Hello all -
I'm writing both to seek your help and to let you know about a little known cycling injury so that you can know the warning signs if it's happening to you.
As some of you may know, I wound up in the hospital with a pulmonary embolism several weeks ago. My embolism originated from a clot in my leg and ultimately lodged in my lungs. I'm better now, but the experience led the doctors to conduct a number of tests. After ruling out all of the typical causes, the doctors ordered a cat scan with radioactive contrast. The 3D model produced by this test is pretty amazing. You can see all of your veins and arteries. While reviewing this model, we found that my right common illiac artery has what looks like a "dent" or a "kink". This artery is located in the pelvis and supplies blood to the right leg (the left common illiac artery showed no damage). When in a typical cycling posture, the arteries in the pelvis can be subjected to extreme mechanical loads, leading to fibrosis that is visualized as a dent or a kink. An that's my diagnosis, Exercised Induced Arterial Endofibrosis.
Why am I telling you all of this? Quite simply, I'm casting a very wide net in order to find a doctor who might understand more about this condition and how it relates to cyclists. The doctor I've been working with essentially told me to give up cycling or run the risk of loosing a leg in 5 - 10 years. As a fellow cycling enthusiast, I'm sure you can imagine how devastated I was to be told I couldn't ride any more. Well, I started doing some Google searches on the topic. As it turns out, quite a number of cyclists, including some top pro's, have developed this condition and been treated successfully. This makes me think that my doctor just presented me with the simple solution without understanding how important cycling is in my life and thus trying to educate me on all of the options. That's where you come in. If you know of anyone in the medical profession or a cyclist who might have had this problem, please put me in contact with them. I have found a medical report published by a group in France who has conducted operations on over 300 cyclists who have had this condition and I will be reaching out to them as well.
I have so many questions about treatment options, posture adjustments on the bike, stretching and nutrition. The research I've done indicates that the primary cause is the repetitive stress in an aerodynamic position, but what does than mean? Does it mean that if you have a very vertical posture, you're okay. Could the damage caused by a very aggressive time trial position contribute more heavily to the overall damage than a climbing position? The literature eludes to possible other contributing factors without clearly defining their contribution. There are just so many question to ask.
My second reason for writing to you is to share my experience so that you can know the warning signs in case this happens to you. Beginning in 2008 I began experiencing cramps at the end of long races. They would occur when the races got hard on a hill climb. I think the first serious cramps occurred on the second lap at Copperopolis. The cramps were worse on hot days and especially at altitude. At Diamond Valley, an altitude of about 5,600 ft, I got dropped very early in the race and when I sprinted for the finish within my chase group, my legs completely locked. This became a recurring problem at most road races. Now I'm sure you're saying, "well, doesn't everyone get cramps once in a while and surely not everyone has this medical condition." You're right, but if you can't resolve reoccurring cramps through nutrition, hydration, and training, you might want to consider this as a possible source of the problem. Another sign is that your flat land power just isn't very good when compared with your hill climbing power. In my case, I've often wondered why I suck at time trials relative to my hill climbing capabilities. For me, the answer clearly was that I was shutting off more blood flow to my legs.
Stuart O'Grady also had this condition and described his problems in a 2001 article on Cycling news. The thing that amazed me is that 6 of his team mates also developed the condition: http://www.cyclingnews.com/riders/2002/ ... =ogrady021
Velo news also has an article that is pretty informative: http://www.velonews.com/article/13064
The French doctor report on the condition and treatments can be found at: http://www.belsurg.org/...oad/RBSS/feugier.pdf