On 12th April 2026, I will be running the London Landmarks Half Marathon, raising money for Pain Concern.
It might seem like an odd choice for someone who spends much of her professional life helping people reduce pain. Considering I haven’t run this far since 2013, why voluntarily induce sore calves, tight hips and the particular existential negotiation that occurs around mile eight?
Because training for a half marathon is a living laboratory in how the brain interprets sensation. And that is precisely what persistent pain is about.
Pain, Prediction and the Protective Brain
When we run long distances, discomfort is inevitable. The muscles fatigue. Breathing deepens. The body signals effort.
But what determines whether that sensation feels manageable or alarming is not the tissue alone — it is the meaning attributed to it.
The brain is always predicting.
Is this safe?
Is this threatening?
Should I protect?
During a long run, if I interpret heavy legs as damage, my body tightens. My stride shortens. Effort increases.
If instead I understand the sensation as exertion — intense, but not dangerous — my system settles. The same input. A different output.
Persistent pain operates in a similar way.
The nervous system, having learned threat, can become exquisitely protective. Sensation becomes amplified. Neutral signals are interpreted as warning. The system errs on the side of caution.
From a survival perspective, this is intelligent.
From a quality-of-life perspective, it can be devastating.
Training the System, Not Fighting It
When preparing for 13.1 miles, I don’t attempt to overpower my physiology. I train it.
Gradually increasing distance. Building recovery in deliberately. Respecting the need for adaptation. There is no benefit in running the full distance in week one. My system would simply revolt.
With persistent pain, the same principle applies.
Boom-and-bust cycles — overactivity on “good” days followed by flares — are often attempts to reclaim normality quickly. Understandable. Human.
But the nervous system does not respond well to volatility.
It responds to predictability.
Pacing is not weakness. It is regulation.
It is teaching the brain that activity is survivable.
The Voice in the Middle Miles
Around mile eight, something interesting happens.
The body is working. Fatigue is present. And the mind begins to narrate.
“You’re not built for this.”
“You could stop.”
“This is too much.”
Sports psychology has long recognised that self-talk alters performance. But the mechanism is not mystical. It is neurobiological.
Threat-based thoughts increase vigilance. Vigilance increases muscle tension. Tension increases perceived effort.
In persistent pain, the internal commentary can be even more unforgiving:
“My body is broken.”
“This will never improve.”
“I can’t cope.”
These thoughts are not chosen. They arise from lived experience. But when fused with them, the nervous system hears danger.
One of the most powerful interventions in pain management is not positive thinking. It is cognitive flexibility.
“This is hard” is different from “This is catastrophic.”
“This is uncomfortable” is different from “This is unsafe.”
The distinction matters.
Acceptance and Athleticism
There is a moment in distance running where resistance makes everything worse.
The more I argue with the fatigue, the heavier it feels.
Paradoxically, when I allow it — when I acknowledge “yes, this is uncomfortable” without adding a layer of alarm — the system softens.
Acceptance is often misunderstood in the context of chronic pain.
It is not resignation.
It is not liking pain.
It is not abandoning hope.
It is the decision to stop organising life entirely around the avoidance of discomfort.
Athletes do not wait to feel perfect before they compete.
People living with persistent pain cannot wait to feel pain-free before they live.
The work is learning what is safe to carry.
Identity and Capability
Training quietly shifts identity. I no longer think, “I’m not really a runner.” I think, “I am someone who trains.” That subtle shift changes behaviour.
In persistent pain, identity can constrict:
“I’m unreliable.”
“I’m fragile.”
“I’m limited.”
Part of rehabilitation is expanding identity beyond pain.
Not denying it.
Not minimising it.
But refusing to let it define the entirety of self.
The brain responds to who we believe we are.
Why am I running for Pain Concern?
I’m running in support of Pain Concern because persistent pain remains widely misunderstood. It is often invisible. Frequently minimised. Sometimes framed as purely structural when the science tells us it is far more complex.
Throughout my career I have always used and shared the accessible, evidence-based information that Pain Concern provide. It’s massively important because…
Education reduces fear.
Understanding reduces stigma.
Connection reduces isolation.
All three influence the nervous system.
On Race Day
There will almost certainly be a moment during the London Landmarks Half Marathon when my brain suggests stopping.
In that moment, I will do what I encourage my patients to do, when I see them in my pain psychology either online or in my clinic in Milton Keynes –
Pause.
Breathe.
Notice the story.
Distinguish discomfort from danger.
Take the next step.
Not heroically.
Not dramatically.
Just deliberately.
Because whether we are running 13.1 miles or living with persistent pain, the principle is the same:
The nervous system can learn.
It learns through experience.
Through repetition.
Through safety.
If you would like to follow my training journey, head to my facebook page