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PainPAINNCT07502742

Pain in Aging Former Athletes, Master's Athletes, and Nonathletes

A study testing Moderate-Intensity Strength Exercise Intervention and Moderate-Intensity Aerobic Exercise Intervention in people with Pain and Pain Management, run by Marquette University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to determine how male and female former athletes experience pain and respond to moderate-intensity exercise (strength versus aerobic) compared with both current master's athletes and nonathletes. The main questions this study aims to address are: 1. Read more about this study

Who is it for?
Ages 35 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Pain, Pain Management, Athlete
What is being tested?
Moderate-Intensity Strength Exercise Intervention and Moderate-Intensity Aerobic Exercise Intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
90 participants
Where
1 siteUnited States
Study dates
2 Mar 2026to May 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 35 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age: 35 years through 65 years
  • Current master's athlete, former competitive athletes, or non-athlete control (see details below)
  • Ability to participate in exercise and exercise testing based on the Physical Activity Readiness Questionnaire (PAR-Q+)

Who cannot join

  • Currently pregnant or planning to become pregnant during the study
  • Currently taking heart rate lowering medications (e.g., betablockers) that would impact exercise testing
  • Contraindications to ice such as Raynaud's, cryoglobulinemia, cold urticaria, and/or impaired circulation or sensation
  • Fibromyalgia and/or chronic regional pain syndrome (CRPS)
  • Myocardial infarction or pulmonary embolism in the last 12 months, active cancer, a pacemaker, or any additional condition or disease that would preclude the individual from being able to perform the tests safely
  • Participants will be enrolled into one of the following three mutually exclusive groups according to the following criteria:
Show all 9Show fewer
  • Former Competitive Athlete: Prior participation in competitive sports at the Tier 3 level or above as per McKay et al. (2022): i.e., "national-level representatives who are performing structured and/or periodized training and are developing proficiency in skills required to perform their sport at the highest level; this tier includes individuals participating in Provincial/State or Academy Programs" or higher participation in sport; Not currently participating in any recreational or competitive sports over the last 5 years (Tier 2 or above)
  • Master's Athlete: Currently (within the past year) participating in sports at the Tier 2 level or above (i.e., committed to sports-specific training at least 3 times per week with the intent to compete)(McKay et al., 2022)
  • Nonathlete Control: No prior participation in sport at the Tier 3 (Highly Trained/National) Level or above and not currently participating in any competitive sports (i.e., Tier 2 or above) (McKay et al., 2022) for at least 5 years

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Jacob J Capin, DPT, PhD contact

414-288-7865

jacob.capin@marquette.edu

United States1 site, 1 recruiting
  • Marquette University

    Milwaukee, Wisconsin, 53233

    Jacob J Capin, DPT, PhD, 4142887865, jacob.capin@marquette.edu

    Recruiting

Other trials in United States

About this study

Official title: Pain in Athletes INtervention (PAIN): A Randomized Crossover Clinical Trial in Aging Former Athletes, Master's Athletes, and Nonathletes

The goal of this clinical trial is to determine how male and female former athletes experience pain and respond to moderate-intensity exercise (strength versus aerobic) compared with both current master's athletes and nonathletes.

The main questions this study aims to address are:

Read more
  1. How do former athletes, master's athletes, and nonathletes experience pain?
  2. How do different types of moderate-intensity exercise (strength versus aerobic exercise) influence pain in former athletes, master's athletes, and nonathletes?

Participants will complete 3 different testing sessions:

  1. Baseline testing including assessments of strength, cardiorespiratory fitness, and pain;
  2. Strength exercise: pain assessments will occur before and after moderate-intensity strength training exercise;
  3. Aerobic exercise: pain assessments will occur before and after moderate-intensity aerobic exercise.

There will be a washout period of approximately one week or greater between each of the three different testing sessions. The order of conditions (strength versus aerobic exercise) will be randomized (crossover randomized trial design).

