# Mental Pain Responses of Ultramarathon Runners: A Scoping Review

## TL;DR

This review explores how ultramarathon runners mentally respond to pain and how these responses may affect their performance.

## Contribution

The study provides a structured synthesis of mental pain responses in ultramarathon runners using a scoping review approach.

## Key findings

- Ultramarathon runners use both associative and dissociative thoughts to manage pain.
- They are less harm avoidant and anxious about pain compared to the general population.
- Cultural discourses within ultra-running influence their mental responses to pain.

## Abstract

Ultramarathon runners experience pain during the race. Their mental responses to pain influence race performance. This scoping review synthesises the existing literature on the mental pain responses of ultramarathon runners. The framework of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for scoping reviews (PRISMA-Scr) was followed. We screened four online databases, obtaining 121 non-duplicate publications. We filtered these publications to eventually include seventeen research articles. Results were structured according to four overarching categories: thought processes, psychological traits, pain expectations, and cultural discourses. Ultramarathon runners have both associative and dissociative thoughts in response to pain. They are less harm avoidant and less anxious about pain than the general population. They expect and accept pain. Their mental pain responses are modulated by ultra-running discourses. While mental pain responses of ultramarathon runners have been moderately described in the literature, their effects on race performance remain largely unknown. This represents an exciting opportunity for future research.