When Good Pain Turns Into Bad Pain

Lauren Fleshman’s memoir, Good for a Girl, recalls her life as a runner—and the culture she says the sport needs to change.

An image of a woman running overlaid with an image of someone with an ankle injury
Getty; The Atlantic

When I was a high-school runner in the late 1990s, slogans such as Pain is Weakness Leaving the Body decorated the T-shirts sold at our championship races. Once, on the bus to the Connecticut state meet, my coach, who was legendary for the decades of New England titles he’d won, told us the story of an athlete collapsing on the course and crawling across the finish line. The coach visited him in the hospital afterward, he assured us; he had “a policy” to do so. That enough athletes needed medical attention for my coach to have a personal creed about it didn’t strike me as dark. I was caught up in the story’s message about determination and sacrifice—and inspired to run hard enough that I myself might end up in the hospital.

During the years I was dreaming of martyrdom, the future national champion Lauren Fleshman was a high-school athlete as well, on her way to becoming one of the most accomplished American distance runners in history. I knew her name from issues of Race Results Weekly, and I liked her because of her genuine smile and uncovered freckles. I also liked that her legs looked strong and her cheeks full—traits we shared. I’d heard mine referenced with undisguised surprise many times: You don’t look like a runner.

Those comments exemplified the culture of girls’ sports at the time. I was embarrassed that I’d never lost my period, and I saw injuries not as signs of long-term damage or even as short-term limitations but as badges of tenacity and toughness. In 1996, Fleshman and I both watched 18-year-old Kerri Strug land her gold-medal-clinching vault on her already badly sprained ankle at the Atlanta Olympics, and we saw her coach carry her, childlike and unable to walk, away. For an athlete, this sort of pain, as Fleshman writes in her new memoir, Good for a Girl, was simply “what it took to be beloved.”

Fleshman went on to win five NCAA Division I titles at Stanford; I went on to barely make varsity at my Division III college. Still, Good for a Girl feels deeply familiar. It is in part a memoir of Fleshman’s failures and successes, but it’s also a call to action for the coaches, parents, and young women of future athletic generations. Fleshman argues convincingly that it’s essential for the sports world to disentangle physical suffering from self-worth. In 288 funny, honest, and sometimes-wrenching pages, she makes clear that empowering girls to better understand the need for balance between pain and elite performance is not only the ethical thing to do—it’s essential to their health and career longevity.

Fleshman writes about the out-of-body sensation of maximum effort in a way that no other author I’ve encountered has managed. She recalls the experience of being “in that part of the race where the pain accumulates and bulges and threatens to spill over at any moment,” and the pride of discovering a “new level” of hurt before asking herself if she could persist just “a little longer.” This kind of instant-to-instant self-evaluation and motivation is crucial in high-level athletic performance, but it also poses a dilemma. It’s easy for athletes to confuse the confidence and power that come from the ability to temporarily push through for the type of self-erasure that might lead to injury.

Personally, I mixed up the two for years. When I eventually did collapse in college, just shy of the finish line in a championship 10,000-meter race, I ended up in a medical tent instead of a hospital. It was not until I told this story, which still inspired in me a strange pride almost two decades later, that I realized that my race had literally been a failure. I had not finished.

Fleshman has plainly reconsidered the role of pain and overexertion in sports too. In parts, her book is dedicated to outlining what she sees as necessary reforms, such as policies that “specifically protect the health of the female body in sport … [including] formal certification to work with female athletes that mandate[s] education in female physiology, puberty, breast development, [and] menstrual health.” She is clear in her belief both that young women need more women coaches and that merely having a woman on a coaching staff is not an inoculation against a system that ignores the needs of girls and women at great cost.

One of the most prevalent and dangerous ways sports culture deprioritizes athletes’ wellness is by willfully overlooking, or even outright encouraging, disordered eating, Fleshman writes. I saw and experienced this firsthand: Friends—ones who ran for female coaches—were publicly weighed or asked to write down and scrutinize everything they ate in a day. Even on my college team, where my coach never commented on size, the glorification of thinness was everywhere. Once, I heard another coach praise an athlete for looking as though she’d lost “a pound or a pound and a half.” Like Fleshman, I often felt defensive and ashamed of being told I looked “healthy,” because “healthy was code for fat; fit was the compliment everyone valued most,” she writes. I’d figured if I wasn’t the fittest, I could be the toughest, or the most willing to endure a certain kind of agony.

Despite my adult perspective and the wisdom of Fleshman’s book, untangling the relationship between pain and athletic success is complex. I’ve read before that recovery from eating disorders can be complicated by the impossibility of going cold turkey, as with a substance addiction—we all need to have a relationship of some kind with food, after all. And maybe there’s something of this in the relationship that serious athletes must develop with pain. Where is the line between willingness to be in discomfort and eagerness to be in it? What separates the decision to hang on in the final minutes of a race and what Fleshman calls “a culture of compliance [that] leads to disassociation from yourself, from your body’s signals of hunger, fatigue, and pain”?

Becoming a runner changed my life because it made me understand that I could do hard things. I think I’d have been a determined and stubborn person no matter what passion I fell into, but my achievements felt so concrete out on the track. Running additionally paved a way into some of the greatest friendships of my life. Although much of distance training is solitary, there’s an intimacy unlike any other I’ve known in matching a companion stride for stride in the late stages of a daunting workout or long, hilly run. Some of the magic of running friendships no doubt comes from the fraught role of suffering in the sport: We have shared the vulnerable experience of pushing our body to its limit, often in a very public way, and sometimes coming up short.

Fleshman eventually learned that any “pursuit of excellence had to center … moments of joy, or it wasn’t worth doing,” she writes. For me, running has been a gift not because of the ways its culture has so often glorified suffering but in spite of it. Competing and coaching have taught me that a certain kind of pain is inevitable in order to succeed as an elite athlete, but we ought not chase it. Instead, we should run toward the delight.