Coping With Chronic Pain as an Athlete: 6 Tips From a Pickleball Pro With Crohn's Disease

Professional pickleball player Rob Nunnery, now 41, looked like the picture of health from the outside.

In March 2022, the former Division I tennis player was traveling the world and competing on the global pickleball circuit. But behind the scenes, he began experiencing a sudden, severe pain in his backside that led to years of chronic pain, fever, chills, and abscesses (pockets of infection) requiring surgical drains. “It got so bad, the pain was so rough, I had to go to urgent care,” says Nunnery, who lives in George, South Africa. “As the pressure built up, it translated into extreme pain.”

After his diagnosis in May 2023, Nunnery underwent several surgeries, including a temporary loop colostomy, and ultimately a proctectomy (removal of the rectum) and permanent colostomy in January 2026. Since then, Nunnery has returned to the court, but he has a more measured approach, adapting his training and competition schedule around his changing health needs.

Nunnery’s journey highlights the challenges of coping with chronic pain as an athlete and staying committed to his sport while managing serious health issues. For Nunnery, who is now a social media ambassador for the Crohn’s & Colitis Foundation, it meant advocating for himself at doctor’s appointments, treating rest and rehabilitation like training, and adapting his sport around changes to his body.

The Challenges of Coping With Chronic Pain as an Athlete

Whatever the cause, chronic pain can not only derail training and performance but it can affect athletes’ sense of identity, emotions, and quality of life.

“In the context of an athlete, we have to be tuned into the fact that the body has been a vehicle for this person to do what they love, to do something that they identify with highly,” says Sara Davin, PsyD, a clinical psychologist specializing in chronic pain and pain psychology and the director of pain recovery at Cleveland Clinic Center for Spine and Pain Medicine. “Typically, even if it’s recreational sports, this is something that is central to the person’s life. And chronic pain is getting in the way of that.”

For Nunnery, the stakes were especially high. Being unable to compete meant potentially losing income and professional opportunities. Playing also gave him a distraction from the pain he was feeling. “It’s the only time that the pain’s not at the forefront of my mind,” Nunnery says.

6 Tips for Coping With Chronic Pain as an Athlete

It can be difficult for athletes to know how to cope with chronic pain, as well as the physical and emotional challenges that may come with it. These six tips can help.

1. Advocate for Yourself, Even if You Look Healthy

One of the most difficult parts of Nunnery’s chronic pain was that his outward appearance didn’t reflect what he was experiencing. While he appeared fit and athletic to his family, friends, teammates, and doctors, internally he was living with severe pain and privately questioning how he could continue living that way.

For months, Nunnery monitored his symptoms, sought out specialists, and navigated the healthcare system to try to get a diagnosis. When his symptoms began, he was living in Maui, Hawaii, where he didn’t have easy access to a gastroenterologist or colorectal surgeon. Ultimately, he relocated to the mainland United States, and at the Mayo Clinic in Jacksonville, Florida, he underwent a colorectal evaluation. He was eventually diagnosed with perianal Crohn’s disease in May 2023.

“The self-advocacy piece was something I didn’t understand until I lived it,” Nunnery says. “I thought when you get sick, you go to tell the doctors, and they fix you. And the challenge is if you saw me, I looked like a very fit professional athlete who was not sick at all, who looked absolutely fine.”

That mismatch between how he looked and how he was feeling encouraged him to speak up for himself. “Even though I look okay, I’m struggling, and I need help. I’m not going to leave here until we come up with a proper plan, whether it’s pain management, whether it’s the next step. I just need to really understand all the options,” Nunnery says.

When it comes to advocating for yourself, tracking your symptoms closely is one of the most helpful things you can do, says Alan Moss, MD, the chief scientific officer at the Crohn’s & Colitis Foundation. For example, in the case of inflammatory bowel disease (IBD), a “simple log of pain, bowel habits, and fatigue gives your IBD team real data instead of a vague ‘I haven’t felt great,’” Dr. Moss says.

Also, ask specifically how a given treatment might affect your performance, recovery time, or ability to train, since it may not be top of mind for a general medical visit, he says.

2. Consider Talk Therapy for Chronic Pain

Psychotherapy, also known as talk therapy, can be an important part of chronic pain management. That’s especially true when it affects mood, identity, relationships, or quality of life, Dr. Davin says.

As a pain psychologist, Davin helps her patients “identify strategies that can help them turn down the volume of pain so they’re able to do the things that they love and value,” she says. “When those things are made difficult or even taken away for periods of time, they understandably create sadness, grief, depression, fear, and anger.”

Depending on the person, helpful talk therapy approaches for coping with chronic pain may include cognitive behavioral therapy for pain, acceptance and commitment therapy, mindfulness-based therapies, or other specialized approaches. Davin recommends working with a mental health professional to determine which strategy is the best fit for you.

