Iliac Artery Endofibrosis

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Iliac Artery Endofibrosis

Postby jules21 » Thu Jul 26, 2012 11:43 am

i think i have it.

i decided to get back into racing this year and was going OK for a little while, before i suddenly started losing form. on tuesday i got off the bike with soreness around the pubis (?) on the RH side, pretty much where this condition is supposed to arise. my RH leg also gets more tired/reaches its 'lactic' limit than the left.

i've had this soreness before, but just put it down to general soreness. but on tuesday there was a very pronounced lump in that spot, which i suspect is the dreaded hardened artery. it's gone down a bit now, but the GP has suggested i go and see a cycling sports injury specialist.

has anyone else had this? the surgical fix appears to carry significant risks :o
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by BNA » Thu Jul 26, 2012 2:19 pm

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Re: Iliac Artery Endofibrosis

Postby gorilla monsoon » Thu Jul 26, 2012 2:19 pm

Can't say I've experienced it and don't think I want to. Sounds bad, good luck with it.

And I hope everyone has the good manners to resist those tasteless "lump in my pants" jokes.
Some days you are a big, strutting rooster, some days you are a bit chicken and some days you are just a complete cocque. Roger Ramjet: 2009 Giant CRX3 Spockette: 2009 Trek FX 7.3 (WSD, property of Mrs Monsoon) Lady Penelope: 2011 Avanti Cadent 1.0 TdF
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Re: Iliac Artery Endofibrosis

Postby jules21 » Thu Jul 26, 2012 2:25 pm

thanks GM. as i understand it, it's not threatening to my broader health, just my cycling. but that is a concern in itself :cry:
gorilla monsoon wrote:And I hope everyone has the good manners to resist those tasteless "lump in my pants" jokes.

i remember reading a post on another cycling forum a while ago, where a female member posted a question about 'saddle issues', and the trail of moderator-deleted posts underneath it :)
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Re: Iliac Artery Endofibrosis

Postby PawPaw » Thu Jul 26, 2012 3:14 pm

Jules, you want to wait until you've had some imaging done and seen a specialist before concluding you have it.
It's a lot more common to get a sports hernia (with lump) or have hardening of the anterior labrum of the hip joint, which can cause pain in this area.
In addition, your weakness might be due to concomitant lumbar spine nerve root irritation, which is also much more common.

Other suggestions that might reduce symptoms:
- losing weight to decrease visceral fat putting pressure on base of pelvis.
- low fat diet to decrease artherosclerosis and associated thickening of arterial walls.
- put your bars up to decrease hip angle
- use a lower cadence to reduce number of compressions of soft tissue at top of pedaling stroke.
- ride a bit more out of the saddle and on the bars
- cut total cycling time by 10-50% for a month, then progress back in slowly. and schedule a month off the bike 2-3 x a year.
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Re: Iliac Artery Endofibrosis

Postby toolonglegs » Thu Jul 26, 2012 3:23 pm

They thought I had this until I saw the guy who discovered it ( he is based in Lyon )... The test was getting on a bike in his offices and going hard for about ten minutes then comparing before and after blood pressures from four different meters on the legs.
Scans show nothing. There is also no lumps to feel.
From what you describe it doesn't sound like you have it ( but I am not a doctor :-) )... But from what I remember that he said... There is often no pain, it only really occurs at or near maximal effort, your faulty leg just loses strength due to lack of blood supply, it isn't dangerous, but yes the operation to fix it is serious.
BTW... He also said that unless you have an underlying problem that was there since birth... Then this usually only occurs in cyclists doing big big km's over a number of years ( read 15-20k plus a year or the equilateral hours ).
BBTW... Just reread your post... There is no lump to feel with this condition. You iliac artery is buried deep. The lump in the area is probably one of the many lymph nodes in that area... Get it checked all the same.
How's your psoas muscle on that side and hip flexors?. How's your body weight?. How's your saddle position?.
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Re: Iliac Artery Endofibrosis

