Learning Self-Defense When You Live With Chronic Pain

by Lene Andersen, MSW Patient Advocate

One in six women and 1 in 33 men have been sexually assaulted at some point in their lives. This number reflects only the cases that were reported — estimates of true numbers may be much higher. The term sexual assault includes rape, verbal harassment, and molestation (that is, unwanted touching). Living with a chronic illness - especially one that causes chronic pain, such as rheumatoid arthritis - may affect our ability to resist a potential attack. So how can we tailor self-defense to our unique needs? Here are some tips. (A warning: This slideshow may contain triggers.)

Fists punching.

Can you be safe?

Most of us consider ourselves fairly safe in our day-to-day lives. Even so, women tend to be particularly aware of assault statistics and many consider a course in self-defense a must. One of the first things they teach you is that the idea of absolute safety is an illusion. Although you will learn what to do if attacked, the primary focus is on prevention of assault by using tactics that may help keep you safe.

Men's shadows on ground.

Pay attention to your surroundings

When you’re out walking, both during the day and when it’s dark, choose well-lit streets with lots of people, don't cut through back alleys and keep an eye out for hiding places, such as bushes, large pillars, deep entrances and entrapment areas (places with only one exit). Don't listen to music or podcasts —having a soundtrack to your day can be a good thing, but it can distract you not just from regular traffic, but also from hearing someone approaching.

City taxi at night.

Pay attention to yourself

We tend to navigate the world with our minds, instead of our instincts. But instincts play a big role in keeping you safe. Listen to your gut. If someone or something makes you uncomfortable, walk away, cross the street, or go into a store or restaurant and call a cab. Keep a ride-service app like Uber on your phone, or have cab fare available at all times. Walk as straight as you can with your head up and always look around. This shows that you are alert and could deter an attacker.

Women with arms around each other.

The more the merrier

You are less vulnerable to assaults if you have company. If you have to visit an area that has a high crime rate, a place you've never been before, or are going out after dark, ask a friend or coworker to come with you. Many companies, malls, and government buildings have security guards who can escort you to your car if you are alone or feel unsafe. Don’t be shy or feel silly about asking — an escort to your car or transit can make a big difference.

Woman hand up to say stop.

Voice power

Simply using your voice may get you out of a sticky situation. If someone's getting too close, look at the person and firmly and clearly tell them to back away. If they persist, get louder, shouting at them to back away! Attackers tend to focus on what they perceive as an easy target and making noise like this shows that you are not. As well, using your voice in a powerful way will bring attention to your situation for people nearby who can help you.

Red assault whistle.


Many self-defense courses sell you what's called a rape whistle, which looks like a regular whistle but is even louder. You can also carry mace or pepper spray (if legal in your area). If you have a condition that affects the mobility and dexterity in your hands, this can make it difficult to find the container and to use it. You may want to consider taking a self-defense course and talk to the instructor about options.

Hand on the head of a cane.

Whack ‘em

Although the goal is always prevention of a physical attack, situations do sometimes escalate. If that happens, mobility aids like canes or a hard splint may serve as a weapon you can use to defend yourself. If you have no choice, it’s important that you don't hold back, even if it hurts your joints. Fight as hard as you can, while yelling in a powerful way to bring attention to your situation.

Woman getting out of a car taking out her gun.

What about a gun?

Some people get a license to carry a concealed gun to use for self-defense, but this may not work for you. Again, chronic pain in your hands can make it difficult to use a gun and unless you get regular practice, it can be difficult to use it the way you intend. Pulling out a gun also pretty much guarantees that any altercation escalates into deadly force, either from you or from the attacker. The aim is to survive and using a gun may interfere with that.

Woman fighting back against attack from a man.

Theory and practice

Acting effectively when you’re scared can be difficult. Self-defense courses include practice and role-play to help you remember what to do and teach you physical moves to use if attacked. Think about your strength and mobility when choosing a course (Wen-Do incorporates modifications for people with disabilities). You can find self-defense classes online or contact your police or sheriff's department. Make sure the instructor has experience in adapting moves.

Me too concept.

What to do if you’re attacked

If you have been attacked, call 911 and do not shower, no matter how much you want to. This can prevent finding evidence to convict the attacker. If you have experienced sexual assault, even if it was years ago, call a rape crisis hotline (check online). As well, the Rape Abuse Incest National Network (RAINN) has an online helpline. Remember: You did not “provoke” the attack. The responsibility for the assault lies squarely on the shoulders of the person who attacked you.

Lene  Andersen, MSW
Meet Our Writer
Lene Andersen, MSW

Lene Andersen is an author, health and disability advocate, and photographer living in Toronto. Lene (pronounced Lena) has lived with rheumatoid arthritis since she was four years old and uses her experience to help others with chronic illness. She has written several books, including Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain, and 7 Facets: A Meditation on Pain, as well as the award-winning blog, The Seated View. Lene serves on HealthCentral's Health Advocates Advisory Board, and is a Social Ambassador for the RAHealthCentral on Facebook page, facebook.com/rahealthcentral. She is also one of HealthCentral's Live Bold, Live Now heroes — watch her incredible journey of living with RA.