Riding while Battling an Autoimmune Disease

Jan 7, 2019 at 6:48
by Jukka Mäennenä  



Joonas is a Finnish enduro rider with a more than a decade of high-level riding under his belt. For the past couple of years enduro riding has been the main focus for Joonas, although his competition experience reaches all the way to the World Cup downhill events. Well before that, his resume included several podium finishes in the national enduro and XC youth cups. What makes Joonas and his situation unique and a story worth telling are the challenges he has to tackle on a daily basis. To get the full picture, it's best to start from the beginning.
Who is Joonas Riihelä?
• Nationality: Finnish
• Age: 28 years
• Riding experience: 13 years
• Most notable results: 2nd in National Enduro Youth Series in 2006, 1st in National Enduro Youth Series in 2007, 3rd in National XC Youth Series in 2007, 6th in National level Downhill Series in 2011 and 4th in National Enduro Series in 2016.
• Interestes besides riding: Videography, car simulator games
• Sponsors: Pole Bicycles
• Favorite food: Hamburgers, of course!


From a Kid on a Bike to an XC Racer
As for many of us, Joonas swung a leg over a bike when he was a young kid. His bike was his vehicle for freedom and speed which had been untapped until then. Eventually, Joonas knew his local trails as well as, or even better than his backyard. The sections that provided even just a little bit of airtime in the form of a banked stone or even a built jump or lip were known to the millimeter.

One thing led to another and in 2005 Joonas spent (or invested, depending on how you want to see things) his hard-earned summer job money on a proper mountain bike. Soon after he entered a national level XC race in Lahti, called Finlandia MTB. A spark burst into a full-sized flame next year in the form of XC racing and early forms of enduro riding. Interestingly, mountain bike enduro was most likely born in Finland although the format was slightly different than it's today. Slightly might be a bit modest term, since most of the races were held on flat(ish) tracks and the segments could be as long as 10km! Pacing strategy was naturally the same as today; start all out and hang on to your dear life and hope that the finish line arrives before you run completely out of steam. If the old format would have remained unchanged, it might be that enduro would not be as popular as it is today but that's a subject of a whole another conversation. With a combination of the limitless energy that adolescent boys have and pure hard work, Joonas earned the national champion title in the XC youth category in 2007.

Gravitational Enlightenment
Soon after things took a turn which is most likely not too unfamiliar to most of us. XC started to feel boring, even a bit dumb. Why pedal your arse off and turn yourself inside out when even more thrilling speeds can be reached with the help of good ol' gravity? Joonas raced downhill first time during 2008 and soon enough XC bike started to gather dust in the corner of the garage. This set the tone for the things to come; bikes equipped with a chainguide were in and ones with front derailleur were definitely out.

The time between 2010 and 2011 was especially prolific and Joonas gained a lot of pure race pace speed. In his own words: “I made very good progress and made a clear leap to the next level when it comes to track speed and bike control.” The recipe for this was simply hard work and plenty of time on the bike. During the winter months in 2011, Joonas rode several times a week with a friend who was considerably faster than him. It's no secret that it's one of the best ways to develop as a rider. According to the saying, you either rise or fall to the level of your peers, no matter the domain. It's also worth noting that riding during the winter time was no easy task. To get a session in, it more often than not required shoveling the track clear from snow. This effectively doubled the amount of time that was needed for riding. To ride couple of hours, snow shovel was put in good use for at least the same amount of time. No dig, no ride, no matter if it's about dirt or white stuff that falls from the sky during the winter months in the northern hemisphere.

Joonas raced with panache during 2011 season. Calpalinna (a legendary bike park for us Finns) hosted the first race of the season. A good run during the qualification resulted in the fastest time of the day which was big confidence booster. Things got even sweeter later in the evening when Joonas received a text from a rider who he had always looked up to saying: “I suppose that there's a storm brewing when it comes to your riding.” Podium finishes were not to be during that season however. Small mistakes during race runs, bike and equipment related problems meant that placings from 4-6th were a common occurrence in national cup races. The season wasn't limited only to domestic races though. Joonas gathered plenty of vertical meters abroad in the iXS cup and even downhill world cup races held in Leogang and Val di Sole.

The infamous "Bomb Shelter Descend" can't hold a chance against Joonas and the Evolink's monster truck wheelbase.


When Crap Hits the Fan
A promising season was ended with a seriously low tune. At the beginning of 2012, Joonas started to suffer from gastric refluxes and severe stomach pains, which resulted in extensive examinations and hospital stay. The first suspected diagnosis was lymphoma which – luckily enough – was turned out to be false soon after. One of the symptoms was heavily swollen spleen which is dangerous since even a slight impact can cause it to burst. Unfortunately, any sports that involved high speeds and the accelerating effect of gravity were out of the question.

Slowly and steadily Joonas started to feel better after the initial symptoms. Anyone who knows Joonas will attest that he is not a one to sit still and fall into despair. Since he could not ride, he needed a new outlet for the time and energy he had on his disposal. While recovering he decided to build a house – an obvious choice for any 22-year old. The courage to tackle a project of that scale is something to wonder, since a typical mountain bike is most likely still eating dirt in the playground that age. Skipping forward a full year and plenty of eventful times, the house was ready. Exactly one month after the house was finished, his left knee got badly swollen which was soon after followed by similar symptoms on the other knee as well. Off to the hospital he went for a new set of examinations.


A New Nemesis
The symptoms in the knees quickly spiraled to almost full body level. Both knees, ankles and the right shoulder got inflamed and except for the shoulder, got heavily swollen by unexplained liquid retention. A doctor in the rheumatology department diagnosed the condition as psoriatic arthritis, which is an autoimmune disease with unknown cause. Looking back, Joonas suspects that the house project could have been too much because of the stress it caused. We continuously learn about the negative effects of chronic stress and its possible unwanted effects to all sorts of health problems. Even though Joonas is made of stuff that you rarely see these days, he says that the house project was stressful at times. This can be translated without a doubt, that it would have brought a lesser man to his knees several times.

