This article is a little bit different to normal. Please note I am not a medical expert, but having two health conditions that effect my daily life and having a scientific mind, I wanted to bring some awareness around a topic less discussed. I also wanted to write this for those who are suffering with chronic pain that want to see how another person manages their symptoms to travel and stay in the active environment they love.
Much like 10% of the female population worldwide I live with a condition called endometriosis. In my most recent laparoscopic surgery it was discovered that I also have a condition called pelvic congestion syndrome. Both of these conditions cause debilitating pelvic pain on their own, along with a number of other symptoms that often interrupt being able to do normal daily tasks.
For Anyone Suffering With This Endometriosis You Will Be Familiar With My Experience:
- Fighting for a diagnosis for over 10 years
- The medical attitude of experimentation from doctors and specialists to see what works.
- From multiple excision and ablation surgeries, hormonal injections, concoctions of pain medications to chemotherapy drugs to induce early menopause and the odd additional measure of a health professional ignoring your evidence of diagnosis to tell you, the pain is in your head.
- Daily pain around my pelvis, legs and back; prescribed pain killers and NSAIDs (that also cause a lot of damage to the digestive system), a hot water bottle and needing to be sat or led down to rest after simple tasks.
- This then escalates regularly to vomiting or passing out from the sharpness of the pain, getting ‘Endo Belly’ (which looks like I’m 9 months pregnant and incredible painful).
- Another common symptom I face is struggling to perform normal daily tasks such as walking, making food and household chores without the assistance of someone holding me up.
- Chronic fatigue plays a role in my pain; it increases the more I try to ignore it and is really unpredictable. This feels like i’m being dragged down by gravity internally. I saw a post on social media once that gave the example of being stood in sea up to your hips and the tide is pulling the sea back. That feeling of resisting the water is entirely relatable for me.
- My legs feel like led generally walking is a big effort for me.
- Brain Fog that goes beyond forgetting the odd things. Sometimes I forget where I am, why i’m there and it becomes very stressful at this point (this kind of ties into the fatigue part).
- Pelvic congestion syndrome also causes unpredictable daily pain I call it veiny pain. It feels more sharp and hot in different areas. The only think I can liken it to, is being burnt. It feels like someone is holding a lighter internally around my pelvis and top of my thigh. Sometimes its sharp and short, other times it lasts for a while gaining intensity. Advice for this from medical professionals is don’t sit for long periods of time, don’t stand for long periods of time (confusing ey?). If it hurts, lie down, take pain killers and rest.
Endometriosis is the leading cause of infertility in the world with >10% of the female population suffering with this, and an average waiting time of 7-10 years for diagnosis in the UK alone.
Unfortunately there is not a definitive cure for either of these, just treatments that might work for a short period of time, with side effects.
Climbing With The Pain… When To Stop
I have always been active and loved being in the outdoors. As I got older climbing has been one of the key activities that has motivated me to keep moving and keep trying (even with many failed attempts). I’m terrified of heights yet I go through a mental fight process with myself to reach the top of a wall or a crag and once I am at the top I feel great. It’s like ‘If I can do this, I can do anything… I just have to put my mind to it and push my body’.
Unfortunately my body doesn’t quite work that way, I am able to push my limits and climb with a certain level of pain but there are things I have learnt from climbing with this pain every day. Here are some of the key lessons I have learnt.
I have to listen to my body. When my body says it’s time to stop, I have to respect that.
I focus on enjoying every sport I do. I sometimes get frustrated through my own ego and it’s easily done. Asking myself why my body isn’t listening to my brain or get a little focussed on wanting to complete a certain route. I have been humbled as my condition worsened and I’m able to just enjoy each moment my body does move and laugh when it doesn’t so well.
The Importance Of Rest To Manage Pain
Rest is so important. Research shows that rest can improve performance, and reduce peripheral fatigue (the ‘pump’ you experience in the forearms and hands), yet there is an urge to rush back to a route despite this.
There are moments when the pain is milder where I have gone back the next day despite the fact I may have done back to back days of the similar levels of activity. Try to consider the balance. Could you do better with an extra day of rest? could you lessen the impact on your pain by allowing for rest? What is the knock on effect when you trigger a flare up (how many hours, days, weeks or more do you lose of other daily activities)?
You will often see me just led or sat down next to a crag between attempts for longer periods of time than others, just for extra moments to give my hips relief from pressure especially when endometriosis is bad and to help my symptoms of pelvic congestion syndrome. I tend to add in extra clothing for changes in weather but also put these in the bottom of my day pack. This will also allow me to use it as a bit of a cushion to sit on when the floor is hard.
