External Iliac Artery Endofibrosis

Puzzling Area

58” I’m trying to get my leg figured out…Today I was great on the bike.  I feel like superman, and better every day…my left leg seems really swollen and turgid [stilted] after the Time Trial in particular when I am having the rest of these nasty sensations. If I keep the hammer down, it starts to be bad, after a while it starts to feel tight, and like it’ll take no more.” Robbie King, Cyclist, noting inconsistency in sensation and performance during a very fit period, eventually diagnosed with EIAE 

A vascular condition common to cycling


External iliac artery endofibrosis (EIAE) is an uncommon disease that affects a large number of athletes and cyclists in particular. Possible causes remain a mystery but one study shows a direct relationship with 59overdeveloped psoas, hip flexors used to propel forward motion. The usual profile for this condition is someone who began riding as an adolescent and engaged in top level competition early. This describes most of the pro and elite racing categories and a lot of top veteran riders.

The principal complaint is intermittent claudication, or ache, cramp, numbness or a tired leg at near-maximal exercise. Confusion and negligence cause the condition to go undiagnosed because mostly the rider feels fine.

60Well known riders with the condition describe balls-to-the-wall rides that come to a halt because one leg just stops, unable to pedal. Its mysterious symptoms are easy to ignore as cramps or tingling or a loss of power in one leg may occur only a few times per season. The sensations may hinder more during cooler weather or in intense events without a long warm-up. Eventually, those who need surgery experience the symptoms with more frequency.

There are a few vascular specialists in the world who readily recognize the symptoms of this condition and can treat it successfully. Testing for it is a specific procedure that requires expert analysis. This diagnostic puzzle coupled with its mystifying symptoms make it hard on motivated riders, trained to avoid pain, to address the perplexing condition without feeling wimpy or questioning themselves. But the condition is real. Blood pressure that drops in the affected leg can dangerously rise elsewhere.

Prayer re: External Iliac Arterial Endofibrosis (EIAE)

 “God threw a barricade across my path—I’m stymied; he turned out all the lights—I’m stuck in the dark.” 61Job 19:8

We confess it’s easy to blame God when things are mysterious or unsettling. We ask for right diagnoses and healing for those suffering with EIAE.

Ponder Do I know anyone who requires an extensive warm-up to clear blocked leg(s)? Affirm I steer others in the right direction by knowing about EIAE. Watch artery or nerve sensations and report them to your doctor; ask specifically about EIAE.

58Conversations with Robbie King. We were fortunate in Robbie’s case to quickly assemble a team of medical experts and cyclists who had experienced EIAE. So while we were puzzled for several months, we got a clear direction for diagnosis and treatment. Robbie had inguinal release surgery and returned to pro racing within a reasonable recovery period; however ultimately, it did affect his career. About half dozen American pro’s had EIAE surgery that season. It seemed almost contagious.

59“External iliac artery endofibrosis: a new possible predisposing factor,” Journal of Vascular Surgery, Volume 38 Issue 1 Pages 180 – 182 V. Scavèe

60“Vanthourenhout better after surgery,” 9/5/07 and “An interview with Stuart O’Grady: Like having new legs,” by Karen Forman, 2002 Interview www.cyclingnews.com. Also for a not so fortunate incident post-surgery see, “Barloworld’s Cox dies following surgery,” Posted Aug. 1, 2007 www.velonews.com

61The Message, Copyright © 1993, 1994, 1995, 1996, 2000, 2001, 2002 by Eugene H. Peterson

6 Responses to “External Iliac Artery Endofibrosis”

  1. Heya i’m for the first time here. I came across this board and
    I find It truly useful & it helped me out much.
    I hope to give something back and help others like you
    aided me.

  2. I suffer from this condition also and I am frustrate on high intense rides. Is there a cure and something that can be done?? help

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  4. Maree Tregoweth Says:

    I have been diagnosed with this condition & I am an amateur runner, can someone pleassseee tell me, does the fibrosis keep thickening/ get worse if you continue to exercise until you get the symptom (ache/loss of power in leg), then rest, then continue etc or does the symptom mean the condition is getting worse!!!! Someone please tell me

  5. Hi Maree no it does not get better in my case symptoms have gotten worse over the 5 yrs I have known about the disease and given up fast running. Only now am i going for the surgery I cant even sit in the car or in one place for more than 45 mins without pain .How bad are your symptoms?

  6. Maree Tregoweth Says:

    Hi Jo, I was diagnosed in December 2012, & basically haven given up the long distance running & just walk now, quite frankly I was too scared to do to much & push myself as no one seems to be able to tell you the consequence . It seems to be ok at the moment, but how do you know if the artery is thickening? Are you having a patch placed in the artery? My vascular surgeon was not happy to,perform an operation, but it seems that your case has your symptoms have deteriated.
    ? Where are you having your surgery? Please keep in touch I would love to hear your progress

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