Read the detailed description

Two major health challenges facing midlife adults in our society are chronic pain and insufficient physical activity (PA). Chronic pain is highly prevalent among females and those who previously engaged in substantial vigorous PA, such as former competitive athletes. Exercise (i.e., a specific planned subtype of PA) is one of the best interventions for optimizing health, maintaining function, and preserving cardiorespiratory fitness - yet ironically often not continued among midlife adults who were highly physically active as youth and young adults in competitive sports. While PA and other lifestyle behaviors (e.g., sleep) likely influence pain processing and response to exercise, the mechanisms underlying pain in males and females with distinct PA trajectories are unknown. Pain is a common and critical barrier to regular exercise. Yet exercise has paradoxical effects on pain, generally increasing pain during exercise and providing pain relief after, i.e., exercise-induced hypoalgesia. While higher exercise intensities may lead to greater exercise-induced hypoalgesia, the greater pain and discomfort experienced during high-intensity exercise may prevent uptake, making moderate-intensity exercise a promising solution balancing physiological benefits and exercise-induced hypoalgesia. The investigators' long-term objective is to alleviate pain, increase PA, and improve health in midlife and aging adults. This randomized crossover clinical trial will determine how markedly different PA trajectories and sex influence pain, lifestyle behaviors, and the pain response to exercise (exercise-induced hypoalgesia). Given that pain is affected by PA and sports history, this proposal will examine pain processing in midlife males and females with distinct PA trajectories evenly split across 3 unique groups: 1) former athletes no longer participating in sports; 2) master's athletes; and 3) nonathletes.

In order to compare pain perceptions and processing in former athletes, master's athletes, and nonathletes, quantitative sensory testing and validated questionnaires will be used. Lifestyle behaviors (PA and sleep) will be assessed using wearable devices. Moderate-intensity strength and aerobic exercise interventions will be included to determine how these influence the pain perceptions of former athletes, current master's athletes and nonathletes. Full participation will involve completing three in-person sessions including baseline assessment session and two intervention sessions (i.e., follow-up 1 and follow-up 2 at approximately 1 week intervals) at Marquette University as well as wearing a small physical activity monitor for 2 weeks following baseline session and an OURA ring for the duration of the study.

Aim 1: Determine the impact of physical activity history (group) and sex on (1a) pain processing and (1b) lifestyle behaviors in midlife adults (former athletes, master's athletes, and nonathletes).

Aim 2: Quantify the effect of physical activity history (group) and sex on the change in pain response to moderate-intensity exercise and explore differences in pain response to exercise modality (i.e., strength versus aerobic).

Being tested
Moderate-Intensity Strength Exercise Intervention, Moderate-Intensity Aerobic Exercise Intervention
Keywords
Former Athlete, Master's Athlete, Pain, Quantitative Sensory Testing, Randomized Crossover Clinical Trial, Exercise, Rehabilitation, Aging, Sport
Medical subject headings
Pain, Agnosia, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Moderate-Intensity Strength Exercise InterventionOther

    Participants will perform 10 isometric knee extension repetitions unilaterally on both sides separately for 10 seconds with each repetition at 50% of their maximal volitional contraction (MVC) on an electromechanical dynamometer. Participants will be provided 50 seconds rest in between repetitions. Numeric pain intensity ratings (0-10) and rating of perceived exertion (RPE) will be recorded before, during, and following exercise. Quantitative Sensory Testing (i.e., PPTs and TSP) will be assessed before and after the exercise intervention. If there is a more affected limb with regards to pain, the less affected limb will be exercised first. If there is not a more affected limb, side will be randomized. A warm up will be performed prior to the intervention.

  • Moderate-Intensity Aerobic Exercise InterventionOther

    Participants will complete aerobic exercise at 40-59% of their heart rate reserve (HRR) through the mode of incline walking on a treadmill for 30 minutes with a 2 -minute warm up and 2-minute cool down with a target intensity of ~50% HRR. Adjustments will be made to the incline and speed throughout the intervention as needed to maintain 40-59% HRR range. Numeric pain intensity ratings (0-10) and rating of perceived exertion (RPE) will be recorded before, during, and following exercise. Quantitative Sensory Testing (i.e., PPTs and TSP) will be assessed before and after the exercise intervention. Heart rate will be measured throughout the walking intervention to ensure the participant is within the targeted range for moderate intensity; pre- and post-aerobic intervention heart rate and blood pressure will be taken.

