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Eddie Howe found himself on safe ground as he rang the bell.

The Magpies head coach had just set the 2023 Great North Run under way to loud cheers in the centre of the city.

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

"The worst abuse I've ever had," he remarked this week. "I got abused by 50% of the people there."

This is not an inter-city rivalry. These North East neighbours have won only one major domestic trophy between them in the past 50 years, and Sunday's game marks the first time they will meet in the Premier League for nearly a decade.

But few fixtures bring a region to a standstill quite like the Tyne-Wear derby as former Sunderland manager Peter Reid knows better than most.

"These are football crackers," he said. "Let's just say, there is a touch of extra needle up there."

'The two biggest games of the season'

A former Newcastle defender also is aware of what can happen when these forces collide.

A huge picture in the former Newcastle defender's home serves as a daily reminder.

It captures the Greek ecstatic, bare chested and surrounded by his jubilant team-mates, after scoring the winner in front of the away fans at the Stadium of Light in 2002.

This was a fixture that definitely made an impression on him.

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

So what is at the core of the intense rivalry between two football-mad towns less than 15 miles apart?

Well, as far as a Sunderland loyal fan is concerned, it transcends football itself.

"You can trace it to the English Civil War with Newcastle siding with the monarchy and the other side siding with the parliament," he said. "It's all historical and economical tensions.

"Newcastle get the investment, 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 "mobbed" by joyous 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 while afterwards to realise the importance of it," the player said.

"It eased my life a lot easier. I was forgiven to make the odd mistake when playing, purely 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 our rivals'."

A derby win can even further elevate the standing of an already beloved 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 technically been three points at stake, but he quickly recognised the "extra weight" of this game because people in the North East "breathe their football".

He said: "There are some derbies where you are unsure why they are derbies. This one, you are.

"These represent two huge clubs - not far away from each other - with their own identities.

"In effect, 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, especially in your own stadium."

A region reignited

That manager need not have worried.

His side ended up thrashing 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 triumphed in six of the last seven contests in the top flight.

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

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

"It's so intense that the result of the club can change the mood of the city so consider the result of the derby? You can sense it.

"They told me 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."

Sunderland, like Newcastle before them, eventually slipped through 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 FA Cup nearly two years ago.

And the difference was pronounced.

The combined cost of Sunderland's starting line-up that day was a mere fraction of the £40m Newcastle had spent on 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 changed."

In numerous ways.

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

Sunderland also have a new manager, of course.

Not only has he led Sunderland to promotion - his fearless side have gone toe-to-toe with 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 unbeaten on their own ground.

Such an impressive start to the campaign means Sunderland go into Sunday's game a point ahead 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.

"Come Sunday, the world will know the North East is relevant again with elite fixtures again," a former player added.