# Retrospective Analysis of Functional Pain among Professional Climbers
## 4 Discussion  
This is the first study that has investigated the prevalence of functional pain in climbers. Additionally, the functional pain dependency on the athletes' proficiency, type of climbing, and gender was analyzed. The results of the study indicate that climbing increases the risk of functional pain in the following areas: GHJ, elbow, and fingers. The female gender is predisposed to functional pain in the GHJ, thoracic spine, and lumbosacral spine, while the male gender reports pain in the fingers. However, the type of climbing and level of performance had no impact on the occurrence of functional pain. Surprisingly, the risk of headaches and back pain in climbers is twice lower and almost twice lower, respectively, compared to the control group. The current study results that demonstrate functional pain occurrence are consistent with the studies reporting injuries among climbers [11; 12; 13; 14; 15; 16]. It has been suggested that the upper limbs are affected by climbing, and acute injuries of the lower limbs are caused by falls [15]. It seems probable that functional pain is a factor that precedes the onset of an injury in a particular region. The biomechanical studies of climbing proved that climbing results in specific adaptations to the musculoskeletal system, such as imbalance in capacity and the activation of antagonist muscles, especially in the upper limbs [17; 18; 19]. These factors may predispose one to soft tissue overloading and--consequently--to pain. The fact that functional pain has currently been classified as neoplastic pain can suggest a probable pain pathomechanism. However, to answer the question of whether functional pain depends on neoplastic pain characteristics, further studies focused on a more precise examination of neoplastic pain are required. Despite the International Olympic Committee's indication of the importance of neoplastic pain, little is known as regards its occurrence among athletes [6]. We do not know if the group presented in the study suffered from neoplastic pain. It is not clear what causes the differences between male and female climbers. The occurrence of functional pain in various areas depending on gender may be explained by mechanical factors, the climbing technique and habits, or some other distinctive features of climbing, which can be different between males and females [20; 21]. However, the etiological basis underlying these sex differences is unknown. The hormonal status is indicated as a possible explanation [22; 23; 24; 25]. Moreover, the female predisposition to the asymptomatic form of trigger points in the lower limbs has been confirmed [26]. Thus, we can speculate that neoplastic pain among female climbers is possible. The differences in pain as regards the type of climbing turned out to be statistically insignificant. Nevertheless, people who reported their preference for bouldering or lead climbing were included in the climbers' group. A possibility of examining a study group that only includes the climbers who perform one type of climbing or spend much more time on training one of the types of climbing should be taken into consideration. We conclude that further analysis is required. The level of climbing performance seems to have no impact on the prevalence of functional pain among climbers. However, in this study, we used the scale of experience level suggested by [PERSON] and [PERSON] [11]. It does not take into account the intensity of climbing. The Climbing Intensity Score (CIS) should be considered instead as it includes