Study groups in NCT07502742
Study groupRoleWhat they receive
Former Competitive AthletesExperimentalFormer competitive athletes will complete baseline testing as well as two separate experimental conditions in randomized condition order: 1) moderate-intensity strength exercise intervention; and 2) moderate-intensity aerobic exercise intervention.
Receives: Other: Moderate-Intensity Strength Exercise Intervention; Other: Moderate-Intensity Aerobic Exercise Intervention
Master's AthletesActive comparatorMaster's Athletes will complete baseline testing as well as two separate experimental conditions in randomized condition order: 1) moderate-intensity strength exercise intervention; and 2) moderate-intensity aerobic exercise intervention.
Receives: Other: Moderate-Intensity Strength Exercise Intervention; Other: Moderate-Intensity Aerobic Exercise Intervention
Nonathlete ControlsActive comparatorNonathlete Controls will complete baseline testing as well as two separate experimental conditions in randomized condition order: 1) moderate-intensity strength exercise intervention; and 2) moderate-intensity aerobic exercise intervention.
Receives: Other: Moderate-Intensity Strength Exercise Intervention; Other: Moderate-Intensity Aerobic Exercise Intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pain Tolerance

    The maximum stimulus intensity that the participant can tolerate will be measured by placing a thermode (Q-Sense, Medoc) on the ventral forearm. Three trials will be completed with the baseline temperature set at 35°C that increases at a rate of 1°/s with a maximum temperature of 50°C. Participants will be asked to press a timing device when they can no longer tolerate the temperature (i.e., pain tolerance), and this temperature will be recorded as the maximum stimulus intensity.

    Measured: Baseline (Aim 1a)

  2. Pressure Pain Threshold (PPT)

    Pressure Pain Thresholds (PPTs) will be used to measure group differences in pain sensitivity at baseline and the hypoalgesic response (increase in PPTs) during the exercise sessions with a pressure algometer (Algomed, Medoc) at the exercising limb, contralateral limb, and systemically at the right upper trapezius muscle. Two trials separated by a 10-second interval will be performed at each site with a 1cm^2 rubber tip at a rate of 50 kPA/sec. Participants will be instructed to press a timing device when the pressure first changes to pain (i.e., pain threshold). Practice trials with be performed on the fourth digit fingernail bed prior to formal assessment at quad/trap and order will be randomized. The change scores from pre- to post-strength exercise and from pre- to post-aerobic exercise will be used as the primary outcome in Aim 2.

    Measured: Baseline, Pre-/Post-Exercise at Follow-up Session 1 (approximately 1 week after baseline), and Pre-/Post-Exercise at Follow-up Session 2 (approximately 2 weeks after baseline) (Aim 2)

  3. Physical Activity - Step Counts

    Physical activity (PA) will be monitored continuously using an activPAL activity monitor. Step counts will be recorded as the average number of steps taken per day.

    Measured: Remote monitoring for 2 weeks during the study (Aim 1b)

  4. Sedentary Behavior

    Total sedentary behavior will be assessed using an activPAL activity monitor and recorded as the average daily amount of time in wakeful sedentary behavior (hours:minutes).

    Measured: Remote monitoring for 2 weeks during the study (Aim 1b)

Secondary outcomes (7)
  1. Pain Intensity (pain perception)

    The Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Intensity-SF v.1.0 3a will be collected at baseline to capture average pain and worst pain intensity over the past 7 days and right now. The survey has 3 questions where respondents rates pain from no pain (1) to very severe pain (5). The total raw score ranges from 3 to 15 with higher scores indicating more severe pain.

    Measured: Baseline

  2. Michigan Body Map for Pain (pain perception)

    Pain distribution or location at rest and with movement will be assessed using the Michigan Body Map for Pain (validated questionnaire).

