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Eddie Howe found himself on firm footing as he rang the bell.

The Newcastle United manager had just got the 2023 Great North Run started to loud cheers in the centre of the city.

But he had failed to anticipate those Black Cats runners who were not so thrilled to see him as they whizzed past.

"The biggest stick I've ever had," he said this week. "I got verbally attacked by 50% of the people there."

This is not an ordinary rivalry. These North East neighbours have won only one major domestic trophy between them in the past 50 years, and Sunday's game signals the first time they will meet in the Premier League for almost ten years.

But few fixtures bring a region to a standstill quite like the North East derby as former Black Cats manager Peter Reid understands better than most.

"They're football crackers," he said. "Let's just say, there is a little bit more needle up there."

A fixture like no other

A former Newcastle defender also knows what can happen when these forces collide.

A huge framed photograph in the ex- Newcastle centre-back's home acts as a daily reminder.

It captures the Greek ecstatic, shirtless and among his elated team-mates, after scoring the winner in front of the traveling support at the Stadium of Light in 2002.

This was a fixture that definitely left its mark on him.

"It's the intensity of the fans," he said. "This feeling that goes from generation to generation. This heritage makes this game so unique."

So what is at the core of the fierce rivalry between two one-club cities less than 15 miles apart?

Well, as far as a Black Cats season ticket holder is concerned, it transcends football itself.

"You can trace it to the English Civil War with Newcastle supporting the monarchy and the other side backing the parliament," he said. "It's all historical and economic factors.

"Newcastle get the funding, Newcastle have the metropolitan status, Newcastle are the ones people always talk about when it comes to the North East. The other side are always overshadowed."

But it is far from one-sided.

A former player's father was even "swarmed" by delirious Newcastle supporters after his son scored a decisive free-kick in a 1-0 victory at the Stadium of Light in 2011.

That is how much it mattered to the home fans.

"It took a little bit of time afterwards to realise the significance of it," the player said.

"It made my life a lot easier. I was forgiven to make the occasional mistake when playing, simply because of that goal.

"I still go up to St James' Park and you've got dads telling their kids, 'See this lad? He scored the winner against the Mackems'."

A derby win can even further elevate the standing of an already popular figure.

A former Newcastle manager had not long delivered promotion back to the Premier League when he took charge of his first derby in 2010.

There may have only officially been three points at stake, but he quickly understood the "added responsibility" of this game because people in the North East "breathe their football".

He said: "There are some derbies where you are not quite sure why they are derbies. This one, you do.

"These represent two huge clubs - close from each other - with their own character.

"Realistically, they are the two most important games of the season so you are conscious that the last thing you want to do is to lose, particularly in your own stadium."

A region reignited

That manager had nothing to fear.

His side ended up hammering Sunderland 5-1 at St James' Park in 2010, but Newcastle have only won a single derby in the Premier League since then.

In fact, Sunderland have been victorious in six of the last seven meetings in the top flight.

A former Sunderland manager oversaw half of those victories, having swiftly realised that the fixture was "more significant" than many outsiders thought.

"Beyond family, the club is the most important thing to the people of Sunderland," he said.

"The passion is such that the result of the club can alter the atmosphere of the city so consider the result of the derby? You can feel it.

"I was informed on the first day. 'Please stay up, but you must beat Newcastle'. I still don't know if it was more important to stay up or to beat Newcastle."

The club, like Newcastle before them, eventually succumbed to the drop in 2017, and spent eight years away from the top flight.

So a division separated these rivals when they last met in the domestic cup nearly two years ago.

And the difference was pronounced.

The combined cost of Sunderland's starting line-up that day was a tiny portion of the £40m Newcastle had invested in a single player.

The most experienced individual in the hosts' starting line-up was a clear margin ahead of others, at just 30 years of age.

"I don't think the fans really expected, deep down, that we were going to win that game," a former midfielder said. "But now it's different."

In numerous ways.

Only two players are likely to be the only holdovers from that 3-0 defeat in Sunday's lineup following the astute arrivals of several new signings.

Sunderland also have a different manager, of course.

Not only has he led Sunderland to promotion - his fearless side have competed evenly against some the best teams in the top flight.

In fact, the reigning champions are the only team in the current top six to have defeated Sunderland this season, while his side are also undefeated on home soil.

Such an impressive start to the campaign means Sunderland go into Sunday's game a point clear of Newcastle in the table.

So it is all set up to be a gripping afternoon when these rivals renew hostilities at the Stadium of Light.

"On Sunday, the world will know the North East is back on the map with top games again," a former player added.