What if pain were all in the mind?

Chris Sidwells investigates the mysteries of pain, and speaks to a super-fast veteran racer who overcame heel agony by altering his thoughts.

Keith Ainsworth is fast. Formerly a very talented runner, he took up bike racing in 2013 at the age of 54, and won in his first year. Now, four years later, Ainsworth has personal bests of 19.43 for 10 miles, 51.18 for 25, and 1:48.29 for a 50-mile time trial. He achieved all this despite being sidelined for the whole of 2015 with searing Achilles tendon pain that left him struggling to walk, never mind ride a bike quickly. Yet every test indicated his Achilles was fine and that his pain was not the result of physical damage. Can severe pain really be all in the mind?

Ainsworth’s story is so intriguing because his pain had no detectable physical cause. It was idiopathic pain, which is believed to be psychological but may involve both cerebral and peripheral mechanisms.

“My problems started around Christmas 2014. My wife and I had split up but we had a family reunion for the holiday. Training was going well, I had plans for 2015, but one day while I washed the breakfast plates I got this terrible Achilles tendon pain, and it wouldn’t go away,” he explains.

“I had an MRI scan, a tendon scrape, which was really painful, and I had physio and treatments like injections of synthetic lubricants, but nothing worked. I couldn’t ride my bike, I could hardly walk.”

The agony continued without let-up.

“It went on for months, and eventually I couldn’t see how I could make any progress. I’d lost my family, and I genuinely felt I couldn’t progress with anything in my life. It got so bad that one day, when I tried walking to the top of the street where I live, which is a fairly steep hill, I couldn’t do it. The pain was too much. I went back inside my house in tears. I was in a very dark place.”

Almost at breaking point, Ainsworth once again sought medical help.