    Measured: Baseline

  3. Temporal Summation of Pain (TSP)

    Temporal summation of pain (TSP) is an increase in pain with a repetitive or constant-intensity, noxious stimulus and represents central pain facilitation. A custom-made pressure pain device, used frequently in the assessment of exercise-induced hypoalgesia, will assess TSP and consists of an 8 x 1.5-mm Lucite edge (Romus Inc., Milwaukee, WI) placed on the mid portion of the middle phalanx of the right index finger for 2 min. A 10-N force (equivalent to a 1-kg mass) will be applied to the Lucite edge, and participants will be asked to press a timing device when the pressure first changes to pain (i.e., pain threshold) and to rate the intensity of pain on a 0-10 numerical pain rating scale every 20-s throughout the test. The increase in the pain intensity during the 2-minute test represents TSP.

    Measured: Baseline, Pre-/Post-Exercise at Follow-up Session 1 (approximately 1 week after baseline), and Pre-/Post-Exercise at Follow-up Session 2 (approximately 2 weeks after baseline)

  4. Condition Pain Modulation (CPM)

    Condition pain modulation (CPM) is the concept that pain inhibits pain and will be used to indirectly measure the efficiency of descending inhibitory pathways. For the CPM protocol, PPTs (test stimulus) will be measured using a pressure algometer (AlgoMed, Medoc) as described above at the quadriceps and upper trapezius muscles with and without the participant's foot submerged in an ice water bath (conditioning stimulus). An increase in PPTs during the conditioning stimulus represents the pain inhibits pain phenomenon, whereas no change or decrease in PPTs indicates low CPM efficiency.

    Measured: Baseline

  5. Numeric Pain Rating Scale

    The numeric pain rating scale (0-10) will be used to assess pain before, during, and after the strength and aerobic exercise interventions.

    Measured: Pre-/Post-Exercise at Follow-up Session 1 (approximately 1 week after baseline) and Pre-/Post-Exercise at Follow-up Session 2 (approximately 2 weeks after baseline)

  6. Prolonged Bouts of Sedentary Behavior

    Prolonged (>1 hours) bouts of sedentary behavior will be assessed using an activPAL activity monitor.

    Measured: Remote monitoring for 2 weeks during the study (Aim 1b)

  7. Sleep Duration

    Sleep duration will be monitored remotely throughout the study using an Oura Ring. Sleep duration will be measured in time (hours:minutes) with greater values indicating longer sleep.

    Measured: Remote monitoring throughout the study (i.e., about 2-3 weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted31 Mar 2026
  2. Study start2 Mar 2026
  3. Primary completionMay 2028 (estimated)
  4. Study completionMay 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
90 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07502742
Sponsor's protocol ID
IRB#5050
Acronym
PAIN
Status last verified
Mar 2026
First submitted
15 Mar 2026
Last updated
31 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data will be shared in accordance with policies of the funder should this study receive extramural funding.

Publications

  • Drawer S, Fuller CW. Propensity for osteoarthritis and lower limb joint pain in retired professional soccer players. Br J Sports Med. 2001 Dec;35(6):402-8. doi: 10.1136/bjsm.35.6.402.

    PubMed 11726474
  • Wewege MA, Jones MD. Exercise-Induced Hypoalgesia in Healthy Individuals and People With Chronic Musculoskeletal Pain: A Systematic Review and Meta-Analysis. J Pain. 2021 Jan;22(1):21-31. doi: 10.1016/j.jpain.2020.04.003. Epub 2020 Jun 26.

    PubMed 32599154
  • Geisler M, Herbsleb M, de la Cruz F, von Au S, Schumann A, Croy I, Bar KJ. Profound neuronal differences during exercise-induced hypoalgesia between athletes and non-athletes revealed by functional near-infrared spectroscopy. J Physiol. 2026 Apr;604(7):2738-2756. doi: 10.1113/JP289766. Epub 2026 Feb 26.

    PubMed 41749046
  • Purcell C, Duignan C, Fullen BM, Ryan S, Ward T, Caulfield B. Comprehensive assessment and classification of upper and lower limb pain in athletes: a scoping review. Br J Sports Med. 2023 May;57(9):535-542. doi: 10.1136/bjsports-2022-106380. Epub 2023 Feb 9.

