Previous studies of the Fear-Avoidance Model of Exaggerated Pain Perception have commonly included patients with chronic low back pain, making it difficult to determine which psychological factors led to the development of an "exaggerated pain perception". This study investigated the validity of the Fear-Avoidance Model of Exaggerated Pain Perception by considering the influence of fear of pain and pain catastrophizing on acute pain perception, after considering sex and anxiety. Thirty-two males and 34 females completed the State-Trait Anxiety Inventory, the Fear of Pain Questionnaire, and the Coping Strategies Questionnaire. Subjects underwent a cold pressor procedure and tolerance, pain intensity, and blood pressure reactivity were measured. Sex, anxiety, fear of pain, and pain catastrophizing were simultaneously entered into separate multiple regression models to predict different components of pain perception. Tolerance was not predicted by fear of pain, pain catastrophizing, or anxiety. Pain intensity at threshold and tolerance were significantly predicted by fear of pain, only. Blood pressure reactivity to pain was significantly predicted by anxiety, only. These results suggest that fear of pain may have a stronger influence on acute pain intensity when compared to pain catastrophizing, while neither of the factors predicted tolerance or blood pressure reactivity.

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Literature on the pain relieving effects of exercise has been reviewed several times. It is equally important to review the literature on the pain-inducing effects of exercise. Indeed, exercise professionals, health care providers, and exercisers must grapple with the fact that exercise can both induce and reduce pain. The objective of this review was to synthesize our current understanding of exercise-induced pain and inspire advanced research. We searched the PubMed database for publications since 2000 about healthy human participants. Disease-specific reviews of the effects of exercise are available elsewhere. The results of our literature review verified that many different modes, intensities, and durations of exercise can induce pain in healthy people. Another important point is that pain can occur within a few hours after eccentric contractions, which should be considered relative to the construct of delayed-onset muscle soreness. In addition, the studies supported that exercise can be painful in diverse muscle groups. Yet another point illuminated by the literature is that different pain measures do not always change in similar directions and magnitudes after exercise. Therefore, our review confirms that a wide variety of exercises can be painful--even for healthy people. We wonder how many exercise professionals and health care providers regularly and appropriately measure exercise-related pain or consider such pain in their exercise recommendations. We also question if exercise-related pain affects exercise behavior in healthy people as it has been shown to do in people with chronic illnesses. Additional research is needed to improve both exercise recommendations and exercise behavior.

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The purpose of this study was to examine evidence for the validity of a stages of change measure of the Transtheoretical Model for exercise behavior. Participants were 152 university students (53.3% women, 71.6% Caucasian, M age = 19.18 years) who completed processes of change, self-efficacy, decisional balance, stages of change, and exercise behavior questionnaires as well as a maximal treadmill test. Participants in the action and maintenance stages had the highest strenuous (PC/C/P < A/M) and moderate (PC/C < A/M) self-reported exercise behavior. Those in the maintenance stage had the highest estimated aerobic fitness (PC/P < MA). The differences between the early stages (PC, C, and P) and the later stages (A and M) as described by the first function were primarily due to the behavioral process of change. The differences between the extreme stages (PC and M) and the middle stages (C, P, and A) were due to the experiential processes of change and the pros of decisional balance. The hypothesized patterns of stage differences were partially supported. Failure to obtain full support may have been due to methodological issues or inherent difficulties in detecting evidence for the validity of stages of change measures.

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There is uncertainty about sex differences in exercise-induced muscle pain and muscle damage due to several methodological weaknesses in the literature. This investigation tested the hypothesis that higher levels of exercise-induced muscle pain and muscle damage indicators would be found in women than men when several methodological improvements were executed in the same study. Participants (N = 33; 42% women) with an average age of 23 years (SD = 2.82) consented to participate. After a familiarization session, participants visited the laboratory before and across four days after eccentric exercise was completed to induce arm muscle pain and muscle damage. Our primary outcomes were arm pain ratings and pressure pain thresholds. However, we also measured the following indicators of muscle damage: arm girth; resting elbow extension; isometric elbow flexor strength; myoglobin (Mb); tumor necrosis factor (TNFa); interleukin 1beta (IL1b); and total nitric oxide (NO). Temporary induction of muscle damage was indicated by changes in all outcome measures except TNFa, and IL1b. In contrast to our hypotheses, women reported moderately lower and less frequent muscle pain than men. Also, women’s arm girth and Mb levels increased moderately less than men’s, but the differences were not significant. Few large sex differences were detected.