La douleur

Quel est le sens de la douleur dans le cadre de la pratique de l'ultra-trail ? Durant une course en montagne plus ou moins longue, il est pratiquement impossible de lui échapper. Qu'elle jaillisse d'un coup ou qu'elle s'invite progressivement dans le conscient, qu'elle soit précise ou diffuse, linéaire ou pulsative, peu importe, elle est là. A partir d'un certain point, elle ne nous quitte plus. Ou bien elle disparait soudain, aussi mystérieusement et inexplicablement qu'elle était apparue quelques minutes ou quelques heures auparavant.

Une bonne partie du succès ou de l'échec dans une course longue, je pense, vient de notre attitude face à la douleur. Et par succès, j'entends modestement le fait de parvenir au bout de la course. Car c'est déjà souvent une véritable victoire en soi. Après, le temps, le classement, tout ça, c'est secondaire. C'est la cerise.

La première chose qu'il ne faut jamais oublier, c'est que la douleur est une expérience subjective de notre conscience. La blessure est une réalité objective, mesurable, et souvent observable, soit à l'oeil nu, soit via des instruments. La douleur, elle, est subjective. Je veux dire par là que ses caractéristiques, son intensité, son existence même varient en fonction de notre personne. A une même blessure objective vont ainsi correspondre des expériences de la douleur associée radicalement différentes en fonction des individus. Tout ceci semble peut-être très théorique, mais croyez-moi, sur un trail, cela revête une vérité très tangible.

La plus sournoise des douleurs, c'est celle qui n'est due à aucune blessure. C'est la douleur préventive, celle que le cerveau crée pour nous protéger, en quelque sorte, d'une potentielle blessure future. C'est ainsi qu'il y a 3 mois je me suis retrouvé complètement coincé dans le bas du dos suite à un footing à allure très modérée de 30 minutes. La douleur s'est manifestée d'un coup, tonitruante, après 30 minutes de course, comme une décharge électrique dans le bas du dos. Impossible de continuer à courir. Après consultation, bien que mon ostéopathe n'ait décelé aucune blessure, mon dos restait bloqué, avec une douleur très sévère, au point que je doive marcher courbé, vouté sous un poids, mais venant d'où? Mais après deux séances et quelques jours de repos, j'ai finalement pu retrouver de la souplesse dans le dos, et courir 3 semaines plus tard la Dragon's Back Race au Pays de Galles (315km) sans qu'à aucun moment, cette douleur, qui avait pourtant été si aigüe, ne se fasse sentir. C'était pour moi la preuve que l'intensité de cette douleur avait été sans commune mesure avec une réalité objective d'une blessure physique au niveau du dos, sauf à me prêter des capacités de guérison hors normes. Pour me faire prendre conscience de ceci, les 15 minutes de présentation (en anglais) sur Retrain Pain m'ont été très utile et je vous invite à aller voir. C'est fou ce que le cerveau humain est manipulable, en premier lieu par lui-même.

Cette expérience a été pour moi la preuve empirique du fait qu'il faille se méfier de la douleur. Mon expérience initiale de cette douleur m'amena à redouter le pire en termes de blessure, ce qui eut pour effet, j'en suis persuadé, de contracter mon dos, créant une sorte de cercle vicieux, mes angoisses dues à cette douleur initiale contribuant à accentuer la réaction de blocage de mon dos face à cette douleur, ce qui eut pour effet d'accentuer la douleur, etc. Depuis, j'essaie, en présence d'une nouvelle douleur, de d'abord me poser 3 questions élémentaires:

  1. A quelle blessure physique pourrait correspondre cette douleur (endroit, nature, sévérité)?
  2. Quelle est la probabilité de l'existence de cette blessure, eut égard à mon expérience passée, aux douleurs que j'ai ressenti les heures/jours précédents, etc?
  3. Si l'existence d'une blessure est probable, est-elle pour autant de nature à entraver ma course, ou à avoir des conséquences à long termes?