The condition was first treated with cortisone injections, which provided some relief. Although the injections dulled the pain somewhat, this type of treatment comes with its own set of problems and less than desired side-effects. Cortisone can weaken the tissues where it is injected to and make them fragile. There are rumors that some former professional road cyclist had to pay dearly after their career because of “generous” use of this particular substance. To sum it up, cortisone treatments weren't the answer, just a short-term fix for the symptoms.

Joonas tackling some roots just a 5min ride away from his doorstep.

Treatment of arthritis includes always a long and tedious testing to find the right treatment. Last resort is usually a new type of biological medicine, which are called biologics for short. They're often times effective in pain relief and they can go a long way in restoring patient's function. Is there a downside? Yes, a hefty price tag which will make mountain biking seem like a cheap sport in comparison. Costs of treating arthritis with biologics can rise up to 20,000 EUR per year. Luckily Finnish national health care covers most of the financial burden, but it goes without saying that all other paths and options are tried first.

The battle with the newfound disease continued all the way up to 2016. It is worth noting that the word battle isn't used lightly here since the disease made even everyday tasks a challenge at times. Think of an occasion when you hit your knee and it was sore the following morning, so sore that flexing it caused pain. This was and still is the situation that Joonas encounters every morning. He needs to make the steps from the bedroom to downstairs with a straight leg since the knee is always stiff after overnight immobility. Eventually it and the rest of the body warms and loosens up as the day progresses. Not the most pleasant way to start the day, but you gotta make the most of it, as Joonas says.

Pumping and carving around pumptracks has proven to be a lot more knee-friendly activity than plain pedaling. Joonas during a summer pumptrack session in Jämsä, Central Finland Region.

Back on the Bike
As it often times happens, a turn for the better came in a form of a friend. A long-time friend was interested of trying his hand at riding and asked Joonas if he could provide some guidance. Recognizing the limitations of his situations, Joonas still agreed. A substantial factor in his decision was that he could be in similar state 10 years from now, whether he rides or not. Why not to make the best of times ahead? Joonas started riding with his friend during the winter of 2016 and 2017 and as one could guess, enjoyed his time on the bike immensely. Although the speed wasn't at the level where it used to be, riding was fun and rewarding. Anyone who has had a long unwanted lay-off from the can surely attest to this.

In the beginning of 2017, Joonas made the decision to race again. He went back to the roots in a way since the chosen discipline was enduro. Much had changed in ten years though since the original debut in the sport (and for the better, one could argue). Although the races are still physically demanding, they don't make yourself question the fun of doing it in the middle of the race several times a minute. Joonas set himself a goal of finishing in the top 30, got into structured training and tackled the challenge. The end result was more than a positive surprise – he finished 4th in the national series by the end of the year! This is a no small feat considering that he had been off his bike for two years, still dealing with the medical condition and modifying his training heavily around it.

In the middle of the 2017 season, Joonas tried the Evolink from Pole Bicycles for couple of laps in his local bike park. Being 189cm tall, he's always been challenged by finding a proper sized bike. This time the match was as good as the contact between a proper pair of flats pedals and the sticky soles of 5.10's. When the Evolink came out, some were questioning the sizing and if even the L-size was just too big of a bike. Nowadays Joonas rides happily an XL-sized frame and the results speak for themselves that he has the right tool for the job. It is no exaggeration to say that Joonas can ride a hard packed berm faster than anyone else in the country. A proof of this was a comment from a former professional downhill rider who said that it was plain scary to follow Joonas on tracks of this type.

Last runs of 2018 before Sappee Bike Park got its snowy cover.

Taking It Day by Day
Early last year Joonas made an extended trip to Spain. Riding felt fast, and most importantly good and confident. Unfortunately, from the beginning of the two months stay In Malaga with his girlfriend, the troubled knee started acting up again. Inflammation in the knee escalated so badly that Joonas was unable to ride any trails or segments that included pedaling. At this point the knee in question was the source of most the troubles. It needed to be drained regularly to keep it in somewhat working condition. Doing this once in every 2-3 weeks in Finland was an ordeal itself and proved next to impossible abroad. Nevertheless, Joonas made most of his stay in sunny Spain while other Finnish riders were plowing snow from their home trails, or just staying inside to avoid the frigid temperatures.

“If I want to race during the weekend, I need to get the knee drained around Tuesday and hope for the best”, Joonas says. Getting scheduled appointments from a skilled doctor is next to impossible which leaves the private sector the only option. To keep himself competitive, Joonas needs to do quite a bit more than just training and his bike in a working condition. He's not the one to complain though, on the contrary.
Costs of getting the knee drained are equal to getting the suspension fully serviced. Doing that several times a month gets on top of just about anyone's wallet.

Many people and close friends have asked how Joonas can ride even when he can't walk around couple of blocks. To this Joonas replies that riding downhill is surprisingly static and you can get away with very little lower body movement when the gradient is favorable. There's an inherent risk though, especially if a crash occurs. Joonas hasn't been able to flex the problem-causing knee past 90 degrees for a long time and he's dreading about the thought what happens if it's forced past that range of motion during a crash. Yes, riding always carries inherent risks, but at the moment Joonas is rolling with an increased risk factor.