Postby jules21 » Thu Jul 26, 2012 3:59 pm

thanks guys.
- doc (GP) recommends it's not a hernia - unsure if that discounts sports hernias but i assume so
- yes, i have some back issues - no idea if this is related or not
- i don't do pro km, but i have done probably ~10k over last year (haven't measured).
- it's not especially painful, it just gets tender and flared up the other night after riding. there is definitely something holding me back in producing power, which naturally is the main thing on my mind :)
- i do most riding on a MTB, which is a pretty upright position
- i'm not overweight - BMI 22-23

anyway i might try and see a specialist.
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Re: Iliac Artery Endofibrosis

Postby PawPaw » Thu Jul 26, 2012 4:00 pm

thanks for the insight TLL. It makes sense differential BP tests (ankle brachial index) is the least invasive and possibly definitive.

there's another occlusive condition called intermittent claudication, a peripheral artery disease, which doppler ultrasound, arteriography and angiography are used to confirm.
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Re: Iliac Artery Endofibrosis

Postby toolonglegs » Thu Jul 26, 2012 4:05 pm

The pain after the fact probably means you have nothing to worry about... I would be looking at structural issues... Go back to my " nuts " thread... I had a similar thing, but I didn't have any power loss even when in extreme pain.
I do know that testing for this problem is quite difficult and scans will show nothing as it will only occur when in cycling position under heavy load with the big muscle groups constricting the artery.
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Re: Iliac Artery Endofibrosis

Postby jules21 » Thu Jul 26, 2012 4:10 pm

i have intermittently read through your thread TLL and i'm unsure it's the same condition - i've never experienced significant pain. i could get on a bike now and ride hard, it's just that i'm worried about the lump and soreness, and low power!

paw paw, i'm confused about how to access proper treatment. my GP is pretty switched on, but he just tested for hernia and ruled that out, before recommending i see a sports medicine specialist. i will do that, but don't want to spend $100s only to find it was a simple diagnosis.
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Re: Iliac Artery Endofibrosis

Postby toolonglegs » Thu Jul 26, 2012 4:21 pm

My pain came from cramps in the psoas, then after ignoring it too long it came from the spine as well.
I would be seeing a doctor who deals in lumps in the groin ( for get what they are called ) before spending a lot of money on the artery problem... look online at pictures of where the iliac artery runs through your body... it is very deep.If you could feel a lump in your iliac it would have a huge strong pulse.
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Re: Iliac Artery Endofibrosis

Postby PawPaw » Fri Jul 27, 2012 9:30 pm

Jules, if you have reason to be confident in your GP, I'd recommend you see a sports physician. They can do scans and will be able to differential diagnose better than physios, chiros, osteos.

Unfortunately, no one clinician can diagnose all conditions well. that's the price we've paid for "specialists".
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Re: Iliac Artery Endofibrosis

Postby jules21 » Fri Jul 27, 2012 10:45 pm

the lump went down pretty quickly. i'll try and do a bit of riding this weekend and see how it goes. i was actually excited that something blew up as i've had such rough form that i'd be happy to identify the cause.

TLL - the lump is definitely on/near the surface, not quite in the groin (not sure where that starts and ends) but that bit where you get hernias (and it's not a hernia, according to GP).
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Re: Iliac Artery Endofibrosis

Postby toolonglegs » Sat Jul 28, 2012 3:05 am

Don't hope this is the cause... if I had been identified with this I would have given competitive cycling away.
Lymph nodes near the groin.... http://www.umm.edu/imagepages/9000.htm ... they can get hard and sore.
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Re: Iliac Artery Endofibrosis

Postby jules21 » Sat Jul 28, 2012 11:35 am

toolonglegs wrote:Don't hope this is the cause... if I had been identified with this I would have given competitive cycling away.
Lymph nodes near the groin.... http://www.umm.edu/imagepages/9000.htm ... they can get hard and sore.

hopefully the latter! it's definitely just blown up and gone down, so i'm hoping that means it's not malignant :shock:
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