Recently, I had a 50 year old healthy male patient who is an intensive cyclist who developed abdominal and back pain several months ago and through the process of elimination and investigation, was found to have “iliac artey dissection”. This is one of the rarer manifestations of “Endofibrosis”.

While this happened at 50 years of age in this patient, it can happen at any age, including younger patients, and in recreational as well as professional cyclists.

“Endofibrosis” is a unique but rare entity, that can affect upto 20% of top cyclists, mainly in the iliac arteries ( they are the one’s that supply blood to the legs).

While this can happen in any athlete, a review of two large series data showed that of all those affected 76% – 85% affected were cyclists.

The most common presentation is that of a high intensity cyclist who develops pain in the thigh while cycling which gets better upon stopping. The distance at which this pain starts really depends on the severity of the problem in the blood vessel.

Further testing in a vascular lab is recommended if these symptoms develop in an athlete. Treatments range from stenting ( where in you can go home the same day) to the more often used, open operations, which can put you back by a few months, but which have more durable results.

Eventually, most cyclists, are able to return to their prior level of cycling with no significant lingering effects.