It's best to take things day by day and be grateful for everything.Joonasbigquotes
On same rare occasions, Joonas might wake up without any considerable pains which makes him feel that he could jump straight up and run a marathon. Of course, he hasn't done any silliness like that, since every bike rider knows that running is acceptable only if being chased (and only with the speed that prevents being captured). At the moment Joonas is waiting in line to get a surgery on his knee. It needs to be cleaned up after the constant and ongoing inflammation. Things are not this simple though. Joonas caught whooping cough that lasted almost 3 months because of the changes in medication that made his immune system temporarily weaker. To get as high a probability for success as possible, he has to be 100 % healthy when getting to the operating table.

If all goes well, we might see Joonas in the Finnish national enduro race circuit in 2019. Give him a thumbs up and a kind word. Although Joonas is not a one to give up, it will make a difference. This is true for anyone who is battling with a serious health issue.

Joonas is anything but vertically challenged. e needs a piece of worthy equipment and the XL sized Evolink ticks all the boxes as far as being longer than the lengthy wingspan of Joonas.



115 Comments

  • + 36
 I found the following quote on the Johns Hopkins University web site:

Clinical and epidemiologic evidence as well as data from experimental animals demonstrate that a tendency to develop autoimmune disease is inherited. This tendency may be large or small depending on the disease but, in general, close relatives are more likely to develop the same or a related autoimmune disease. A number or genes have been implicated in causing autoimmune disease, primarily genes related to the human major histocompatibility complex called HLA.

Please people. I am glad that your vegan or carnivore diet "cured" your autoimmune disease. But "data" is not the plural of "anecdote". Many autoimmune diseases are known to involve a genetic predisposition and a trigger event. If I don't have the predisposition I am very unlikely to have the disease. Many of the comments here remind me of the number of people who blame stomach ulcers on "stress" instead of h. pylori bacteria.

Under the direction of one physician I tried a truly horrid "migraine trigger elimination diet". Two months of can't eat this or that or anything with flavor. No change whatsoever. A couple $100K later we found evidence of permanent damage from a TBI I received when I banged my head on a low hanging beam walking down a staircase.

My wife has had two autoimmune diseases. The first responded to surgical treatment which eliminated the symptoms. The second was Rheumatoid Arthritis.

Ultimately she was treated with a biologic and her Rheumatoid Arthritis went into remission. We went down that route because 80% of the patients treated with that biologic have damage reversal, and 30% go into remission. She was in the latter category. So every winter we plan where we will take our on/off road tandem bike adventure instead of wondering if this will be the year she can't pick up a fork to feed herself.

The biologic in question is hideously expensive. We paid 1/3rd out of pocket. I actually had one insurance company tell me that they would not pay for it because it was "not medically necessary". My response was to tell them to pay by the end of the day or I would get a cop and place their CEO under arrest for practicing medicine without a license. We will never know how that would have gone because they backed down.

Please don't tell me that this shows the need for a single payer system in the USA. Joonas Riihelä lives in a country with a single payer system, and reading between the lines, he is not yet getting biologics to treat his condition. They are expensive to develop and to manufacture. All 3rd party payer systems need to control costs. Telling someone with RA or PA "sucks to be you" is cheap. Biologics are expensive.

I wish nothing but the best outcome to anyone dealing with an auto immune disease. Hopefully your outcome will be as good as my wife experienced.
  • + 7
 Thank you! So much pseudoscience and wannabe doctors in this thread.
  • + 8
 If I could up vote this a million times I would. I suffer from asthma, allergic rhinitis, psoriasis, psoratic arthritis and a host of digestive problems...all of which inherited from my mother, and from her father before her...he was adopted so who knows how far back it goes. I have tried every magic cure, diet, fast, salve homeopathic remedy under the sun. Bottom line minimal to absolute zero effectiveness at treating my autoimmune diseases. What actually has work is a biologic drug that turns off the component of my immune system which is hyper active and keep my immune system from attacking my own body. True Autoimmune diseases are genetic and can be exacerbated by environmental triggers, but those are not the root cause. Removing the trigger does not cure the disease but is a tool in helping to control it.
  • + 7
 Hi! I want to say thank you for all the positive comments, it feels really good to get messages that I have inspired someone.

Let me answer to these couple things some of you wondered
- I have tried different diets to help my condition, none have made a big difference, but I have stayed on a vegetarian diet and also try to avoid excess sugar
- I am already taking biological medication (3rd one going since the first two didn't work)

I'm a bit lazy to post anything here, but if you want see what I'm up to, feel free to follow me on Instagram @joonasriihela
  • + 2
 @Dangerous-Dan: Thank you for some actual fact-based info!

Yes, I agree @samimerilohi I've had RA for ten years now and I've had countless (unasked for) advice from so many people: what to eat/not eat, what to drink/not drink, what to wear/not wear, things to rub on my skin, how to move/not move and the list goes on.. it's probably all well meaning but it gets soooo tiring. Especially when it's from people who are not doctors or not even ill themselves, but have just heard/read something somewhere.
  • - 1
 @dangerous-dan, I disagree with your approach--- You're stating your own anecdote as if it is a fact and misquoting Johns Hopkins to discount the valid diet and lifestyle advice that people have shared.

Johns Hopkins states that autoimmune diseases result from a combination of genetic risk factors and an "environmental contribution." The biologics (hopefully) address the genetic component but diet and lifestyle changes can help the environmental side of the equation.

"Common threads uniting the autoimmune diseases are the presence of an autoimmune response based on cumulative genetic risk factors, combined with an environmental contribution (infectious, chemical, physical, or other)."

