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In Our Own Words

“I spent almost 20 years trying to figure out why my legs hurt."

By: Katie Compton  November 12, 2019

USA Cycling’s Katie Compton, 15 time-national cyclocross champion, copes with debilitating pain. Perseverance, mental toughness and self-advocacy have been central to her ongoing success.

***This is one individual's experience and not meant to represent a broader population***

I think one of the most challenging obstacles I’ve dealt with as an athlete is a variety of health issues I’ve encountered since I was a teenager. I spent a lot of hours as a junior riding my bike and really enjoying racing and training, sometimes a little too much, but it was mainly because I had the energy and was having fun. I look back and think that maybe 20-25 hour weeks over the summers when I was a junior was a bit much, but I wouldn’t change those experiences for anything. I had a great time riding with friends, learning new things, and exploring new places all while racing my bike. The only thing I wish I didn’t have to deal with was debilitating muscle pains I started to suffer from when I was 18. What kept me going for so many years was trying to solve the problem and figure out the why, so I could continue to race my bike and do something I truly loved doing.

Some people who have followed my race career or know me well know how hard it has been through the years and how many times I’ve had to opt out of racing due to my leg pains. It hasn’t been easy, and I still remember a couple World Championships where I couldn’t race and had to sit by the sidelines and watch as someone else won. One of them was a season I was racing great and winning a lot, and it was a race I had a real chance of winning. It’s soul crushing to work super hard for something, do all the training and prep and to be riding better than I ever have to then arrive at the venue after international travel barely being able to walk. Disappointed doesn’t begin to describe how much that hurt emotionally. This was something I have trained around since I was 18 and have learned to cope with emotionally, but it still isn’t easy.

Luckily, it’s not in my character to give up, and I am super stubborn when it comes to pushing through something (to a fault) which has helped me get to the place I am right now. I spent almost 20 years trying to figure out why my legs hurt and what was abnormal about my body. I definitely went through some ups and downs and wanted to quit a few times, but I kept wanting to race my bike and also be a healthy person who wasn’t in pain. That itself is pretty good motivation to keep trying.

The muscle pains would only occur in my quads and my glutes and only after intense training and a travel or rest day. Initially they lasted for about 14 days, but each episode got a little longer and more painful so they lasted for 21-30 days and occurred about every 6-8 weeks. Needless to say, it was pretty hard to train around those breaks. I was either recovering and working on my base again or jumping back into racing way too soon and struggling to keep up. It got to a point when I was in college when I just wanted to stop since the pain was so bad, I saw all the doctors I could see, had all the tests done and still everything came back normal. There was no diagnosis so my doctors were at a loss as to how I could be helped. I remember one of them I went to see for a muscle biopsy to check for a possible enzyme deficiency that was preventing my muscles from functioning properly, and he was a doctor who specialized in bariatric surgery but also did biopsies. Everyone in the waiting room was staring at me and probably wondering why I was there, since I was the only thin person in the room. That doctor was fairly overweight himself, and as he looked at my blood work and spoke to me about my pain, he asked me why am I even trying to ride my bike? He told me that I’d be healthier if I stopped exercising since my level of training wasn’t good for my kidneys (I suffered from rhabdomyolysis each time I had my muscle pains). I thought that was the stupidest thing. He was a doctor who worked daily with overweight individuals and thought it was perfectly fine to discourage me from exercising. I realized at that point I would rather live my life riding my bike and enjoying myself than to stop doing all of it and spend my life on the couch, so we carried on with the test.

In order to get a large enough sample to do the testing they needed to do, they ended up taking a 1x3cm triangle muscle sample out of my left quad (which left a nice scar I can still appreciate today) and the tests came back inconclusive, because of course they did. That was my last attempt at trying to find a diagnosis. There weren’t any more tests they could do to figure it out. At that point, I decided to go from solving the problem to managing the symptoms and trying to train and race around them. Those 20 years were a good lesson in learning how to adapt and carry on with my goals. I was fairly successful and have accomplished a lot over that period of time but none of it has been normal or easy. I adjusted my training intensity and recovery, stopped taking complete rest days (rode rollers or did yoga), changed my diet over the years and dialed in my nutrition to feel better. All of those things allowed me to perform better and only suffer from my muscle pains once a year or so.

Fast forward to three years ago while I was working through other health issues (I had recovered from being hypothyroid but was still dealing with bad allergies, asthma, immune issues, mood problems, and extremely low energy), I was listening to health podcasts hosted by a variety of doctors. While listening to a functional medicine doctor describe symptoms of a gene defect that pretty much described all of my symptoms, and that they now had an easy blood test to diagnose it, I decided to ask my endocrinologist to do the test at my next appointment. That result came back as a defect on two of my MTHFR (methylenetetrahydrofolate reductase) genes.

I’m not going to go into detail because it’s simply too much science to explain, but in short, it affects my energy metabolism through my body’s folate pathway. My body lacks the enzyme that metabolizes folic acid so my body cannot process it. I need the real form of folate (found in fruits and veggies) and slightly higher doses in order to feel and function better. I need to stay far away from any food products that contain folic acid since that will trigger my muscle pains and health problems. Finally knowing what I need to do to manage it has pretty much been a life changer for me. The reason I initially started having problems when I was 18 was it coincided with the timeframe that the FDA started enriching all flour and processed foods with folic acid, so I had no idea I was ingesting something that my body couldn’t process. Now that I have changed my nutrition and don’t eat any folic acid nor any processed foods, I’m much better and can live without pain as long as I’m careful about what I eat and make sure I get enough folate and B vitamins.

It’s annoying that all my health issues were really that simple to fix, but I’m happy I finally figured out the root cause. I’ve learned what my body can do and how I recover. I know that I don’t respond to training like most people, nor do I recover as well or as quickly. It’s taken a lot of trial and error to allow me to figure out what my body can do and how I can get the most out of it with quality workouts and dialing in my race schedule to suit my strengths.

I think the biggest thing I’ve learned from many years of dealing with this is to be your own best advocate, do your own research, listen to your body, ask for help, and see a therapist if needed. Being a professional athlete is hard and it takes leaning on others and asking for advice or help when needed. Also, be kind to others who may be struggling with something, whether it’s being sick or injured or struggling with mental and emotional problems, we all need help and kindness at some point to help us get through. Being an elite athlete is a challenging job to manage both physically and emotionally, and being able to lean on others and ask for help when needed makes it a little easier.

Bike racing is super fun and amazing most of the time, but it’s not always easy. There is a level of disappointment you’re going to endure throughout your career, despite the successes, and learning how to process and manage those negative emotions will make your life a little easier. Every single one of us goes through bad times at some point in our life, and it’s how you deal with those moments, take on those challenges, and what you learn from those experiences that gives you the tools to fight through the hard times and truly enjoy the successes.

About the Contributor

Katie Compton is most well known for winning the Cylco-cross National Championships for a record 15-times in a row. In 2007, she became the first American woman to podium in the Cyclo-cross World Championships. Compton was also the pilot on a tandem for a blind athlete, and would win two Paralympic titles at the 2004 Games in Athens, Greece.