Iliac Artery Endofibrosis

By September 10, 2016 Cycling

It’s been a whirlwind of a month – racing, wedding, honeymoon, launching our first tour & a diagnosis for iliac artery endofibrosis.

After finishing our honeymoon ride from Girona to Kent Lee and I headed straight to Bristol to see a vascular surgeon about the cramping in my legs.

I’ve been having episodes of ‘cramping’ for the last three years (ever since I started racing) but have never quite got to the bottom of why they were happening. I’ve seen physio’s and chiropractors, who have helped to relieve the symptoms, but I’ve never got to the root cause.

A few months ago Lee was chatting to a cyclist in Girona and she mentioned a condition called Iliac Artery Endofibrosis. Endofibrosis of the artery is basically a thickening of the artery wall, the iliac artery carries blood to your legs. When exercising the blood flow is restricted and so the leg muscles are starved of the oxygen they need. This results in ‘bursting’ pains which can’t be pedaled through.

Cue lots of research, trips to the GP and a battle to get a referral to see the specialist.

It’s a condition that has only recently been recognised and it occurs mostly in male cyclists and runners. It usually occurs in athletes after years of competition (the average mileage before onset of symptoms is somewhere around 120,000!) The only treatment is an operation to remove the endofibrosis.

After reading up on the symptoms it became pretty obvious that I needed to get the tests done to find out if this was what was causing my problem. My symptoms weren’t textbook, but they were certainly pretty similar.

So, after getting back from honeymoon we drove straight to Bristol to see the specialist.

The testing was pretty impressive. First they took my resting blood pressures at my arm and at my ankle and used ultrasound to check the iliac arteries in my left and right leg. Everything was normal.

Then I hopped on my bike on the turbo trainer and pedaled until I couldn’t pedal any more. The results were pretty conclusive.

After exercise the blood pressure in my arm went up as would be expected. In my right ankle my blood pressure stayed the same (not good) and my left ankle my blood pressure actually got lower (definitely not good). This is not normal and is a sign that the blood is not flowing as it should.

The diagnosis was that I had the early stages of the condition. The news came as a bit of a relief (knowing what the problem is can only be good) but mostly as a complete bummer. The endofibrosis wasn’t bad enough that surgery was the solution, but equally it won’t get any better on its own.

The silver lining is that there are some athletes out there who have learnt how to manage the condition without treating it and who have gone on to reach the top of their game.

I decided after that to end my race season early, take stock and to do loads of research to enable me to make a decision on my racing plans for 2017. The trick will be in not overloading the legs, but still training enough to improve and win races! I think it’s possible, I hope it’s possible and I will do my very best to make it possible.


  • Brendan O Reilly says:

    Hi there. I’ve been following the E.S.Cycle site for a while now. Was considering the Girona -Biarritz trip on October but probably look at 2017.
    Anyway I had exactly the same issue as yourself. Iliac A Endofibrosis. Left leg and a dramatic drop in pressures after exercise. Had the operation in Ireland. Never an issue since. I got some advice from other riders -Ciaran Power and Michelle Geoghan. Have to say found it a great help. Not too sure if its something that would be “managable” if you are competitive racing. Anyway welcome to get in touch if you want or have any questions etc.
    Regards Brendan

    • Louise says:

      Hi Brendan, thanks so much for your comment, reassuring to hear you’ve had a successful procedure. I will drop you an email – would be good to hear about why you decided to go for the op. Would be great to get you on the next G-B trip – i will email you the info and see if we can tempt you for october 🙂 Louise

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