By Joe Vanden Acker
Lawrence University Director of Athletic Media Relations
    APPLETON, Wis. -- Every athlete has heard the expression, "Play through the pain." 
    Athletes wear it as a badge of honor. To see how tough they are. To compete despite the agony. To not let the pain win.
    Paige Ference doesn't play through the pain, she lives with it every day, every hour, every minute of every day. Despite that, Ference plays at a very high level for the Lawrence University women's soccer team. Ference and her Lawrence teammates are preparing to play in the Midwest Conference Tournament this weekend with a NCAA Division III Tournament berth at stake.
    "The worst thing right now is my neck," said Ference, a junior defender from Courtenay, British Columbia. "I have chronic, deep pain at the base of my skull. Every day I have headaches, pain that doesn't go away with practically everything I do."
    Ference has been dealing with pain for many years due to ankylosing spondylitis, a type of arthritis that causes inflammation in the joints and ligaments of the spine, according to the National Institutes of Health. NIH also noted that is may affect other joints like knees, ankles and hips. 
    "I was in chronic pain, basically. It started in my lower back and spread," said Ference, who has played in 40 matches, including 22 starts, over the past three seasons. 
    It took about two years for doctors to finally nail down the diagnosis of ankylosing spondylitis, a disease that affects roughly 3.2 million Americans, according to the Spondylitis Association of America. Ference had been diagnosed with Crohn's disease when she was five years old, but she recalled that it went into remission when she was in middle school. Ference doesn't know whether there is a connection between the Crohn's disease and the arthritic condition, but she continues to fight a daily battle.
    "Now and for the past years I've been (at Lawrence), the majority of it stems from pain within my spine, low back and neck," Ference said.  
    Lawrence head coach Joe Sagar first met Ference at a tournament when she was in high school and had no idea the journey the young player was on. Sagar and Ference were staying in the same hotel, and he told her to keep in touch. Thankfully for Sager, she did.
    "Paige reached out, and we were really excited about having her," said Sagar, who has rebuilt the women's soccer program into a conference title contender. 
    Sagar saw Ference as a part of that rebuilding effort, but he had no idea about her medical condition until well after she arrived on campus. Ference didn't talk about it and didn't expect any special treatment.  
    "Paige always underplays it and it's a testament to her and the pain threshold she has. It's also an example of you never know what people are going through," Sagar said.
    "It took probably 18 months for us (coach and player) to get to the point where if you're sore and you need to sit out so you can play on Saturday then you can sit out. She basically handles it and doesn't look for anything additional or special. She's the most hard-working and humble player."
    Each day is a challenge from the moment Ference rises in the morning. She deals with stiffness in her body first thing in the morning. It might take an hour or more for that to recede, but that's just the start.  
    "The majority of it is kind of chronic pain. Each day is different depending on what I'm doing," Ference said. "As I do more during the day, the pain sort of progresses."
    Just sitting in class for extended periods can be difficult. Ference said she can't sit for more than 10 minutes without feeling like she needs to move around. The discomfort in those settings ranges from an ache to a stabbing pain, Ference said. To put it in perspective, we've all been in the doctor's office when the physician asks how you would rate your pain on a scale of one to 10.    
    "I feel like I live my life in a seven or eight on a daily basis," said Ference, adding, "I've been lucky that I haven't reached a point where it restricts me to the full capacity." 
    An interesting thing about ankylosing spondylitis is that physical activity can have benefits. Doctors likely weren't thinking about the training regimen of a college athlete when they told Ference that, but she always knew she wanted to continuing playing in college. 
    "The funny thing about this is when I was diagnosed I asked, 'How is this going to impact me playing?' " Ference asked.
    "I can't let this affect me to the full extent and not do what I had planned. I feel it when I'm playing, but it's something I've adapted to and can play through. After playing 90 minutes of an intense sport, I notice that I'm in more pain and completely exhausted."
    Sagar said he's not surprised that Ference is completely drained at the end of a match. 
    "She's not the type of soccer player that stays on the periphery. If you're in the trenches, you want Paige next to you. That's how she lives her life, in a constant state of triumph. Today is not the day it gets the better of me," Sagar said.
    "If you take this away, if you didn't know about her condition, she still does something remarkable. She's a long, long way from home. She's a high-achieving student-athlete in a major (neuroscience) most people wouldn't look at. And she's got this terrible illness where she could just pull up the covers and stay in all day. That's impressive for someone operating under a normal bill of health, but you add in she's got this ailment and you just go wow."
    With no cure, the only relief doctors can offer is medication. Ference has tried some different medications to deal with the inflammation and provide pain relief, but the current medication hasn't been particularly effective.  
    "I'm hoping the next thing I try can have a bigger impact than what I'm on now," Ference said.
    While many of the Vikings have an understanding of what Ference is dealing with, it's not something she talks about regularly. 
    "I don't believe my whole team knows what I go through. I haven't said anything this year so the newer players don't know anything in particular," Ference said. "Some people with things like this are very vocal about it. I would consider myself pretty humble and not speak about it unless it comes up. But in the future I wanted to share my story to inspire other people."
    Ference is likely inspiring her teammates and other student-athletes at Lawrence right now, but her personal struggle to continue is very real. 
    "Honestly, I think every year that I've been here, both after and even during the soccer season, I've had to reassess," Ference said.
    "I definitely think about it and soccer and working out has been a part of my life and I truly enjoy it. I think it would be pretty hard for me to drop it completely."
    In other words, Ference will continue to play through the pain.