Source: autoimmune.pathology.jhmi.edu/whatis_approach.cfm

There is plenty of peer-reviewed data out there to support the benefits of gluten-free, dairy-free, Mediterranean diet, probiotics, fasting, stress-management, meditation, yoga and even fecal transplants. Some of the more extreme diets like Keto, Paleo and no-nightshade work for other people at n=1 levels. It's possible to incorporate diet and lifestyle changes as methodically as we change our training routines and stick with the changes that work for us. I hope his latest round of biologics work, but I hope that Joonas keeps an open mind and keeps experimenting with his lifestyle factors to optimize his own health.
  • + 5
 @Marcencinitas:
My point in citing JHU's page was to get people to look at it. I am glad you did. Yes, there are triggers to autoimmune diseases. But I stand by my point: absent genetic predisposition you are not very likely to develop a particular disease.

If you have celiac disease by all means go on a gluten free diet. Or if you have an allergic reaction to other proteins in wheat. Or if it makes you feel good. What I am saying is that pushing this or that or the other for someone's issues which are rooted in autoimmune disease is very likely to be counter productive.

Diet can be invaluable. Type I diabetics can greatly reduce the complications of diabetes by controlling their diet, and people with a family history of Type I should consider a low sugar, low carbohydrate diet. I don't know of a single relative with diabetes. I doubt it would help me avoid a disease I have a very low probability of developing.

Not meaning to be harsh, but placebos work very well. I think bike riding for more than an hour daily makes my head stop hurting. Once I have daylight after work, I try to ride for an hour or more. Is it relaxing? Maybe or maybe not the way I ride. Is it placebo? I don't care. It works for me.

Is there science to support my feelings? Yes. But I do it because it makes me feel better, not because someone said it might help. And until recently we didn't know of any reason why it would help. Sometimes science has to catch up with reality.

I don't recommend it to relieve anyone else's migraine symptoms. It has helped me get back to what I weighed when I graduated from High School 40+ years ago, and there is very good evidence supporting the idea that that is a good thing.

I went to a shrink and learned meditation techniques to deal with chronic pain from my head injury. I am lucky. I can do it. Not everyone can. But if I can't meditate myself to sleep or restfulness, there are drugs.

I eat a Mediterranean diet because... because I grew up on it. Is it healthy? If I don't eat too much, maybe yes.

And, yes I am saying that stress is overrated. I like adrenaline. I work at a job that is generally thought of as high stress. I spent 10 years as a volunteer firefighter. I built my own house while working full time. No autoimmune disease. I picked very good parents.
  • + 4
 I have a lot of similar issues to Joonas, and still haven't gotten a diagnosis. It's been on going for years now, the problem is I get tossed around in our 'medical' industry and I've pretty much given up on it and tried taken matters into my own hands with not much luck. Tried numerous diets, have eliminated red meats, most sugar, etc. Sucks to not be blessed with great health like so many people who have that just sit on the couch or in bed watching TV and waste it away...
  • - 1
 @destructo: Everyone is different and everyone claims to be an expert, but as soon as I read this I guessed you were a vegetarian, I am afraid you require meat in your diet, it is the way we have evolved and this is fact. I won't say any more but for your health and well being I will point you in the direction of this website, all the data on here is scientifically driven www.paleomedicina.com/en I wish you all the best health wise.
  • + 1
 What kind of Biologics are we talking about? Here in the US, I've had 3 biologics i've paid for out of pocket
- stem cells with PRP @ $5000 for 2 joints
- PRP injections into 1 shoulder @ $1100
- Biocartilage injected into my left shoulder @ $4500

