For the Olympic athlete, dealing with pain is a brain game

On an injured ankle, Kerri Strug had to not only land a vault but also run 75 feet first in 1996 in Atlanta. Mike Powell/Getty Images

It's hard to know what world-class swimmers are feeling from looking at them power through their races lap after lap. Most of them betray so little when they hit the final wall, other than urgency to see their time and where they finished. The same goes for reading the expressions of plenty of other Olympic athletes. Boxers and judoka understandably grimace when hit, weightlifters scream when they hoist bar-bending weights, and plenty of distance runners' faces betray the agony they're in.

But other athletes are the picture of serenity or stoicism as they compete. You know it can't be that easy, right? The poker-faced endurance of pain is the Big Lie of sports.

At a news conference earlier this year, a handful of U.S. Olympic swimmers were asked to describe what they're thinking as muscle-burning fatigue overtakes them during a race. Four-time Olympic medalist Missy Franklin joked "lifeguard?" Defending gold medalist Ryan Lochte squeaked "help!"

But many athletes say absorbing pain and fatigue -- or refusing to acknowledge they exist at all -- is something that's practiced, not just inherent.

Sixteen-year-old American gymnast Laurie Hernandez, a first-time Olympian, said the six-hour daily workouts that elite gymnasts endure are grueling, bone-rattling, muscle-searing and all the rest. Their hands are callused, and their shins hurt.

"But the bottom line is, if you want to go to the Olympics, you're going to do the training," Hernandez said with a nonchalant shrug.

End of story.

Still, it's hard to not be amazed at the sight of Greg Louganis cutting his head on the edge of the diving board but coming back to win the 3-meter springboard gold medal at the 1988 Olympics, or by the memory of 4-foot-9 gymnast Kerri Strug making her dramatic second vault on an injured ankle at the 1996 Atlanta Olympics because she thought the U.S. had to have a strong score from her to win its first team gold medal.

Twenty years before Strug's feat, Japanese gymnast Shun Fujimoto made a similar decision. He kept competing after he broke his kneecap in the floor exercise, his second of five events in the team competition at the 1976 Montreal Olympics. Fujimoto decided to not tell his teammates about the injury because they were in a tight race against Russia for the gold medal. For years, ABC Sports ran a replay of him in its "thrill of victory, agony of defeat" mashups. It showed Fujimoto nailing the landing of his triple-somersault dismount on his last event, the rings, then buckling over in pain and willing himself to stand up straight.

Remarkably, his score of 9.7 was his best ever on the rings, and Japan won the gold medal.

The stakes were thought to be similarly high for Strug in '96, after American teammate Dominique Moceanu performed her two vaults just before Strug.

"When Dom fell the first time, I thought, 'No, I can't believe it. She never falls,'" Strug recalled that night. "Then she fell a second time, and it was like, 'Forget this. This is a nightmare.' My heart was beating like crazy, knowing that it was now up to me."

The pressure got worse when Strug fell on her first vault, landing on her butt and badly spraining her ankle. The .897-point lead over Russia that the U.S. took into the final event really seemed in jeopardy as Strug hobbled back to the starting position. Most of the Russian team stopped to watch. No one -- including Strug -- was sure she could run down the 75-foot runway to do her second attempt. But she never considered not trying.

"As I started running toward the vault, my ankle felt displaced and unstable [and] I remember thinking I was going to trip and fall on my face," Strug recalled to espnW a few weeks ago. "I don't remember the vault itself, but when I landed, I didn't think I'd done anything special. I was supposed to land the vault. Anything else would have been unacceptable."

She stuck the landing but later learned that the sound she heard were two ligaments in her ankle snapping. Nonetheless, her score of 9.712 allowed the U.S. to break Russia's stranglehold on the women's team gold medal that dated to 1948 and left the crowd at the Georgia Dome chanting her first name.

"In that moment, all the years of doing one more vault when I was too tired or sick or didn't want to perform another rep paid off," she said.

Plenty of athletes -- not just gymnasts -- talk openly about taking risks such as that and about how their sports can result in injury, paralysis or even death. (On Saturday at the Olympics, French gymnast Samir Ait Said broke his left leg while attempting a vault in qualifying and was carried off on a stretcher; several reporters in the arena tweeted that they heard his bone snap.)

Jillion Potter, a member of the U.S. sevens Olympic rugby team, wasn't thinking in such fatalistic terms before she took a hit and felt something had gone grievously wrong in a test match against Canada six years ago.

"It was a freak accident, really," she insisted.

She later found out she had broken her neck.

"Once I was hit, my neck popped so many times -- pop, pop, pop, really loud -- I just remember laying there on the field. I could move and everything seemed fine, but I just remember telling my teammate, 'Jane, something's really wrong with my neck. I'm scared. I don't know what to do,'" Potter said at the U.S. Olympic Media Summit this spring.

As it turned out, she needed spinal fusion surgery on her C-5 vertebrae. Doctors eventually told her she could play again, but her rehab took more than a year. Even then, her suffering wasn't over. In August 2014, she was diagnosed with a rare form of cancer. She underwent chemotherapy and treatment until March 2015 and lost all her hair.

