Hollywoodynia: why soccer hurts so much

The pain of a bad performance. PICTURE / GETTY IMAGES

Why does football cause so much pain?
Pain is a shared human experience. It is the outcome of a collection of messages from outside our brain, which when run through a few cerebral transmogrifiers and relay stations, become a full-blown production, either to the magnitude we might describe as Hollywood, down to the quiet disquiet, which might be more "off Broadway".

It is this Hollywood variant of pain that perplexes me. It is peculiar as it is almost exclusively found to occur within a 120m x 90m rectangle, and can occur in 22 individuals at any given moment within a mystical time frame of 90 minutes, give or take a few extra minutes for time taken probably in the experience of the same Hollywoodynia.
Of course you instantly know that this phenomena is a magical component of that game we all tolerate in this land of ours, Association Football.

I happened to witness the four-yearly event that is New Zealand's attempt to jump through the near impossible hoop of FIFA qualification for the tournament that is the jewel in the crown of the beautiful game, New Zealand (122nd in the world) vs Peru (10th in the world). For my first physiological evidence for Hollywood type pain on the football pitch, surely it must be the psychological yoke that is Oceania's 0.5 guaranteed spot in the World Cup.

The angst and catastrophic thinking engendered by this outrage and unfairness must surely linger in All Whites players' minds.

I might explain to the uninitiated or rugby lovers, that in order to qualify for the World Cup, the All Whites must not only win their division, but then go on to play a team from a division that is so stacked with top 20 teams and former cup winners, that it is only outrageous to our own populace.
Surely if you win your regional competition you have more right to be at the World Cup than the fifth place losers of another? I digress, and I am indeed manifesting my own pain.

Catastrophic thinking, harboured ill-feeling and a sense of injustice are all key contributors to the pain experience. The relay station to the brain is made more sensitive by psychological modifiers, and so perhaps the All Whites enter the fray with up-regulated, centrally sensitised nervous systems.

This is then a pain amplifier of boy racer proportions and is my first thesis for the cause of Hollywood pain, within the confines of the football arena.
The second explanation for footballers succumbing to on field pain and suffering may lie in the highly evolved sub group of humanity that is the footballer.

Just as Darwin witnessed variety amongst a species of Galapagos Finches, so too if you look closely, might you see macro evolutionary change within footballers. This hypersensitivity to pain is so highly attuned that in many cases, you will see a player tripped up by the air eddy currents of an opponent's moving leg.

I wish David Attenborough would set up his slow motion cameras and investigate this as I believe he would make the most venerable VAR (video assistant referee) and go on to make a compelling documentary season for the BBC with all the footage.

Of peculiar interest to me is the major loss of balance and proprioception that these enhanced humans experience in the penalty box. Something about the extreme ends of the oblong shape of the pitch makes these subjects very unsteady in this zone.
It is testament to their skills that they can remain upright very often at all.

Perhaps this loss of sensation and balance is then overcompensated by the pain enhancements. Melzack and Wall put forth the theory of pain known as the gate theory.
Simplistically, when you smack your thumb with a hammer, if you rub it furiously, you may beat the danger message to the brain travelling along slow conducting nerves, by stimulating fast Bugatti Veyron sensation nerves, closing gate to pain if you will.
When you see a Peruvian player rolling around from a glancing blow from an All Whites shirt, perhaps you are seeing a pain gate phenomenon in action.
Just as you rub your thumb, perhaps if you make as much contact with the ground aka breakdancer, you will spare the agony of the abrasion from silky football strips. This is a third proposition to Football Hollywoodism.

Pain can be magnified in cases of workplace injury or overuse.
Can you imagine how you might feel if you were going to lose your modest pay packet of several hundred thousand dollars a week through worksite injury (ie, during the game). Perhaps again, through the biopsychosocial model of pain, a trifling fall may enact thoughts of work insecurity, creating an overwhelming threat value, thus giving the poor footballer a 20 out of 10 level of pain.

All of these theories do not explain fully the rapid recovery that these players experience, going through childbirth like pains over maybe one minute, followed by full recovery.
Perhaps you might theorise again that these powers are mutation of the human genome, and if so I could point you to several Marvel franchise films on the topic. For now, we cannot clearly know fully what is going on within that 11,000 square metres.
If I can say anything to this blossoming field of scientific endeavour, I would say that our own All Whites seemed slightly more immune to Hollywoodynia than just about every other country, so perhaps we may hold the key to an antidote, or dare I perhaps hope for a cure?

Footballers' pain sensitivity may hold the key to solving many normal human illnesses, so I for one will not be discouraged by live studies on particular variants, such as the Joey Barton strain, or the Diego Maradona mutation, or even the Besart Berisha anomaly.

For now, all we can do is watch and feel the strongest empathy for these brave heroes who are indeed suffering greatly for our enjoyment.

Greg Bell is a physiotherapist practising at Bell Physiotherapy. www.bellphysio.co.nz