Just curious what Biologic you got, and the cost...
  • + 1
 What's a biologic? I have Ulcerative Colitis and am always looking for ways to manage.
  • + 13
 Over-exercise, stress and a poor diet can all contribute to triggering autoimmune issues. Drop some antibiotics into that mix and you have the perfect storm (not saying Joonas had all of these, but it seems like he has most...). The fact that his troubles all began with symptoms of the gut suggest exactly what I would expect. Our guts are the centre of our immune system, in fact the centre of our everything, and to heal ourselves this is the first place to start - not building a house!!! Big Grin Start with your diet Joonas. It's admirable to fight on regardless but you're only damaging yourself further. Good luck!
  • + 2
 Look into periodic fasting, as it can help regenerate your immune system. news.usc.edu/63669/fasting-triggers-stem-cell-regeneration-of-damaged-old-immune-system
  • + 4
 @rustybones, agreed. There is so much new research pointing to the guts being the center of or health. So fascinating, and promising for helping the body heal itself.
  • + 0
 This 1000%. So many diseases and ailments come back to flora imbalance in your gut. Start by cutting way back on refined sugars, eat foods high in insoluble fiber and inulin, and give time restricted eating a try. You will see results.
  • + 0
 @rustybones Great advice. I hope he gives it a shot and finds some success.
  • + 3
 Thank goodness Hippocrates said all this a zillion yrs ago yet some how modern medicine still grossly ignores the founder of medicine and treats the symptoms with a lobbied drug and shoved you out the door so they can meet their 18 patient quota for the day. And then we wonder why everyone is overweight and depressed with expensive ailments. The Healthcare community has failed a vast many by failing to do and say what is necessary. Especially the children
  • + 0
 @SlodownU: Foods high with inulin are a nightmare for many people with gut flora imbalance. Many prebiotics in general can cause issues. Cutting refined sugars, grains and any type of processed foods is a great place to start.
  • + 0
 I thought he only had one leg in the first pic.....
  • + 2
 @garrettstories: I've been dealing with autoimmune symptoms for the last few years. Quit gluten two years ago, dairy last year. After blood tests it looks like I have sensitivities to cane sugar and egg white on top of wheat and dairy. Totally sucks, but just fixing the diet is a game changer. Gotta do it if you want to ride bikes into your 70s+!
  • + 0
 @SacAssassin: Do you have some resources on inulin, I thought the consensus was the other way around. I'm interested in learning more.
  • + 1
 @JasonVH: I heard naturopaths usually do these blood tests?
  • - 3
 @Svinyard: doctors (well, clinics) are just pawns of insurance companies which are just marketing firms seeking whatever they can to large employers. Healthcare is a joke. It’s way more than 18 pts/day around here... Find an unaffiliated private practice doc/concierge physician ... yes it sounds expensive, but so is the $600 a month premium one employee of mine pays for her own benefits for just herself. My business doesn’t provide benefits because only one person would enroll. Have a low low premium high deductible plan in case of catastrophe and pay out of pocket essentially for out of network care and the costs are about a wash... unless you’re having a kid. Then buy in for a year. Eh?
  • + 0
 *selling
  • + 2
 Stress...number 1 mother of all f*ckers. Destroys your guts, and the immune system spirals out of control, destroys your blood pressure. Adds cortisol which increases belly fat. I ride/work out/and sleep more to combat stress. The more the symptoms flare up, the harder I ride/work out - the rest/recover. There is no one did for any autoimmune disease. What works for one may not work at all for another. Sufferers really need to get in touch with themselves and take note of triggers/life events/times of year/foods/lack of sleep and talk with your doctor and be willing to experiment to figure out what combination works best. Auto immune diseases are genetic abnormalities so each fix will as different as tge maligned genetic code of each sufferer.
  • + 0
 @SacAssassin: I’m not suggesting a pre-made prebiotic, unless you want to be bloated, gassy, and fart for a week. I’m suggesting eating foods with natural inulin and insoluble fiber like garlic, onions, green bananas, apples, that way you don’t overload yourself and feel like shit. Changing your flora is a slow process that starts with diet and lifestyle. It doesn’t happen overnight, and those expensive pre-biotic blends just lead to pain.
  • + 11
 The article focuses on riding a bike with this decease, and to inspire people with medical issues. Thank you for the comments.
  • + 7
 Thanks for sharing your story, Joonas. Ten years ago I was diagnosed with severe osteoarthritis in my left hip and moderate osteoarthritis in my right hip and my first response was to fight the disease by willing myself to keep doing the things I loved without modification. Fighting it by chomping ibuprofen, ignoring pain and forcing myself to complete big rides and runs just triggered more inflammation and worsened the cycle. After ten years of trying everything under the sun I am able to do big rides and big ski days again and live mostly without pain, My inflammatory issue is mechanical and not an autoimmune disease, but I still thought it might be useful to share the things that worked best for me: eliminating most sugars and grains from my diet, eating tons of vegetables, eating more turmeric, eating more fermented foods, cutting out most running, reducing multitasking and reducing my overall workload, spending less time sitting down, doing physical therapy and yoga, lifting weights, improving the ergonomics of my house and office, adapting my riding and activities to respect the disease, and having one hip surgically repaired. I also tried a bunch of new activities that were more osteoarthritis-friendly and found a few that I loved. Bottom line is I am a slower rider than I was a decade ago, but I'm a better friend and family member and I've found myself appreciating things that I didn't even notice back when riding was the main focus of my life.
  • + 1
 Ive been doing much the same over the last five years for my myofacsial pain syndrome. Been on a keto diet for nearly a month now. After just two days my joints felt brand new and I've been feeling better ever since. I've been researching the carnivore diet now as my next option. Call me crazy, but the bit of science I've found behind it so far a long with personal and professional stories from medical doctors makes it compelling.
  • + 1
 @bcmrider: maybe look up the health problems associated with a meat heavy diet first? And since when have green vegetables fruits EVER been a bad thing?
  • - 1
 @blackthorne Yeah, I'm definitely looking at research on all meat diets, but not meat heavy Western diets.

But there is a crap ton of controversy around certain fruits and veggies. Take a look at FODMAP, GAPS, and the new Plant Paradox book to name a few.