Mon expérience sur les courses longues m'a appris que la première caractéristiques des douleurs, c'est qu'elles ont tendance à aller et venir. Même les douleurs les plus localisées, comme une douleur au ménisque extérieur droit par exemple, peut très bien s'installer pendant une après-midi, et avoir complètement disparu le lendemain, pour ne plus revenir jusqu'à la fin de la course, voir durant les courses suivantes.

" Durant l'Ultra Trail des 4 Massifs 2015, alors que j'étais parti comme une flèche et était dans les 25 premiers après 40 km, j'ai commencé à ressentir une douleur au genou droit chaque fois que je me mettais à courir. Cette douleur a cru, jusqu'à m'empêcher tout bonnement de courir à partir du 50ème km. Je suis arrivé au ravito de Rioupéroux à mi-parcours avec la certitude, ou du moins la volonté de croire, que je développais une tendinite nécessitant mon arrêt immédiat de la course sous peine de conséquences à long termes.

En analysant cette expérience par la suite, j'ai compris que j'avais instrumentalisé la douleur dans le but d'abandonner. Je m'étais servi de ce qui n'était finalement qu'un signal subjectif émis par mon cerveau dans le but de mettre fin à ma course. Je ne saurai jamais si cette douleur aurait finalement disparu ou pas. Mais ce qui est sûr, c'est que j'aurais pu finir la course, nonobstant cette douleur. Certes pas dans les temps que je m'étais fixé, mais c'est ça aussi l'ultra trail, savoir adapter ses attentes en fonction des conditions."

Pour moi aujourd'hui, une douleur ne "mérite" mon attention que si elle est accompagnée de signes objectifs de blessure imminente. Par exemple, durant la Dragon's Back Race, j'ai ressenti durant toute une après-midi une douleur au niveau du tendon d'Achille gauche, qui s'est accompagnée d'un gonflement au niveau de ce dernier. Il y avait donc là un signe objectif d'inflammation, requérant mon attention : j'ai pris de l'Ibuprofène avant de me coucher et j'ai dormi les pieds surélevés pour facilité la circulation sanguine. Le lendemain matin, la zone tendinaire avait dégonflé, et j'ai pu poursuivre la course sans plus de problème de ce côté là, mais j'ai continué à prendre des anti-inflammatoire en dose modérée et en veillant à bien m'hydrater.

Une fois que le diagnostic de la douleur a été posé en suivant les trois étapes énoncées plus haut, si il s'avère que la douleur nécessite notre attention immédiate, ou s'impose à notre conscient de par son intensité, la première réaction est de s'arrêter. Il suffit parfois d'une pause de 15 minutes pour qu'une douleur perde de son mordent, nous permettant de reprendre la course, ou que notre perception de la douleur lui enlève son caractère débilitant, ce qui revient souvent au même. Il ne faut jamais oublié que courir un ultra trail, c'est engagé une lutte sans merci entre notre cerveau qui désire maintenir l'homéostasie et éviter les blessures, tandis que notre volonté, notre orgueil, peu importe, désirent eux nous voir terminer la course. Il en découle que notre cerveau va chercher à faire feu de tout bois pour nous convaincre qu'il serait plus raisonnable d'abandonner, que tout ceci n'a aucun sens, que nous avons déjà montré qu'on était capable de courir longtemps sur d'autres courses, qu'une bonne douche bien chaude nous attend dès l'arrêt de la course, etc. C'est fou les trésors de créativité dont peut faire preuve le cerveau dans ces circonstances.

Donc en s'arrêtant 15 minutes, on laisse le temps à la douleur de redescendre, et par conséquent au cerveau d'arrêter de nous bombarder de messages alarmistes. Il est alors encore temps de réévaluer la situation et de décider si oui ou non cette dernière justifie vraiment, objectivement, une abandon.

Bref, la douleur est protéiforme, versatile, capricieuse, et peu fiable. Elle est notre système d'alarme, avec parfois de fausses alarmes, et parfois aussi, des alarmes qui ne se déclenchent pas. La douleur est intrinsèquement liée à la pratique de l'ultra trail. La petite vidéo de Errol “The Rocket” Jones, un coureur de 65 ans, racontant son expérience sur le Bay Area Ridge Trail, résume bien à la fois pourquoi nous nous infligeons cette souffrance, et son caractère constitutif du sport.

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