Australian Mountain Bike - - Contents - WORDS: ANNA BECK PHOTOS: TIM BARD­S­LEY-SMITH

Our global search for the best moun­tain bike pho­to­graphs has at­tracted hun­dreds of en­tries – and now it’s your turn to get in­volved and se­lect your favourite in each of the four cat­e­gories. And each on­line vote puts you in the draw to win a pair of Shi­mano XC7 or ME7 shoes. Our panel of ex­perts will pick the over­all win­ner who will be named ‘AMB Photo Awards Pho­tog­ra­pher of the Year – Pre­sented by Shi­mano’.

Cycling is some­thing we do be­cause we love it, and it’s a huge plus that there are so many health ben­e­fits of reg­u­lar aer­o­bic ex­er­cise. These hid­den ben­e­fits - re­duced in­ci­dences of hy­per­ten­sion, heart disease and chronic con­di­tions such as diabetes - are the rea­son many peo­ple be­gin to ride a bike again in later in life. But did you know that in a per­cent­age of young, healthy in­di­vid­u­als, cycling puts them at risk of a vas­cu­lar dis­or­der that can have dev­as­tat­ing con­se­quences?

Ex­ter­nal Iliac Artery Endofibrosis (EIAE) is a rare disease, which is in­creas­ingly com­mon in cy­clists and en­durance ath­letes, and could be at­trib­uted to 10 to 20 per cent of leg symp­toms in com­pet­i­tive cy­clists. Though the ex­act patho­gen­e­sis is un­clear, endofibrosis is es­sen­tially the thick­en­ing and de­po­si­tion of col­la­gen within the artery from a repet­i­tive in­flam­ma­tory process, re­sult­ing in less arterial com­pli­ance, arterial steno­sis (or nar­row­ing), and re­duced blood flow which can lead to neu­ro­log­i­cal­type symp­toms. For cy­clists, this can mean weak­ness, numb­ness, burn­ing, pain and loss of power to the af­fected side.

The ex­ter­nal iliac artery is the artery pro­vid­ing per­fu­sion - or blood sup­ply - to the lower limbs, bi­fur­cat­ing or split­ting from the

aorta in the lower ab­dom­i­nal re­gion. There is a right and left ex­ter­nal iliac artery, and com­monly ath­letes with the con­di­tion will only be symp­to­matic on one side.

Un­like other vas­cu­lar prob­lems, EIAE isn’t be­lieved to be re­lated to ath­er­o­scle­ro­sis - the more com­mon vas­cu­lar disease which is main ag­o­nist of car­dio­vas­cu­lar disease and is­chaemic stroke. Rather, it af­fects young, healthy in­di­vid­u­als with en­durance sport back­grounds, and it is claimed that the con­di­tion could be caused by a num­ber of fac­tors. These in­clude: ge­net­ics (length and lo­ca­tion of the artery); an ag­gres­sive flexe­dat-the-waist cycling po­si­tion that ‘kinks’ the artery; high blood flow rate dur­ing in­tense ex­er­cise; and even mus­cu­lar com­pres­sion (psoas). How­ever, there is no sin­gu­lar de­fin­i­tive cau­sa­tion at this stage.

It’s im­por­tant to note that EAIE is usu­ally ex­ac­er­bated by higher in­ten­si­ties, so while long slow rides and re­cov­ery-paced pot­ters may not elicit symp­toms, the prob­lems most com­monly ap­pear when it’s time to crank up the noise train­ing in higher zones.

But how would you know if this is some­thing you are suf­fer­ing from? For­mer pro­fes­sional en­durance moun­tain biker Matt Page knew some­thing was wrong on the bike when he be­gan to lose feel­ing in his left leg dur­ing harder ef­forts. “High in­ten­sity races such as cross-coun­try road races and hill climbs be­came un­vi­able,” he ex­plains.

For­mer pro­fes­sional road racer Stuart O’Grady also suf­fered with the con­di­tion un­til he sought med­i­cal at­ten­tion in the early 2000’s, re­sult­ing in sur­gi­cal in­ter­ven­tion and a month off the bike. He re­cov­ered and sub­se­quently claimed a fa­mous win in the 2007 Paris-Roubaix, as well as Olympic and Com­mon­wealth gold medals.

Get­ting a cor­rect di­ag­no­sis can be tricky and many doc­tors would per­haps not con­sider EIAE in a young ac­tive per­son com­plain­ing of loss of power in their leg. But if you are con­cerned about EIAE, don’t hes­i­tate to con­sult a sports doc­tor or raise the is­sue with your GP. There are a num­ber of max­i­mal ef­fort tests and imag­ing pro­cesses that can lead to a di­ag­no­sis and treat­ment path­ways.

As cy­clist Matt Page says: “Don’t try and guess the prob­lem - if you have any numb­ness or weak­ness in one leg then get it checked out.”

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