There's no way of knowing who to trust these days. But if you're suffering from health issues, you've got to start somewhere and be willing to experiment.
  • + 0
 @blackthorne: Maybe educate yourself properly, look at the actual content of research study papers, look into who funds the research and then make a decision. Think about things logically, how have we evolved over the years? What do you see on cavemens paintings, people picking fruit or hunting? If you want to see something bad in vegetables and fruits othe rthan the sugar, look up oxalates.
  • + 1
 @Jocky: What was their lifespan, like 35? It’s ok, keep eating your meat dude, it doesn’t matter to me. At least cavemen didn’t abandon their respect for the natural order by breeding caged animals on an industrial scale. We have modern smart humans to thank for that.
  • + 1
 @blackthorne: Read the first line of my post and come back when you have bothered to look into it. Yep caging animals is a horrible situation, but if you care you can source meat responsibly where the animals wellfare has been catered for.
  • + 9
 After reading this story I'm not going to complain about anything today and realize how grateful I am at 50 to be in good health!!!!
  • + 6
 Thank you for bringing some awareness to this and other auto immune diseases. Having recently been diagnosed with Psoriatic Arthritis I find one of the hardest things is the lack of understanding from people because outwardly the symptoms are pretty invisible. People think you're fine or just complaining. I am on the path to getting the right medication but so far nothing has helped (including months of an extremely restrictive autoimmmune diet) and the pain just keeps increasing. Biologics seams like the answer but here in Canada there's a just as many hoops to jump through to get it due to the cost.
Good luck on your season Joonas, thanks for the inspiration to stay on the bike!
  • + 6
 Got diagnosed with rheumatoid arthritis 8 months ago. Thought I had carpal tunnel because my hands had become swollen and extremely painful to do anything. My whole life being I have been very healthy and athletic, mtn biking, skateboarding, snowboarding, hiking, and this development has been extremely depressing. Working through the medication process, but no magic bullet yet. Able to ride, but still a lot of pain in the wrists. My ankle has been randomly hurting bad enough that it's sometimes hard to walk. I am 42, and now I am trying to take advantage of every day I feel good. Rode two days this week which is good for mid winter. Not sure I will ever be able to do super long rides again, but I am going to get after it as much as I am able going forward. Riding bikes is still the thing I love most. I am going to do some handlebar experimentation to see if increased angle will help my wrists. And I am getting a longer travel bike to further insulate myself from pounding. Don't ever take good health for granted. I would have done a lot more things earlier in life if I had known this was going to happen to me.
  • + 4
 I’m 45 and have been dealing with this since I was 30. Some things that work for me are staying compliant with my meds, staying active, and carbon handlebars, to name a few. Keep riding my friend!
  • + 3
 Big up coil suspension. I used to ride rockshox. Ask someone with carpal tunnel to evaluate whether a rs pike is spiking under load!
  • + 5
 Fair play and a good write up. Same age, diagnosed with the same condition 3 months ago and finally start my biologics on Monday. If I can get anywhere near these enduro results I'd be mad proud. Coil suspension really helps with the old joints, thanks cane creek!
  • + 5
 Wow can relate on many levels! Started as a Junior XC racer, turned into a DH racer. Through my pro career was dealing with undiagnosed Chrons disease. I decided to stop DH after getting diagnosed in 2013 after a injury filled season and went on a two year journey to fix my broken health. Read a lot of books, researched online, tried a lot of things and realized the foundation of life is good health and understanding how balance a heathy lifestyle. How much and how well you sleep, when and what you eat, and how much stress you pile on all matters. Adding in travel and elite MTB racing makes finding balance even harder but also more important. I’ve progressed back into racing Enduro including some EWS rounds. The ancestral health “paleo” community has the strongest case for there approach to curing disease and living well. Thanks for sharing your story and good luck.
  • + 5
 I also suffer from psoriatic arthritis. It’s a tough disease,, but along with its cousins psoriasis and rhumatoid arthritis can be controlled with systemic drugs. Unfortunately these drugs are extremely expensive, and not widely available. In the US, drug companies are given exclusive patents for decades and the drugs are so expensive, even with private insurance, many can’t afford to take the drugs without subsidies offered by the drug companies themselves. We gotta get drug pricing and healthcare figured out in the US guys!
  • + 4
 Jukka... as a 66 yrs old biker who has battled Mantle Cell Lymphoma AND is still dealing w/Psoriatic arthritis, i can tell you there is hope for your riding career!... i came back from the dead and am enjoying every day... in remission for 6 yrs and counting and riding!... reach out to me for a chat if you like and ride on brother!
  • + 4
 I’ve had rheumatoid arthritis for the last 15 years. Even with the biologics it’s tough, the joint pain, and fatigue make riding a daunting choice. If I become sedentary the joint pain and fatigue multiply. The best thing to do is stay active.
  • + 4
 i've had RA since age 3. it's a tough one because the conditions are not always visible and everyone around you thinks you are OK. but you're not. it's like having a glitch in your nervous system that saps your power out of nowhere. the physical inflammation and mobility is just skin deep. .. but you just keep moving. and ride. and do whatever it is you love to do and help others to do too.
  • + 4
 got 3 different arthritis for 23 years now. I am trying to stay on my bike with heathy diet and a lot of training for the whole body. Just never back down and fight for the things that make life worth living and take one day at a time. I just signed up for the Enduro2 in davos I sept. So that is the next goal to complet that race.
  • + 3
 I can relate very well, also having an autoimmune disease affecting the digestive system for a few years now. Mountain biking is one of the main things that helped me through, both in terms of motivation and physical strength to get through the severe flares.

Causes of these diseases are mostly unknown. Genetics may be a part, and diet could be as well. However there are few reliable studies showing real impact of diet changes, the information you find is mostly anecdotal. A change in diet also has a placebo affect, which makes things more difficult. In my case fiber-rich food, lean meat (steaks!) and probiotics seem to have a positive impact, but I could be imagining that. ;-)

I am very thankful for our good public health care system here in Austria. My doctor tried cortisone first, but it did not help, and then we went directly to the biologics mentioned in the article, which work very well, and the public insurance is paying without complaints. With the biologics I have almost no symptoms at all and can live a normal life.
  • + 3
 i'm 26 and i've had arthritis all my life with multiple other complications because of it. there were flares so bad i couldn't walk. i feel so grateful now for advances in biologic medications and that i can shred my bike without (much) pain. i'll always be sore but biking is the best thing i've ever done and i'll always try to keep moving.

