Thursday 9 May 2019

Body in mind; My journey with chronic pain


Pain is complicated in nature and after so many years dealing with it, it has become very personal to me. This is my journey to experience, no one els’s. 
One of the hardest things I have found is when people are trying to make me feel better by saying “just race for the fun of it” or “I have bad weeks in training as well”. If only things were that simple.

Explaining what it feels like to live with chronic pain is not easy and I think it is a different experience for different people. Being an athlete, the pain you feel in your body after a hard week of training or the burning sensation of lactic acid in your legs during high intensity sessions, I call that good pain. Chronic pain is a whole different sensation. It feels like something is very wrong.  The best way I can describe it is like a bad tooth ache in my whole body. I call it bad pain. The worst pain is in my legs. It takes the fun out of everything I do. My philosophy however, is that I would rather be on my bike in pain, or be in the outdoors in pain, than be sitting on the couch or laying in my bed in pain. It is this motivation which keeps me going.
Meeting Rob racing Dukes Weekender 
When I look back at my training diary I started having symptoms after the 2013/2014 season when I tried to combine my career as a veterinarian whilst racing at elite level. I got myself into a chronic state of overtraining and depleted my parasympathetic nervous system. Of the back of that I fractured my back in 2015 in a rather benign bike crash. I ignored the pain until symptoms had become so bad in 2016 that I was told not to run for 12 months and only ride my bike at low intensities. Not being mentally ready for this, I stopped running but kept on riding my bike and started training for MTB stage races guided by coach Rab Wardell who tried everything in his power to slow me down. 
Riding the Dolomites with people like Siegrid easing my chronic pain symptoms

I landed at Whatsyourmeta through Rab, where I started working together with James McCallum and physio Morgan Llyod on getting my strength back after 12 months of what I considered as taking it easy.


Running trails is my chicken soup for the soul
My biggest complaint to my coaches both Rab and James, was that I felt like I could not push myself through threshold intensity in training. Looking back now I was never honest to them or myself about the amount of pain I was in during these sessions. I did not want to be told I had to rest because rest days made me experience more pain. No professional could really explain to me what was going on. It was like my body was blocked. With my primary injuries being kept under control with the help of physio Morgan, I felt that there was only one way to beat it and that was to try harder and fight against it.

Last Summer I experienced the worst pain flare up to date which left me mentally and physically broken. I started having difficult conversations with my coach James questioning if the effort was worth it, and what I was trying to achieve. I was so lucky James got never negative and kept me believing there was a way out even if we could not see it yet. Although he always worried about me, he never gave up on me.

It was during this time Rob Friel reached out to me after having read my blog about racing  an awesome event he organises; The Dukes Weekender . He educated me about chronic pain and it was like a light bulb went on. A million messages, a few phone calls, and a couple of meetings followed. To me Rob is worth his weight in gold. It was like a whole new world opened up. The three key things which made me understand my pain were these;

 1: The brain produces pain as a response to anything that can form a threat to the body, not just physical stressors but also mental stressors, it produces pain in an attempt to protect the body. It relies on previous experiences to decide how much pain to produce.

 2: Pain is not directly related to the amount of physical damage 

 3: Chronic pain often leads to central sensitisation. Which means that the nervous system gets regulated in a persistent state of high reactivity. This state of reactivity lowers the threshold for what causes pain and comes to maintain pain even after the initially injury might have healed.

The way I had been dealing with my pain only caused for more symptoms. On top of a stressful job as an equine veterinarian I had been overloading my body with high intensity training sessions in an attempt to “overcome” my lack of performance. With a central nervous system which was screaming at me to slow down by producing more and more pain. Once I realised that there was a reason for what was going on with me which had nothing to do with my ability, (or in my head lack of ability) as an athlete it was much easier to accept that I had to change my approach.

one day I will get back to this
Understanding where my pain was coming from was the easy part, how to desensitise my central nervous system is the tricky part. Rob and I call my pain “the bear” and the key is to poke the bear enough to make him pay attention and stimulate adaptation but not poking the bear to much, waking him up growling causing more flare ups. 

I started to learn about my pain triggers. My job as a veterinarian being a huge trigger, running was another one, and riding my bike at high intensities/race pace. The cold Scottish climate was not hugely beneficial for my overactive central nervous system either. Once I knew this I tried and adjust to prevent flare ups as much as I could. Backing off my training after a stressful day at work. Choosing turbo over riding outside on cold days and being kinder to myself on bad days. On the bike we started doing consistent sub threshold power sessions, giving threshold power and over a gentle nudge every week.

Although running was a huge trigger. Giving it up was not an option for me. So with Rob’s guidance I started with a 2km run 3xweek rehab program. That distance was increased by 10% each week. I was in quite a lot of pain when I first started. Barely managing the 2km. But with Rob’s support I persevered. 2kms turned into 3, 3 into 4, 4 into 5kms. All the way to 10km’s where I am at now. Once I started to run over 5km’s I started to feel less pain. I was able to lengthen my stride and produce more power. The more I enjoyed it and relaxed I run the less pain I would feel. Interestingly with decreasing pain in my running, my overall pain decreased.
My succes at Ten Under The Ben does not mean by any means that I am "fixed"
This is where I am at now. Finding the right balance is a work in progress. I still get growled at quite a lot by the bear but he is not as loud anymore. I am not sure if I ever will be pain free. Which makes me sad from time to time, because all I long for is to be able to move freely. But as frustrating as it gets, I now understand what is going on. And instead of telling myself to "try harder and push through it” I tell myself to “chill out and stop fighting against the bear" And hopefully one day the bear will stop fighting against me. 

A huge thanks to Rob, James, Morgan and Carol and the team at Whatsyourmeta for the endless support and positiveness. You really have been my rock. Here is to baby steps forward because I am simply not giving up.

“Sometimes the strength within you is not a big fiery flame for all to see. It is just a tiny spark that whispers ever so softly “You got this. Keep going”













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