Ireland tear Portugal apart for record Test win
Ireland secured their record Test victory with a 106-7 win in their first ever capped international against Portugal at the Estadio Nacional do Jamor.The visitors to Lisbon, whose previous biggest win was an 83-3 victory over the USA in June 2000, set new marks for points, tries and winning margin. Without their large British and Irish Lions contingent, Ireland's interim head coach Paul O'Connell gave debuts to Alex Kendellen, Hugh Gavin and Shayne Bolton with the latter pair each crossing twice among the visitor's eight first-half tries.Kendellen would then mark his own Test bow with one of the eight Ireland scored after the turn. Portugal got their only score through flanker Nicholas Martins in the second half, although they did have an earlier try chalked off by the television match official (TMO) before communication between the referee and his off-field assistant failed meaning there were no replay reviews in place for the final hour.After last week's win over Georgia, Ireland finished their two-Test summer tour with a pair of wins and will next be in action when they meet New Zealand in Chicago on 1 November.
Portugal impressed at the 2023 World Cup when they beat Fiji and drew with Georgia in their first time at the tournament since 2007.This version of Os Lobos, however, finished only fourth in Rugby Europe after defeats to Spain and Romania and never looked competitive against superior opposition. Despite being without 17 players who are on Lions duty, as well as their head coach Andy Farrell who is leading the tourists in Australia, the visitors dominated from start to finish.They took the lead with less than a minute on the clock when Stuart McCloskey crashed over from close range after some neat involvements from Jack Crowley.That proved to be the first of eight first-half tries with debutants Shayne Bolton and Hugh Gavin both crossing twice in the opening 40 minutes. Tommy O'Brien, who scored a pair of tries during his own debut against Georgia last week, also scored twice in the first half with tight-head Tom Clarkson the other player to go over. The loss of the TMO, in a game played in front of fewer than 10,000 supporters, came only after Portugal had a score chalked off when Vincent Pinto's pass to Nuno Guedes was judged to have gone forward.A difficult half for the hosts was made all the tougher when they lost both captain Tomas Appleton and his replacement Gabriel Avriagnet to injury, forcing back row Francisco Almeida into a role on the wing.
After eight in the first half, Ireland would score eight after the turn too.Their first after the restart came just 90 seconds into the half when captain Craig Casey marked a sharp performance by scampering between the posts.Cian Prendergast, who missed out through illness against Georgia, crashed over after a short line-out move with half an hour to go, while Martins' response involved a neat exchange of passes.Replacements Calvin Nash and Ciaran Frawley were the next players across before Prendergast matched his Connacht team-mates Bolton and Gavin in scoring twice.It was debutant Kendellen whose score edged Ireland past their previous record margin of victory while Ben Murphy became the third replacement on the scoresheet before a last-play penalty try rounded out the huge rout.
Portugal: Guedes; Bento, V. Pinto, Appleton (capt), M. Pinto; Aubry, Camacho; D. Costa, Begic, D. Ferreira, De Andrade, P. Ferreira, De Carvalho, Martins, RuizReplacements: D'Cunha, Lopes, Souto, G. Costa, Almeida, Baptista, Campos, Avriagnet.Ireland: J O'Brien; T O'Brien, Gavin, McCloskey, Bolton; Crowley, Casey (capt); Boyle, McCarthy, Clarkson, T Ahern, Murray, Baird, Kendellen, Prendergast.Replacements: Stewart, Milne, O'Toole, Izuchukwu, Deegan, Murphy, Frawley, Nash.