Rest between attempts, climbing sessions/days. Full rest days from exercise needs to happen for everyone (even top level athletes). In my case even days off from physical activity beyond normal daily tasks need to happen.
My climbing shoes and harness are now more focussed on comfort. Less pressure on the hips and comfort when placing my feet really help me to commit to a harder movement in climbing. On a low pain day, having a tighter shoe or one with more of an arch and point may be more helpful for heel hooks and tougher foot placements, but my daily pain levels are more moderate-high.
My Pain Pack
I have to take a kit with me including: heat patches, tens machine, sanitary towels and pain medication with me to the climbing wall or crag (hot water bottles or heat blankets for before and after).
Clothing Considerations When Climbing With Chronic Pain
These are personal to me but after having conversions with more endo warriors or those with other conditions that cause daily pain, some of these may be very relatable.
I wear high waisted climbing pants or leggings in summer. I also need them to be good quality for two reasons.
- The high waist to help put light pressure on my endo belly, slightly hug it in and stop them from rolling (especially if i’m bouldering without a harness holding them there everytime I put my leg up).
- I also want the quality to be there so they provide a bit of warmth when its cooler or windy especially at the top. Sometimes the cold draft can set my symptoms off or exasurbate them.
I also have a similar approach to my tops. I want them to be long enough to cover the length of my body (I have a long body, short legs) and minimise the harness rubbing and sliding the top up.
The Climbing Rack and Gear Considerations When You Have Chronic Pain
I prefer trad climbing so for me I will be carrying a rack of protection on my harness when I lead or or adding to my harness when I second. An average rack can weigh between 2.5kg – 4.8kg. Which may not sound like much, but if you consider any rope drag when you are leading, the time of placing gear etc. It can add up for those climbers that are light in body weight.
I also take a pair of approach shoes clipped up on my harness so the decent is more comfortable.
- If we consider this a little more, those with chronic pain like myself may find their body mass fluctuates quite a lot due to periods of time on different medications and inactivity during flare ups, losses in strength relative to your bodyweight.
This extra weight, when you are fighting gravity as a sport can result in increased energy output and awkwardness when struggling to complete climbs especially those requiring a more advanced techniques.
You also want to consider your overall backpack that you take with you to the crag. If you can save weight on your equipment and space whilst including the things that make you more comfortable, it’s a win.
Dont Be Afraid To Sit On The Rope
This one seems obvious but often our adrenaline or ego can stop us from rationalising and cause pathological behaviours when doing adventure sports. Having those pauses when your body or mind need it to reassess a route or just rest before retrying a section of the route.
Same goes for bouldering, sometimes we cant get to the top because of pain so we drop down. Instead of letting your ego get the best of you and cause frustration. Get a more open grip or jug that you are stable on and take a few seconds, try again. If you decide this isn’t going to happen today then why not down climb. Save the impact (even with the mats) on your body, by lowering gradually.
Other Exercise To Support My Climbing and Pain
Stretching and Yoga have really helped mentally and physically for my climbing. When you suffer pain regularly, ‘good posture’ can deteriorate, excessive tightness can occur in the hips and chest from the natural instinct to fold forward or curl up when feeling tired, vulnerable or in pain.
I have to spend longer warming up than most people for climbing and other sport or exercise. Outdoors a lot of this comes from the approach which helps (although it can be a fine line when it’s a long approch meaning I may need to rest).
The benefits of appropriate warm up’s are often underestimated, but the easing of consequential muscle pain from compensating soon becomes a motivator.
Many of us when warming up or initially undertaking a physical challenge will tend to rush a warm up and be too focussed on what’s next (the main routes we hope to climb), then move first and react to how we are moving retrospectively. However. when I am warming up by doing some dynamic stretches or traversing across some empty wall or climbing an easier route I am focussed on what my body feels like when I move in certain ways, do I need to do more or less, If I put pressure on one foot or hand in certain holds or stretches is this causing discomfort.
I’ll then be able to tell just how many climbs my body will be able to manage that day and what kind of movements I may struggle with. This has helped me to become more in tune with my own body.
Train The Specific New Challenges For Your Climbing
Often as climbers we are daring and do movements that are new and at risk of a fall on the rope or onto the boulder mats. Whilst the calculated risk is definitely something I like about the sport, I find practicing certain new movements at the boulder wall or on a familiar crack really helpful. If I struggled the first time but finally got it, it doesn’t mean I can automatically get that move again or transfer it on to another route. So repeating a route or a section with the new movement (or movement you haven’t used in climbing for a while) can be very helpful. Preparing both mentally and physically for the next new challenge.