    PubMed 36759138
  • Simon JE, Docherty CL. The Impact of Previous Athletic Experience on Current Physical Fitness in Former Collegiate Athletes and Noncollegiate Athletes. Sports Health. 2017 Sep/Oct;9(5):462-468. doi: 10.1177/1941738117705311. Epub 2017 May 5.

    PubMed 28475420
  • Schwenk TL, Gorenflo DW, Dopp RR, Hipple E. Depression and pain in retired professional football players. Med Sci Sports Exerc. 2007 Apr;39(4):599-605. doi: 10.1249/mss.0b013e31802fa679.

    PubMed 17414796
  • Simon JE, Lorence M, Docherty CL. Health-Related Quality of Life in Former National Collegiate Athletic Association Division I Collegiate Athletes Compared With Noncollegiate Athletes: A 5-Year Follow-Up. J Athl Train. 2021 Mar 1;56(3):331-338. doi: 10.4085/107-20. Epub 2021 Feb 18.

    PubMed 33150419
  • Dzau VJ, Pizzo PA. Relieving pain in America: insights from an Institute of Medicine committee. JAMA. 2014 Oct 15;312(15):1507-8. doi: 10.1001/jama.2014.12986. No abstract available.

    PubMed 25321905
  • Lachman ME. Mind the Gap in the Middle: A Call to Study Midlife. Res Hum Dev. 2015;12(3-4):327-334. doi: 10.1080/15427609.2015.1068048. Epub 2015 Aug 27.

    PubMed 26848288
  • Street JH, Larson AM, de Guia R, Bansal N, Hunter SK, Capin JJ. The paradox of sport: adolescent athletes are highly sedentary across competition, practice, and rest days. BMC Sports Sci Med Rehabil. 2026 Jan 22;18(1):86. doi: 10.1186/s13102-026-01539-6.

    PubMed 41572326
  • Piacentine LB, Wolf TL, Capin JJ. Transitioning to life after sport: empowering former college varsity athletes to live more healthfully. Front Sports Act Living. 2026 Jan 12;7:1713432. doi: 10.3389/fspor.2025.1713432. eCollection 2025.

    PubMed 41602799
  • Larson A, Street JH, de Guia R, Capin JJ. Sport training day affects adolescent athletes' sleep schedules. Front Sports Act Living. 2026 Jan 27;7:1731173. doi: 10.3389/fspor.2025.1731173. eCollection 2025.

    PubMed 41675555
  • Capin JJ, Ridgers ND, Street JH, Fial A, Tomkinson GR. Activity levels across the intensity spectrum in athletes: a systematic review protocol. BMJ Open Sport Exerc Med. 2024 Aug 16;10(3):e002148. doi: 10.1136/bmjsem-2024-002148. eCollection 2024.

    PubMed 39161555
  • Street JH, Boos ZP, Fial A, Lennon SL, Smith CS, Creasy SA, Hunter SK, Farquhar WB, Capin JJ. Long-term function, body composition and cardiometabolic health in midlife former athletes: a scoping review. BMJ Open Sport Exerc Med. 2023 Oct 27;9(4):e001605. doi: 10.1136/bmjsem-2023-001605. eCollection 2023.

    PubMed 37920279
  • Capin JJ, Wolf TL, Street JH, Smith CS, Lennon SL, Farquhar WB, Hunter SK, Piacentine LB. Midlife health crisis of former competitive athletes: dissecting their experiences via qualitative study. BMJ Open Sport Exerc Med. 2024 May 9;10(2):e001956. doi: 10.1136/bmjsem-2024-001956. eCollection 2024.

    PubMed 38736641

Questions about this trial

What is this clinical trial studying?

A study testing Moderate-Intensity Strength Exercise Intervention and Moderate-Intensity Aerobic Exercise Intervention in people with Pain and Pain Management, run by Marquette University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 31 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jacob J Capin, DPT, PhD (414-288-7865, jacob.capin@marquette.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pain Tolerance (time frame: Baseline (Aim 1a)). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07502742, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 31 Mar 2026.

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