great article! love reading all the comments as well from people who can relate
  • + 2
 @crysvb Hi Crystal, it's your arthritis friend from Instagram! Wink
  • + 3
 I have rheumatoid disease and it is a constant battle. Riding definitely helps most days. Staying active and keeping the joints moving is key, if you can of course. Some days you can’t and the mental anguish is daunting. I lean towards the gut being the issue, but not 100%. I think our food supply is full of nasty stuff. Methotrexate is the devil and ruined me in many ways. The biologics are a crap shoot and super expensive. Keep on riding! Best medicine so far.
  • + 6
 It's a struggle; I understand living with Chron's for 22 years now. A lot of ups and downs. This is a great Read!
  • + 3
 Not a nice thing to have and to be riding with
Done so for last 8 years and had a lot of ups and downs but glad I stuck to riding as it’s helped me in the fight with this disease
I was diagnosed with osteoporosis and when I had my last scan it was near enough gone
I had read that cycling promoted bone density and the doctor actually asked why I was at her clinic when she said she couldn’t see any signs
She checked my records and seen it had previously been found and was intrigued with the results
Now off all meds after stoma surgery and never looked back????????????????
  • + 2
 I was diagnosed with Rheumatoid Arthritis about 18 years ago, I went from feeling great to not being able to walk down stairs in a matter of weeks, luckily I was able to find a mix of medicine a couple months later that worked for the last 17 years. A year ago they stopped and have had to go back to experimenting with other biologics I think I finally have a working combo again. I did my best to keep riding over the last year but it hasn't been the best. Looking forward to a kick ass 2019!
  • + 2
 It’s good to see this sort of article. It’s nice to get some visibility of what we go through, but it’s even better for making people aware so that they can get faster diagnosis and treatment if they are affected.
I’ve got ankylosing spondylitis and it took my the best part of ten years to diagnose and another five to get it under control. Sometimes when it’s bad it’s incredibly painful even trying to get onto a bike, but exercise is important in keeping it under control and each ride makes me feel better by the end.
  • + 2
 Autoimmune condition generally go in clusters. Given the story here, I would be looking at whether coeliac disease is in the mix. My clinical nutrition work is in the area. At the very least, dietary factors, such as gluten, can be provocative to most AI conditions. Anyone with one should at least trial a gluten free diet.
  • + 2
 I have a skin disorder that apparently is embedded in my T cells . No one understands why my immune system is trying to destroy and heal my skin cells. On my own I found out red meat triggers out breaks and more important stress does. We are all different. Try watching very closely what you eat and observe what may cause the condition to get worse. Your doctor offers no cure or prevention just pain relief. That not helping you battle this. You are correct building a house is very stressful ! Change your diet reduce your stress and I hope with all my heart you can live through this with some comfort.
  • + 2
 Thank you PB for the article. It's becoming apparent that more & more people are being taken down by autoimmune disease(s). Isnt it simply amazing, the onslaught of 'bad genes???' I don't buy the 'bad genetics' theory entirely, such a cop out. Anyhow, if you are struck by autoimmune issues be your own advocate. Do your homework, never stop learning. Find your AI triggers; food sensitivities, MTHFR status, nutritional deficiencies, find potential underlying culprits (viral, bacterial, even parasitic loads) weed out the toxic crap in your life (in some cases Aholes in PB threads.) Pharma won't cure you. There will be no magic pill, no pretty pink ribbons will be handed out, & no marathons will be ran fighting for Auto Immunity. Get off your saddle & figure it out
  • + 2
 This is a really interesting article and I've read through most of the comments. I rarely post here but this article and comment thread has egged me on. I have had psoriatic arthritis for the last 5 years. Thankfully my case responds well to methotrexate which is cheap since it has been around for so long. Had a lot of problems with my shoulders (couldn't raise my hands above my shoulders), hips (couldn't climb more than 3 flights of stairs), and my back (couldn't get off the floor without help which my kids hated). I've also cut carbs out of my diet which has helped but didn't cure my arthritis outright.

I see a lot of comments on the cost of the biologics here and I happen to have worked for big phama in that area. What a lot of people don't know is how expensive it is to get something on the market. The last figure I heard was that to get a biologic from the idea to the FDA approved finish line was a cost of 1.4 billion dollars. Less than 5% of the biologics that are started in the process make it to the finish line. The money to do these projects is usually raised from investors who expect a payoff for their investment. Dealing with the FDA is an expensive and labor intensive process. And a lot of times the number of people that the biologic will be administered to is pretty low compared to a condition that is more common and the scale of the production helps cut costs. Also, actually manufacturing the biologics is an expensive process. Mammalian celled biologics is a costly way of doing things but so far it is the only way to make these therapies.

I currently work for a plant based biologics company that should be a lower cost per dose because the process is cheaper.
  • + 3
 Nice article. Rare to see some awareness of these issues. I'm also on these drugs (simponi in my case). Without it I'm pretty much crippled and cant ride. Its a life changing drug!
  • + 1
 This article has really struck a chord with me. I too was diagnosed with psoriatic arthrits about 4 years ago. Also, it was following a stomach infection (H. pylori to be exact). To be honest, my diet was never that great and I'd only recently restarted mountain biking to try and lose some of the excess weight and get fitter again. No sooner had I bought my nice shiny new Scott Genius than my shoulders started to ache. This spread to most of the major joints in my body and was a real motivation killer to say the least. Anyway, after a couple of shoulder operations and a fair amount of drug taking (prescription! Lol), I'm at last able to enjoy my mountain bike. Mornings for me are pretty much as described above and it takes a while for my body to loosen up. Moving little and often helps. Sitting still for long periods of time make it much worse and lead to one feeling sorry for oneself, which in turn leads to more sitting about. A vicious cycle. I've never been on biologics yet and am currently trialing Leflumonide. The jury is still out on whether it's improving anything. I'm a slow rider and have a fear of falling off as any impacts which are too jarring bring tears to the old eyes. You sir, are an inspiration! Keep on keeping on.
  • + 1
 Well written piece and goes to show never give up! I’ve suffered with poor joint mobility all my life although not as bad as Joonas. Am about to try celery juice as part of my diet, used correctly it apparently works wonders with the gut and joint pain. It’s an acquired taste is all I can say for now! Good luck for the future Joonas!
  • + 2
 I have auto-immune arthritis and have been having some success with starch free diet. Good luck, I hope you find your path to remission.
  • + 4
 I think you might need some air in your front tire!
  • + 3
 Or maybe I need to eat less burgers
  • + 2
 @destructo: More air = more burgers
  • + 3
 @nug12182: More burgers = More speed
  • + 2
 huge amount of respect for you Joonas, my wife has a autoimmune disease so i can fully appreciate your struggles, keep fighting man, stay strong.
  • + 1
 acupuncture and Class 4 IR therapy laser can often be helpful in conditions like this. For some reason, acupuncture can improve the function of the immune system in some people. It's worth a trial.
  • + 3
 Has auto immune disease. Favorite food? Hamburger. Oomf
  • - 6
flag mishspins (Jan 12, 2019 at 0:19) (Below Threshold)
 Hamburger=beef , there are people eating a beef only diet to cure auto immune diseases
  • + 2
 @mishspins: Come on, really? Stop spreading bullshit!
  • + 0
 @mishspins: red meat is tough on the gut and intestines
  • + 3
 @bashhard: www.healthline.com/health-news/meat-only-diet-eased-autoimmune-disease-symptoms#1 how does my comment conflict with the article I post here. I didn't say a meat only diet cured auto immune diseases, I merely said people are taking such an option. So I suggest you just do a bit of research before claimin somebody is "spreading bullshit" as you so politely put it
  • + 0
 Check out The Carnivore Cast podcast and judge for yourselves.
  • + 5
 @mishspins: part of the problem with the carnivore diet is the benefits are anecdotal and the risks are scientifically proven. It’s hard to get people on board for that. I’ve tried several diets to manage my RA and had little or no success. I would give it a shot, but one thing I’ve learned is my body runs pretty well on carbs in the right amount.
  • + 1
 @mkotowski1 That's a common misconception. Beverly Hills Cop had a scene in it saying people have 10lbs of undigested meat in their gut and it became an urban myth. Meat is absorbed mostly in the small intestines quite easily. Health experts examining the carnivore diet theorize that this diet gives the gut a restorative break, fixing chronic gut issues and microbiome imbalances.
  • + 0
 @bcmrider: please cite some bullet proof scientific data to back up these claims.