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Questions like these rattled around the mind of Lorimer Moseley when he showed up at Sydney's Royal North Shore hospital years ago as an undergraduate physiotherapy student. He wanted to interrogate a quip made by a neurology professor as he left the lecture theatre one day, that the worst injuries are often the least painful. So Moseley sat in the emergency room and watched people come in, recording their injuries and asking them how much they hurt. 'And this guy came in with a hammer stuck in his neck – the curly bit had got in the back and was coming out the front and blood was pouring all down,' Moseley recalls. 'But he was relaxed. He just walked in holding the hammer, relaxed. Totally fine.' Then the man turned around, hit his knee on a low table and began jumping up and down at the pain of the small knock. 'And I think, 'Whoa, what is happening there?'' The curious student ruled out drugs, alcohol, shock. He realised that the reason the man did not feel pain from his hammer injury was due to the very point of pain itself. Sign up for a weekly email featuring our best reads 'Pain is a feeling that motivates us to protect ourselves,' says Moseley, now the chair in physiotherapy and a professor of clinical neurosciences at the University of South Australia. 'One of the beautiful things about pain is that it will motivate us to protect the body part that's in danger, really anatomically specific – it can narrow it right down to a tiny little spot.' It is an evolutionary self-protection response that meant the man with the hammer in his neck did not appear to feel pain. To feel pain would not have aided his survival in that moment, Moseley says. Instead, fear is probably what impelled him to race to the emergency ward. 'So these people on the battlefield, their arm gets ripped off, they look for their arm, they pick it up, they walk to safety, no arm pain. Perfect. That is an extraordinarily bold and sophisticated protective system.' Prof Michael Nicholas is used to stories like these. 'You can see it in probably every hospital ward. If you stay around long enough you'll hear comments like 'this person has more pain than they should have' or 'you might be surprised that they're not in pain',' he says. 'What that highlights to me is the general tendency for all of us to think there should be a close relationship between a stimulus like an injury or a noxious event and the degree of pain the person feels. 'In fact, that's generally wrong. But it doesn't stop us believing it.' The reason we get it wrong, Nicholas says, 'is that we have a sort of mind-body problem'. Eastern medicine and philosophy has long recognised the interconnectedness of body and mind, and so too did the west in early civilisations. In ancient Greece the Algea, the gods of physical pain, were also gods associated with psychic pain – with grief and distress. 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Sometime between 11am and 11.30am on 22 May 2024, as I sat at a big white conference table, before a screen of colleagues zooming into a meeting, a cyst on my right ovary exploded. I felt pain right away. With my right hand, I pressed hard into my lower stomach and breathed in and out slowly to ride through the feeling. Jesus, I thought. I shouldn't have eaten so many Jols. I returned to my desk but still felt sore so went for a walk around the block to shake it off. I felt a little better, returned to my computer, popped in and out of smaller meetings, answered emails, edited articles, finished work at 5.30pm, then walked half an hour to my sister's apartment and lay on her couch. While the pain was fairly strong I was still convinced an overconsumption of sugar-free sweets was responsible. Only when my sister called a helpline two hours later and a nurse told me to go to hospital did I relent. We arrived at emergency about 9pm, 10 hours after that first sharp twinge. Later in the night, as I climbed on to an examination bed, I froze. Pain sloshing around my abdomen violently halted my movement. As I stopped there silent, halfway to laying down, I saw the serious look on the doctor's face. Sign up to Five Great Reads Each week our editors select five of the most interesting, entertaining and thoughtful reads published by Guardian Australia and our international colleagues. Sign up to receive it in your inbox every Saturday morning after newsletter promotion I realised that perhaps my report of my pain was an unreliable guide. She was looking for other clues. (I would later learn that medical staff use self-reported pain as only one of a few measures to assess a patient, others include observations of movement, the ability to talk, facial expressions and guarding.) It was the middle of the night before an MRI returned the findings that I had spent the day with what the doctor called 'a belly full of blood'. The next day I had surgery. At my bedside an obstetric surgeon shook his head as he explained what was going on in my body. A burst cyst has a reputation for being very painful, he said. Why had I rated my pain as a six or seven? Didn't it make more sense to give it a 10? I shrugged. I'd wanted to give myself some wriggle room. So why was my experience and report of pain so out of whack with the tissue damage my body experienced? 'It actually starts with our judgments,' says Associate Prof Melissa Day, from the University of Queensland. 'So it's not what happens to us. It's how we judge what happens to us.' In other words, if we give ourselves a convincing explanation for what we feel, an explanation that does not include danger or damage to our body – if we think it's the Jols and it will pass – we are less likely to feel pain severely. We have a tendency to valorise those who do not complain of pain when they confront an acute injury. To say this is a tough person, a stoic person. But individual toughness or weakness is not what's at play in pain responses, and the same person can have two entirely different reactions to pain-inducing events in different contexts. When Lorimer Moseley tried a heat pad pain test on himself, increasing the temperature on the pad on his hand and noting his rising pain levels, it took removing the pad from his skin to realise he had given himself two-and-a-half-degree burn. 