Mind Over Matter
I find self talk helps me, when I am climbing, kayaking, paddle boarding or even just hiking. Sometimes I have pain that is mild but if I’ve had a recent flare up, fall or its progressing I can catastrophise what my pain will do (being more scared of a fall or taking a knock than I would normally). I recognised this as I was going through diagnosis and reached out to get some professional support for my behaviours so I not further holding myself back. Self talk can sometimes be the motivator I need to try a move again, or reinforce what I am planning to do with the climb.
Previewing Routes or Top Roping
Using your time between attempts productively can help to move your focus slightly away from the pain. Previewing the routes has also been shown to improve climbing performance and reduce fear when climbing. In addition to this, when approaching a route you have not been able to do the time before you can break this down into what is known as chaining. Have the rock or route split into sections in your mind. Some benefit from a bottom up approach others a top down. If its one i’ve done before I focus on top down, what is coming next after that movement that stopped me last time. If its a new movement I start at the bottom and have check points that I can see where there may be a nice foothold or hand hold etc.
If I have the novelty of a small group joining me for a climb instead of attempting to second or lead where I have to spend more time with the protection in the wall, I sometimes opt to be the third person on a route or go for sport routes where the anchor is set up and others have set up the top rope. This allows me to work out what movements they are doing with foot placement and see if I can mimic, or need to adjust (if they are taller or I need smaller ranges of movement in each move that day).
Having Discussions and Raising Awareness
I used to be very reserved and private, however since having my diagnosis I have felt it’s sometimes better to speak with those around you. Being honest can feel embarrassing with these conditions. In society we have removed stigma, misinformation and improved awareness for so many illnesses by creating open discussions.
Professionally my boss, colleagues and students are all aware of my conditions and it makes for a better work environment. Sometimes adaptations are made by myself or my supervisors to support me in my roles.
When climbing you might just need longer to ascend to the route or even approach the crag, you might need increase rests or just a longer day overall to allow for that extra rest. You may need to factor in the choice of wall or crag into your pain levels and have days where you will be tentative with your initial climbs (by using a lower grade to further warm up).
Adjusting Habits To Support An Active Lifestyle
As both of these illnesses and many others are affected by hormones (in particular oestrogen production), I have to adjust my diet and training to support this.
- By implementing resistance training alongside (this can be bodyweight exercise through to weightlifting) it can help to maintain bone density which tends to decrease when on hormonal medications for treatments. You should also increase your strength and muscular endurance to help make daily tasks and the movements in climbing easier.
- The day before climbing I am careful to avoid foods that may cause a flare up (these slightly differ depending on treatments and your own body). I would recommend logging food and flare ups to spot patterns or working with a dietician to get the best guidance on diet as it is a lot more complex than this.
Recognising When It’s Game Over… For That Day or Week.
This is probably the hardest part. I have to accept I do have an illness and there will be times when I wake up and getting out of bed is a no go. Again informing those around you is important so they can recognise the possibility of change or cancelling. It also took me a few years after my diagnosis not to feel guilty and to stop tolerating those who would try to make me feel that way if I bailed due to my illness.
The Attitudes Of Climbing & The Outdoor Community
There is thankfully little to no ego in the outdoor community I am around. My experience especially amongst the climbing and outdoor industry is of everyone enjoying their climbing, and trying to do better than they did the last time rather than looking or doing better than others. There certainly feels like less elitism (comparitively), which is really prevalent in other sports I work with. I imagine this may be different at higher levels but I still haven’t experienced this when training competitive climbers or working alongside professionals who work with ‘elite’ level climbers.
- I have to say I wouldn’t be doing half of the things I do with my life professionally and personally without the support of some amazing friends I have met through climbing (especially from my time at Lakeside).
Things To Remember
Physical activity and mental activity are not mutually exclusive. Just like physical health and mental health are also not mutually exclusive. If you have a chronic illness of any kind, you need to take care of both. If you love a hobby, make regular time for it but leave your ego at home. I have had support from counselling and cognitive behavioural therapy to help with my wellbeing more than once. These illnesses took a toll on my mental health for many reasons.
There are numerous research studies that highlight the detriment to mental health for those suffering with either of these conditions (as well as other similar conditions). If this is the case for you as a reader please reach out to your doctor, specialist or local MIND support. If you suffer with endometriosis I really recommend reading The Doctor Will See You Now (and get your partner, friends, family or those you live with to have a read through).
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