Still, Potter made it back in time for Rio and was voted team captain by her peers.

"It's so much more about the psychological piece, not just the physical piece," she said of her comebacks.

With cancer, she said, the toughest thing was telling her mom about her diagnosis. With rugby, it was grappling with the fear that rugby sevens has potentially higher velocity collisions than the 15-person-per-side version of the sport because there's more open space.

"I had to get confident in my tackling and contact during play again and not play tentatively because that can be dangerous," Potter said.

Dwelling on such things is to be avoided. Scientists who study pain seem to agree on that.

One of the more oft-quoted findings on athletes and pain was done by University of Heidelberg researchers who looked at 15 studies that examined pain thresholds in athletes and non-athletes for an article that appeared in a 2012 edition of the journal Pain. Two of their conclusions: Contact sport athletes tend to have a higher tolerance than other athletes, and athletes, as a group, often rely on cognitive strategies, including big doses of association/disassociation, to help them deal with pain.

"It's very funny because outside of a match .... or we'll be training and I'll be like, 'Owwww! You hit my leg!' I'm such a baby sometimes." Taekwondo competitor Jackie Galloway

Jackie Galloway, who will compete for the U.S. in the +73kg taekwondo competition in Rio, joked that she has the disassociation part down.

"It's very funny because outside of a match, I'm like, "Oh no, I tripped and bruised my leg! Ugh!' or we'll be training ,and I'll be like, 'Owwww! You hit my leg!" she said with a laugh. "I'm such a baby sometimes."

She changes into a different person during a match.

"I think my pain tolerance is just really higher during the match because that's not what I'm really focusing on. My mind is in other places," she said. "I already know going in there's a possibility and a great probability that I'm going to get hit on my arms, on my legs. As far as feeling pain, probably one of the worst times was during one of my matches when I broke my hand. There was like a minute and a half left. I got it kicked, and yeah, it hurt. But I didn't even know it was broken 'til afterward. I wasn't even thinking about it 'til then."

Judoka Kayla Harrison and 100-meter hurdler Dawn Harper-Nelson, a two-time Olympic medalist who just missed making her third Olympic team this year, have a slightly different pain coping mechanism: They reframe what the discomfort means when it hits them in wave after wave, day after day, and use it as motivation.

Harper-Nelson, who trains in Los Angeles under legendary taskmaster Bobby Kersee, said, "Last year, when I took a tumble at worlds [and didn't finish], I was sitting there crying. But pretty soon I was also [yelling], 'USE IT! USE IT!' ... I think, as an athlete, you have to do that. I mean, you didn't train for nothing, right? So cry. Let it out. Ruin your clothes. Rip your shirt up. Do what you gotta do."

Harper-Nelson decided to put her bib from that race on her wall as a reminder that, "Pain is just part of the journey you go through, you know?"

Has that helped?

"It helps when you're out there on the track training, and you have to remind yourself of that because you are hurting," she said. "Your legs are shaking. You literally can't feel them. You're tripping over yourself because your legs have literally gone numb, and your coach is still like, 'I don't care. Get on the line. If you want to win a medal, get on the damn line.'

"And you're like, 'That's right. That's right. The pain doesn't matter. I have to do it up here,'" she said while tapping a finger to her temple.

"But you know," Harper-Nelson added with a smile, "that's why when you do get on the [medal] podium, those are the moments you think about: 'My legs were numb. ... I cried at night. ... I didn't eat ice cream for three years!' You know? You think about all of that. And that's why you break down. That's why you cry. The way I look at it is I'm so excited to have this ability that I have to go charging at 10 hurdles and look up at the end and say, 'Who got it? Who won?' The feeling is like, 'God, track and field is amazing! The Olympics are about amazingness!'"

Harrison agrees. She's the only American to ever win a judo gold medal, and she's a favorite in Rio in the 78kg weight class. But like Harper-Nelson's, Harrison's journey hasn't been easy.

Four months before the 2012 London Olympics, Harrison tore the medial collateral ligament in her right knee and still won. Earlier this year, she separated her shoulder a week before a Grand Slam meet in Tokyo, one of the toughest events in the world, and had to decide what to do.

"I wasn't sure I was going to fight. I didn't want to fight. I didn't need to fight," she said. "But my coach looked at me and said, 'This is about you. Your legacy. Are you tough enough? Are you willing to go out there? You're not going to make it worse, but you're going to be in pain. What if this were the Olympics?'"

"I would be fighting!" Harrison answered. "This is my one day every four years. You don't get another shot."

She competed in Tokyo after that conversation. She won her event.

She's proud to be the first American to capture a title at that prestigious competition, and she expects that pushing herself like that will help her overcome anything she might encounter in Rio.

"If I wake up on Aug. 11 with a separated shoulder, I know I'm still going to win because I did it in Tokyo," she said. "And that's the kind of thing that makes me realize pain is just a feeling. It's just like feeling fat. It's just pain, you know?"

That said, even battle-toughened Olympians such as Harrison have their limits.

When asked if she might hang on for the 2020 Summer Games, Harrison burst out laughing and said, "I'm crazy, but I'm not a masochist."