Monday, June 13, 2011

Between Petzschner’s back and Fognini’s leg

A few years ago I read about a study that found no differences in the pain complaints of two groups of people – one with and the other without anatomical back injuries. The conclusion was that for many people the experience of pain is at least partly psychological. We now know that negative emotions such as anger and distress keep the pain gate wide open, allowing pain signals to make their way through the spinal cord to the brain centers that process pain. The result can be a worsening of pain experiences under conditions of excessive negative emotion.

It is possibly the recognition of this psychological component to the experience of pain that has lead one of the Army’s leading research hospitals to explore alternative ways of treating pain among combat survivors. I read today that Walter Reed has reduced from some 80% to around 12% the percentage of injured soldiers who are taking narcotics and other addictive medication for pain management. Instead soldiers are being offered such complementary and alternative treatments as hypnosis and biofeedback to manage their pain. This is a wonderful development in the world of pain treatment.

I found myself thinking about this issue –the psychology of the experience of physical pain – over this past weekend as I watched the aborted match between Germany’s Petzschner and Kohlschreiber. Among the ironies of this match is that both men are named Phillipp, and both played scintillating tennis for one set. The match was so tight that the first set came down to a nail-biting tiebreak that was too close to call all the way to the finish. Phillipp #1 delivered some blazing first serves which Phillipp #2 matched with equal fire. Really, for the first set, the players were interchangeable.

And then Petzschner requested and received treatment for his aching back. I thought nothing of it at first. After all, this was the same Petzschner who had taken out my newbie love, Milos Raonic (seeded # 8, huzzah!), as well as the formidable Tomas Berdych, to reach the final. There was no way he was going to lose this match! Then Petzschner got broken in his first serving game of the second set. And then he retired. And just like that a match that I was truly enjoying was unexpectedly over. I didn’t see it coming.

I found myself asking the TV if Petzschner would have retired if he had won the first set. Isn’t it amazing how increasingly likely it seems to be that players will retire from matches that they are clearly losing? If there is a chance in hell of winning, the same injured player will be seen hanging in there, playing for dear life, confident that if he keeps hitting out he can close the deal.

This I believe is what Fognini may have experienced in that insane match against Montanes at Roland Garros. With one leg cramping and barely able to keep his big-assed feet off the service line, Fognini started playing out of his mind. Buoyed by the positive emotions of his supporters in the crowd, Fognini just kept lashing out until poor Montanes just did not know what to do.

But I can’t help but wonder if Fognini’s pain suddenly became more unbearable the following morning when he started contemplating the fact that his next opponent was going to be Novak Djokovic. There’s probably nothing like the anxiety around facing a formidable opponent to inspire you to call in sick.

My point is that the experience of pain can be affected by the psychological circumstances facing the player. Once a set or two is lost and the player has to come from behind, he may find himself becoming aware of being in much too much pain to continue. There is no doubt in my mind that there is a psychological aspect to this – which is that the negative emotions of disappointment, fear, and frustration can in the moment augment the pain experience and make it intolerable. Could this be what happened to Petzschner? Why don’t I let him speak for himself?

“Both of us played solid tennis, we both served really well. And then out of the blue I’m serving and I notice that something is wrong. The more balls I hit the more obvious it became that I couldn’t finish the match like this. Not on a normal level anyway, I could have just stood in court, but that doesn’t make any sense. Maybe I would have really hurt myself then, or something really bad happens that costs me another eight or 10 weeks.” (emphasis mine)

Please understand that I am not accusing these players of consciously or deliberately cheating – although this may be very true in some cases. I believe that for many players, all they may become aware of in the moment is that their physical pain has out of the blue become unbearable. I can’t help but wonder if this is what (out of the blue) happened with Petzschner’s back after he lost that first set to his countryman. We may never know.

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