And no, Shawn Baker etc. dont count.
  • + 2
 @notnamed You can easily google the Beverly Hills Cop reference. And Chris Kresser is one to put forth the theory on the gut healing. Of course like I said, it's a "theory". Google that too if you need a definition.
  • + 1
 @mishspins: Well, you said that Hamburger= Beef. Although in some burgers there is beef, a Hamburger is far more than the meat that was used. And even if beef alone helps, a burger surely won't.
  • + 1
 @bashhard: Oh, so you’ve tried the diet? If not then please refrain from calling people out on something you know jack shit about. I’ve tried a variety of diets, some work better than others. I’ve seen people have great results on either keto, carnivore, vegan, paleo, or elimination diets. The one thing they have in common is getting rid of refined foods and carbs. Do what works best for you.
  • + 1
 @bcmrider: never have seen Beverly Hills cops so that’s not where I got my info fun, lean red meat ain’t so bad but let’s get real most people are getting a load of fat with their meat nor do they burn enough calories to to keep that fat from building up
  • + 2
 @bcmrider: a podcast “carnivore cast” is probably not the best place to find objective information. They pretty clearly have a theory and only put forth information that supports their agenda.
  • + 3
 I have a degree in nutrition and worked in the nutritional services department in a hospital for several years. I worked closely with a gastroenterologist and asked her about the old tale of gum staying in your intestines for seven years if swallowed. She told me there is nothing that stays in the intestines for more than a day or two.
  • + 1
 Thumbs up and keep up biking every time you can. I am doctor and have type I. diabetes for 2 years so I can imagine how hard it must be.
  • + 3
 Yes, I do eat burgers. But have you heard about burgers with vegan steak.
  • + 2
 I believe people were referring to everything except the steak.
  • - 1
 Thanks for the tip on something to look into. I don't consider myself an "anti-vaxxer" and resent being called that especially in the manner you have. It's just something I started looking into and have followed the evidence where it leads me. I challenge you to do the same.
  • + 2
 The fact that you don’t consider yourself an anti-Vader just adds to your delusion. And that fact that you resent being called one shows that you realize anti-vaxxers are lunatics. But you’ve somehow convinced yourself that you are smarter than them and that you have it all figured out.
  • + 1
 The evidence leads me to a modern world where people who are vaccinated don’t die of smallpox, pneumonia or influenza.
  • + 0
 It's the exact opposite. After spending a lot of time looking into this issue I've learned there is so much we don't know, because the studies haven't been done. If you'd simply take the time to look into it for yourself you'd learn how corrupt much of modern science is unfortunately. It's the same pharmaceutical companies that bring you things like vioxx also you bring you the vaccines. Vaccines are pharmaceutical drugs with all the potential benefits and risks of pharmaceutical drugs. Why would you dogmatically worship them vs being willing to continually put them to the scientific test to continually improve them? If vaccines are so safe, why in 1986 did the US government grant vaccine manufacturers exemption from liability in the US? The only other industry with this sort of exemption is the nuclear industry. Doesn't that raise a red flag to you? Doesn't that make you curious?

You insults only show the emptiness of your arguments or lack there of. Please, all I'm asking is spend some time to put your knowledge to the test by doing some research into the matter. That's what I did and I had to follow the evidence where it led me.
  • + 5
 @westeast: No you are exactly like all the other anti-vaxxers. You just laid out the classic anti-vaxxer arguments which are all wrong and have all been disproved. You sound like every other wack job conspiracy theorist out there claiming dumb shit like there is "so much we don't know". No, we know everything we need to know, which is vaccines are safe and effective and save million of lives. This has been proven over and over again whether you choose to recognize that or not,
  • + 1
 @sino428: Your comment "we know everything we need to know" is very revealing. Good luck with that.
  • + 2
 @westeast: I'll be just fine. If I need any information on chemtrails or a recommendation on where to buy a new tinfoil hat I'll let you know.
  • + 1
 Be careful about vaccines--- They've been proven to cause wrinkles and gray hair.
  • + 1
 The suggestions are all over the place. I guess the take away is everything in moderation?
  • + 1
 Great article. Kudos to the author.
  • + 1
 Thank you very much! That meant a lot.
  • + 1
 Great read.
  • + 1
 Thanks!
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