Most elite cyclists have never heard of this condition.
But it can silently destroy a career.
External Iliac Artery Endofibrosis (EIAE) is a vascular disease that shows up only under pressure.
Literally.
It causes one leg to cramp, weaken, or underperform during high-intensity effort while everything looks normal at rest.
No trauma. No pain outside of training. No easy diagnosis.
This is what makes it so dangerous for elite endurance athletes.
A study out of Annals of Vascular Surgery finally gave us some clarity.
They looked at athletes with unilateral (one-sided) EIAE and compared the affected leg to the unaffected leg.
→ The affected side had significantly larger psoas muscles, especially at the L5 vertebral level.
→ There was no difference in artery kinking, tortuosity, or inguinal ligament compression.
→ Psoas hypertrophy at the L4 level correlated strongly with post-op satisfaction.
What does this mean?
Repetitive hip flexion,especially in cycling can cause muscle overgrowth that compresses the artery.
This leads to reduced blood flow during high exertion, and a dramatic drop in performance.
Surgical correction usually helps. But awareness helps more.
If one leg suddenly underperforms during peak output,do not ignore it.
It might not be a strength issue. It might be vascular.Activate to view larger image,
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