For Nunnery, weekly talk therapy sessions beginning in 2023 became an important part of coping with years of pain, uncertainty, and illness. “Being able to share what’s really going on under the surface has been super useful for me,” he says.

3. Know When to Push and When to Hold Back

When it’s in an athlete’s nature to push through pain, knowing when to hold back can be tricky. But distinguishing between the two becomes crucial when someone is recovering from surgery or living with chronic pain.

For Nunnery, medical clearance helped guide that decision-making. After his proctectomy, he couldn’t exercise normally, run, or jog for a couple of months, and he had to be especially careful while the surgical area healed. But he could walk.

“I would put my phone down and walk progressively a little bit more each day. I made that my new religion for those two months,” he says.

Moss says that medical clearance from your healthcare team is essential, especially after surgery, since pushing too hard, too soon can have serious health risks.

Generally, soreness or fatigue that improves with rest is a reasonable sign to keep going, but pain, swelling, and symptoms that worsen after physical activity are a sign to pause and check in with your team, Moss says. “Recommendations are always individualized, factoring in disease activity, infection risk, nutritional status, and medications, which is why return-to-activity plans are built case by case rather than off a generic timeline,” he says.

While some people are eager to return to physical activity, others may be fearful of returning to movement that may have injured them, Davin says. This is why paying attention to how your body is responding to exercise — and pacing accordingly — is key.

“Look at information your body is giving you as data. Sometimes you might push yourself a little bit further than you should have, and you learn from it, and that helps you adjust for the next moment,” she says.

4. Treat Rest and Rehabilitation Like Training

For Nunnery, managing chronic pain and postsurgerical recovery worked best when he approached it with the same discipline he brought to training. Instead of measuring progress by how quickly he could get back on the court, he focused on self-care and the specific exercises that strengthened his body.

Physical therapy was a major part of that process, and it is a tool he recommends to fellow athletes with chronic pain to learn how to safely move their bodies. “I would go weekly, then I would make sure that I was doing the exercises when I wasn’t at the therapist’s office,” he says.

Rest is just as important, Nunnery says. He now tries to use his energy when he has it, and he stops when the heavy fatigue sets in. “When I don’t feel well, I stop and give myself proper rest. I found that to be more productive than trying to push,” he says.

Davin says that setting these manageable recovery goals can help restore a sense of control and agency when it feels like chronic pain is derailing your plans. “It’s realistic, it’s achievable, and it instills a sense of control, confidence, and self-efficacy, which is the term that’s used in the chronic illness world,” she says.

5. Make Room for Grief — but Keep an Open Mind

Sadness, anger, and grief are normal responses when chronic pain changes your relationship with physical activity and your identity, Davin says.

Make room for these feelings, but don’t feel like you need to think in absolutes, she says. “We, as humans, reach toward a finality, like ‘I’m never going to be able to do this again in the way I wanted to.’ And that prevents us from being flexible in our thinking,” she says.

Keep an open mind, Moss says. “Many patients modify technique, adjust timing around medications or bathroom needs, or shorten sessions on harder days rather than giving up their sport entirely,” he says.

Nunnery had a similar approach. After surgery, he learned how to play pickleball with an ostomy bag, practicing jumps, lunges, and reaches with the equipment belted to his torso.

His goal is no longer recreating the exact athletic life he had before Crohn’s disease. Rather, it’s finding a version that works for the body he has now, he says.

6. Build a Support System

The period before Nunnery’s diagnosis in 2023 was his darkest. He was living alone in Hawaii, going through a separation, and experiencing severe pain without understanding what was happening to his body. "I didn't know how severe or complex my perianal disease was at the time,” he says. "I just thought this is not the way to live.”

Then a friend in Utah called him unexpectedly to see how Nunnery was doing. “He didn’t try to fix it. He just checked in on me and gave me his ear for a while,” he says. “I remember thinking back on how important that phone call was to me. That got me through the rest of that year, believe it or not.”

Alongside weekly talk therapy sessions, Nunnery has leaned on the support of family and friends. He also found another form of support within the IBD community: learning about experiences of people he had never met through reading about quality-of-life study findings on Crohn’s disease.

“I can’t describe how lonely it is when you feel like you’re the only one managing something,” he says. “I was seeing the quotes from other patients who have it. And it was the first time that I felt like there were other people experiencing the exact same things I’m experiencing. This is actually real, and it’s hard.”

Today, Nunnery is training, competing selectively, and working on products and content for people navigating gastrointestinal problems. For him, shedding light on IBD and what he went through has become another way of finding connection after years of feeling alone. This experience helped drive his decision to appear in a recent public service announcement for the Crohn's & Colitis Foundation.

“If I can share my experience honestly, without any of the walls up, then I hope it helps someone experiencing something similar,” Nunnery says. “And it’s been a healing part of the process for me to be able to connect with others on it.”