Training With Ulcerative Colitis

Training with Ulcerative Colitis (or “When the S**t Hits The Fan”)

By: Mac McGregor, BLOC Staff Coach in the UK

“I’m crapping blood, and it won’t stop.” Those were my words to my teammates just after we started the most brutal event I’ve ever attempted. The characteristically stoic reply was, “Yeah, you need to be careful with that.” And just like that, emergency care was completed, and off we trotted. I lost count of the number of times I had to stop and frantically drop my trousers in full view of the world; there was just no hiding from it. As odd as it may seem, these guys had already seen far worse, and I was able to mentally cling onto their doggedness and humour to help keep one foot stepping in front of the other. Mercifully, but perhaps unsurprisingly given our location, there were few other spectators.

After around 30hrs, 130km, and 12,000ft of ascent through, around, and over the Cairngorm Mountains, we finished, and I made a direct line to the Senior Medical Officer the very next day. 

Fast-forward a few miserable weeks of uncontrollable bowel movements, mucus, and blood. I was subjected to the unique horror of the first of many Sigmoidoscopies and Colonoscopies that confirmed that I had a form of inflammatory bowel disease called Ulcerative Colitis. Don’t worry; I hadn’t heard of it either. So, I became an “expert” on it. This particular autoimmune condition causes the lining of my large intestine to become inflamed and ulcerated. It is a bastard, and the chances are I am stuck with it. It’s left me with an amazing paranoia. I HAVE to know where the nearest bathroom is at all times; long journeys on public transport are my worst nightmare.

That was ten years ago. Up until that point, I had maintained my fitness in the traditional manner of running, circuit training, and tabbing (that is to say, carrying lots of heavy things quickly over long distances with a lot of shouting). I tried to keep at it but found after a few minutes running, my guts would churn, and the irresistible urge to go potty would override every other motor function. And once it had started, it just wouldn’t stop.

Over the next few frustrating years, my fitness dwindled. I was losing weight but somehow getting fatter at the same goddamned time. But my desire to keep moving never left, and I kept on trying to run. I lost count of how often I would be caught unawares with the inevitable pressure of having to let loose my bowels in 10, 9, 8, 7… often without cover and in full view of disgusted and astounded strangers who were understandably quick to make known their distaste at my brazen and abhorrent behaviour. I had even tried a running “Linear Progression,” where I would see how long I could run for at a certain speed and gait before feeling “the need.” Then I would try again to see if I could last any longer. Suffice to say that it was a futile effort.

I can’t remember exactly when my determination broke, but I think it was around the time my illness flared badly when I took up a new and stressful post. A flare-up is when, for reasons unknown, the disease goes into overdrive, overwhelms my medication, and turns the inflammation up to eleven. It’s an all-consuming vortex of cramp, fever, weakness, nausea, never-ending diarrhea, anxiety, fatigue, and hopelessness all rolled into one. It broke bad, and I was reduced to a feverish, nervous wreck. I was sick of the pain, sick of being paranoid about leaving the house, sick of feeling as if I was being judged, sick of the chaffing, sick of blood tests, sick of the threat of medical discharge from the military, sick of the smell, and sick of feeling weak and powerless.

I COULD NOT go on like this, and it slowly became obvious that I needed another outlet, some other form of training that didn’t incite the gut-churning and public displays of incontinence. I turned to the most unlikely thing I could imagine: the barbell. For years I had laughed off the prospect of such unnecessary tomfoolery; surely, with all the running, mountaineering, and tabbing, I was already strong and had no real need to train “legs.” 

I scoured the internet for a programme, got started, and immediately fell in love with the squat. Incredibly, I noticed that I was able to complete most workouts without having to scramble away to the toilet. After about a month of training three times a week, I noticed that the sore knees and back that I had been living with since joining the military had slowly melted away. More importantly, I was enjoying lifting, and my training mojo was back in the room. After a couple of months, muscle was reappearing with reinforcements, the fat was saying cheerio, and it gave me hope.

All that being said, the condition has slowly gotten worse over the years, and it makes its presence known every single day. But I’ve learned how to manage, just a little, the impact it has on my lifting. The payoff is the positive impact that lifting has had on my life.

One major issue is eating enough food, and I haven’t figured out an answer yet. The seemingly straightforward concept of “just eat more food” has very real, incredibly simple, and immeasurably evil consequences that do not make for polite dinner conversation. My experimentation with various whey protein powders created a noxious Frankenstein’s Monster so foul it put my marriage at risk. Thankfully, a swap to whey isolate may just have permitted a stay of execution.

I’m lucky enough to run my own gym, conveniently located about 90 seconds walk away from my front door. However, even that minuscule journey is plagued by surprise countdowns from the bowel area, usually when at the halfway point between house and gym. When I was outfitting the place, I installed a separate toilet and shower just for me in case of accidents, and it has proved a wise investment more than once.

Sometimes a workout will go smoothly; other times, I’ll have to make repeated toilet breaks between sets, and I’ll cool all the way down. Sometimes having the confidence to make depth on heavy squats is a real leap of faith, and it takes all I have to squeeze EVERYTHING and commit (The squat certainly trains ALL the deep musculature!). Other days, I have nothing to give, and even a light squat threatens to crush me into the floor. These are the good days. I imagine that this is how ya’ll who have healthy bowels feel about squats.

Bad days are something else entirely, and they come during a flare-up. The prospect of working out becomes a terrifying dread, and it’s so easy not to train. It’s much easier to draw the curtains, stay in bed, and hide from the world. But I HAVE to train. I’ve been folded in half by that damned barbell and had to shuffle out from underneath so many times it’s embarrassing, but if I fail, I back off the weight and DO SOMETHING. I don’t care if it’s just the empty bar and I have to change my underwear afterwards; I just DO SOMETHING. If you’re living and lifting with this disease, I hope you eventually find the most effective methods that suit your own situation. It might be some simple load or intensity reduction or volume management like ascending or descending sets. I’ve recently enjoyed getting my volume in with cluster sets focussed on finding some acceleration, which is particularly helpful in my case since I failed to inherit any fast-twitch muscle fiber from my parents.

I’ve found that the physical strength I’ve built up on the good days, and more importantly, the intangible feeling of self-worth, doggedness, humour, and resilience that grow alongside it, get me through those bad days. Then it helps me get back into the swing of things sooner than I thought possible. It’s easy to succumb to the feeling that I’m just treading water since my squat and deadlift PRs seem to have been stagnant forever, but the lifting process reminds me that the tortoise wins this race, and eventually, I’ll grind those PRs down, and I’ll be stronger when the next flare hits. I’m now stronger, fitter, more mobile and have fewer aches and pains than when I was in my twenties. 

Over the past year, another huge difference is that I’ve been coached. I’ve had someone looking out for me who knows my background, can adjust my workload accordingly and, most importantly for me, someone who I don’t want to let down. Your coach and fellow lifters who know and respect you will understand when you’re fighting through a bad day. The chances are that they find lifting helps them to combat their own demons; we all have them. Lifting has taught me how to see through the self-pity and doubt and how to push myself again, how to hold myself accountable and to realize that I am something more than my diagnosis. Besides, what am I going to do, not train?