A diagnosis of psoriatic arthritis led Pam Relph from the army to the Paralympics, just in time to win gold (twice)

Pam Relph’s heartbreak when she was medically discharged from the army due to psoriatic arthritis was rapidly followed by elation at finding herself on the British Paralympic rowing team, training for the 2012 London Paralympic Games.A gold medal win was followed four years later by another at the 2016 Rio Paralympic Games, making Pam the first double gold medalist in Paralympic rowing. It’s a far cry from the army career she had dreamed of, but as Pam says, “everything happens for a reason”.

Pam first experienced symptoms of arthritis in her wrist when she was just seven years old.

“I was convinced I had arthritis and told my father, but he replied that ‘arthritis is an old person’s disease’,” she remembers. “Our GP diagnosed repetitive strain injury, but instead of improving over the next months, my symptoms deteriorated.”

As well as a stiff and painful wrist, seven year old Pam was coping with terrible fatigue, and was eventually diagnosed by a rheumatologist as having juvenile idiopathic arthritis, which would disappear when she stopped growing.

“When I was 13 years old I was put on sulfasalazine, which initially helped,” Pam says. “But my symptoms would flare again, so the dose would be increased, which controlled the pain and inflammation for a time… and then the cycle would repeat itself.”

Arthritis began to affect Pam’s right knee and left ankle, places she had injured playing sport at a high level. But Pam would not be held back from achievement, either academically or physically.

“As a child the pain was relatively bad at times as I was on no medication for the fist six years,” she says. “My wrist was so swollen it looked deformed. I’m right-handed so had a scribe in exams.

“My parents never made a big thing of my diagnosis. Dad was in the army and we are a hugely sporty and competitive family. I loved pushing myself, forcing my way out of any stereotypes. Nothing was going to stop me from the army career I had in my sights.”

Pam was accepted into a military sixth form college when she was 16 years old.

“The army was happy to take me despite my diagnosis of juvenile idiopathic arthritis as I had been assured it would resolve when I stopped growing,” she says. “My strong academic record and number of sporting achievements proved that it had not held me back.”

Two years later, however, Pam’s data showed that she had stopped growing but her condition had not improved.

“I had noticed that at times when I was stressed or run down I would experience a little psoriasis, and it wasn’t long before I was diagnosed with psoriatic arthritis and put on methotrexate and folic acid,” says Pam. “But I saw no reason why I shouldn’t continue to pursue my goal, which was for the army to sponsor me to study engineering at university.”

The military, however, disagreed.

“I had to explain my diagnosis of psoriatic arthritis to the army in a medical evaluation, and was informed I was no longer eligible for the scheme as I was reliant on methotrexate and because my condition would never be cured.

“Devastated, I appealed a number of times, and even came off the methotrexate in an attempt to show that I didn’t need it. Over a period of six months I effectively ground to a halt, proving to both the military, and myself, that I could no longer consider an army career.”

But where one door closes, another opens. Monica Relph, Pam’s sister, was in the British Olympic rowing team and asked her coach if Pam could be eligible for the Paralympic squad. As Pam’s condition is permanent, progressive and restricts her movement, she classified, and was soon training for London 2012.

The picture today

“I’ve been taking methotrexate weekly since I was 18 years old,” Pam outlines. “The day after I take it I feel terrible and have to take the day off training. If I can’t for some reason, I split the dose, which helps a little. Injecting methotrexate is an option but there are so many rules for athletes about injecting, that I’ve steered clear so far.

“My wrist doesn’t move so it limits me in training. I have to do lifting exercises and press ups differently, often with straps around my wrists. It’s important not to overcompensate with my good side. A team from the University of London designed a hand strap for me to use on the rowing machine that equalizes the load on my body.”

Since winning gold at the 2016 Paralympic Games in Rio, Pam has taken some well-deserved time away from her rigorous training regime. She is working with companies giving keynote speeches to inspire people, using her experience overcoming adversity and performing under pressure.

“My advice to anyone living with arthritis, is to keep moving as much as possible,” she says. “I know it can feel counter intuitive to move when you’re in a lot of pain. Even getting out of a chair can be difficult, so it’s tempting to stay still. Try to do a little more every day. Medication does some of the work, but the rest has to come from us.”

For more information about Pam Relph visit: www.pamela-relph.com.

Words: Iona Walton

Image credit: Tom Miles

First published January 2017.