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Eddie Howe was technically on firm footing as he rang the bell.

The Magpies manager had just got the 2023 Great North Run started to loud cheers in the heart of the city.

But he had not accounted for those Sunderland-supporting runners who were less than pleased to see him as they sped past.

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

This is far from 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 signals the first time they will meet in the Premier League for nearly a decade.

But hardly any fixtures halt an area quite like the North East derby as former Sunderland manager Peter Reid knows better than most.

"They're 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 knows what can happen when these worlds collide.

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

It captures the Greek wild-eyed, shirtless and surrounded by his jubilant team-mates, after scoring the winner in front of the traveling support at the Stadium of Light in 2002.

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

"The key is the passion of the fans," he said. "This feeling that goes from father to son. This heritage makes this game so special."

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

Well, as far as a Sunderland season ticket holder is concerned, it goes beyond football itself.

"You can go back to the English Civil War with Newcastle siding with the monarchy and the other side backing the parliament," he said. "It's rooted in political and economic factors.

"Newcastle get the funding, Newcastle have the big city, Newcastle are the ones people always talk about when it comes to the North East. The other side are always shadowed."

But it is not at all one-sided.

A former player's father was even "mobbed" 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 meant to the Geordies.

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

"It eased my life a lot easier. I was allowed to make the odd mistake when playing, purely because of that goal.

"Even now when I visit 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 boost 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 technically been three points at stake, but he quickly understood the "extra weight" of this game because people in the North East "live for 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 - close 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 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 contests in the top flight.

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

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

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

"I was informed on the first day. 'Please stay up, but you must beat Newcastle'. I remain unsure if it was more important to stay up or to beat Newcastle."

The club, like Newcastle before them, eventually succumbed to the relegation trapdoor in 2017, and spent eight years outside the top flight.

So a division divided 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 tiny portion of the £40m Newcastle had invested in a single player.

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

"It's unlikely the fans really believed, 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 survivors 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 beaten Sunderland this season, while his side are also undefeated 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 top games again," a former player added.