Even suggesting a tattoo can negatively impact endurance performance sounds like heresy. Tattoos have become part of our life (or more accurately our bodies). Approximately 30% of Americans have at least one tattoo, which is a significant increase over the last seven years. Against this backdrop is a recent report that suggests tattoos could impact endurance performance.

The association with pain and improved performance evolved from research in many laboratories showing that when muscles are stretched, they activate specific metabolic pathways responsible for building new and stronger muscle protein. In fact, after intense exercise, muscle remodeling, which ultimately leads to improved performance, takes place. Athletes have interpreted this research as "more is better". The more pain, the greater the improvement in performance through an increase in the size and strength of muscle cells.