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Mental Pain Responses of Ultramarathon Runners: A Scoping Review

Delalay M, Boendermaker SH

Sports (Basel, Switzerland), 2026

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.

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