'This happens to people who do a lot of pain research because you just get exposed and your brain doesn't think it's worth protecting you as much as it should,' he says. 'But I put my hand in hot water to do the dishes – I'm hopeless.' Just five years ago the International Association for the Study of Pain revised its definition of pain. The new definition follows what is called a bio-psychosocial model, which recognises not just the biological causes of pain but the role of psychology and social context in creating, amplifying – or dulling – it. While this is the contemporary thinking about pain, says Nicholas: 'Most people don't use it. Most clinicians, unfortunately, even.' The biological causes are clearest. Pain tolerance, researchers speaking to Guardian Australia say, has some genetic component. Red-haired people, for example, Moseley says, have on average a different threshold at which their nerves are triggered by a change in temperature in a heat-based pain threshold test. Complex social factors play a substantial role: multiple studies have found that people from a lower socioeconomic status experience both more chronic pain and, in experimental pain tests, demonstrate lower acute pain thresholds. For all people, injury or tissue damage activates the brain's warning system that creates pain. The associated stress can trigger a psycho-biological response that helps the hurt person get through it without being immobilised. 'Short-term stress actually motivates us,' Day says. 'Gets adrenaline pumping through our bodies, allows us to have natural endorphins to push through. There's also endogenous opioids that our brain releases to have that short-term relief of pain.' The psychological elements are becoming more widely understood. 'One thing we know is perhaps the strongest predictor of pain tolerance is how people think about pain,' Day says. 'If we think 'this is terrible, this is awful, it's going to do me serious damage' – those types of people will have lower tolerance.' This includes people who tend to be anxious or who catastrophise pain. The perception of the damage being done can have a substantial role. A violinist is more likely to report higher levels of pain when a pain stimulus is applied to their dominant playing hand than when their other hand is subjected to the same stimulus, Moseley says – because an injury to their dominant hand could end their career. Farmers are known to delay seeking treatment , he adds. 'It might be that farmers expect that a part of being a farmer is to have pain. So [their brain] doesn't urge them to do anything about it. Their expectation is: you have pain.' Our past experience of pain also plays a substantial role. Should I have another cyst explode, Moseley suggests I might feel more pain – I will have learned that this sensation signals serious damage and should not be ignored. Research suggests men generally have higher pain thresholds than women. Pain fluctuates for women at periods of hormonal change. Moseley says differences in sensitivity in immune systems and response to hormones plays a part. But so does 'the way that they're related to from birth'. 'Nature versus nurture – you can't really separate them,' Day says. 'There's a range of factors there in terms of learning histories about pain and how from a young age responses to pain are very much linked to gender as well – how parents respond to a son versus a daughter.' As psychologists working in pain, Day and Nicholas are interested in what behaviours might help people in pain tolerate or reduce the amount of pain they are experiencing. 'The best coping techniques will be different for different individuals and will be different across different contexts' Day says. Nevertheless, for acute pain suppression – 'I'm not thinking about this because I've got this goal I need to achieve' – can work well in the short term, says Day. ('Longer term, it rebounds.') Emotional regulation strategies, meditation and learning how to calm the body can be effective. Working on beliefs about the pain and shifting attention away from it, says Nicholas, fall under individual control. 'If you can control those factors you will have a better response to pain,' Day says. An individual's sensitivity to reward and punishment plays a role in acute pain thresholds too, Day says. People who are more sensitive to punishment tend more often to retract at the appearance of pain, whereas those more oriented towards rewards are more likely to push through it to achieve a goal, she says. Elite athletes are known to have higher pain thresholds as they are habituated to pain in their training regimes. Which is to say, if you are in a grand final and you think you've got a shot at winning, and you know the national team selectors are watching, your fixation on your goal might increase your ability to ignore the pain radiating from your jaw. Is that what made John Sattler play on? I will never know. He died in 2023. But we know he had all the predispositions for withstanding acute injury: he was habituated to pain as an athlete in a game famed for its big hits, he was reward-oriented in a moment when the stakes were high, he was a male socialised to value withstanding pain as a badge of toughness, and saw toughness valued as a social virtue. The clash would have got his endogenous opioids pumping. His attention was redirected away from his injury. Pain is a protective mechanism but, from all we know about that day, Sattler judged protecting his jaw as less important than claiming the premiership. 'People who think they have a higher pain threshold – we will never know,' Moseley says. 'It's the same human that makes the pain and that tolerates it.' And so the experience of acute pain is caught in the realm of mystery and mythology; where we can understand much of what is happening in a body and part of what is happening in a brain but never actually know what another person feels. The legend of John Sattler goes that after that fateful right hook from Bucknall, the bloodied captain turned to his teammate Matthew Cleary. That no one knew, perhaps not even himself, the damage that had been done to him became his mythological power. 'Hold me up,' he said. 'So they don't know I'm hurt.'
