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. And for those who are suffering with chronic pain that want to stay active to see how another person manages their symptoms to stay in the sport and 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.
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. 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.
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.
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 is also moments when the pain is milder where I have gone back the next day despite the fact you may have done back to back days of the similar levels of activity.
You will often see me just led down next to a crag between attempts now, just for moments to give my hips relief from pressure and to help my pelvic congestion syndrome.
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 shoe 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.
I have to spend longer warming up than most people for climbing and other sport or exercise. The benefits of appropriate warm up’s are often underestimated, but the easing of consequential muscle pain from compensating soon becomes a motivator.
This is linked to point 5 but I am also more in tune with my body. 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.
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 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).
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. Be honest, it can feel embarrassing but in society we have removed stigma, misinformation and improved awareness for so many illnesses.
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 crag, you might need longer rests or just a longer day overall to allow for that extra rest.
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 my pain. I recognised this as I was going through diagnosis and reached out to get some professional support for my behaviours so I not holding myself back.
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 deteriorate when contraceptives are used in treatment or if you are suppressing oestrogen.
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 its 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 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. And less elitism, which is really prevalent in other sports I work with. I imagine this may be different at higher levels but I have yet to experience this even when training competitive climbers (in the gym) and even with friends who are coaches and researcher at higher levels.
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.
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 endometriosisI really recommend reading The doctor will see you now (and get your partners, family or those you live with to have a read through).