced pain when training at a high intensity and competing. Beliefs and sensations influenced the experience of EIP and athletes used 17 psychological strategies to manage this prominent psychological demand. Mental Performance Consultants are encouraged to:Emphasize the development of preparation strategies to manage EIP as this phase seems to be a priority. Specifically, accepting and committing to experiencing EIP appears to be essential.Help endurance athletes focus on performance-relevant cues (e.g., cadence, technique, relaxing, race plan) and the present moment (e.g., one repetition/segment at a time) when experiencing EIP.Develop a brief guided self-reflection tool that endurance athletes can use to assess the experience and management of EIP. Emphasize the development of preparation strategies to manage EIP as this phase seems to be a priority. Specifically, accepting and committing to experiencing EIP appears to be essential. Help endurance athletes focus on performance-relevant cues (e.g., cadence, technique, relaxing, race plan) and the present moment (e.g., one repetition/segment at a time) when experiencing EIP. Develop a brief guided self-reflection tool that endurance athletes can use to assess the experience and management of EIP.

How elite endurance athletes experience and manage exercise-induced pain: Implications for mental performance consultants