Cyclist iliac Syndrome

[Flemish Lion]

Good luck Chris! Both sides will be a bit more uncomfortable for sure, but well worth it!

 

Its more common then you think. We already have 3/4 guys who will have the op within a month!

 

I cycled 15 to 25 hrs a week for the past 4-5 years.

 

Its pretty hard to determine as in the case of Bigelo, I also had it in both legs. So you get the feeling the lactic acid doesn't leave your legs and your leg(s) get numb. But it only happenens at high intensity so one thinks not enough intensity training, but in reality they just don't get enough blood! Over the years the frequency of bad races increases and the leg(s) stay numb for longer after a hard effort.

 

A simple ABI test (Ankle Brachial Index) where they measure the pressure before and after excercise will show if you have it.

 

Keep us posted Chris!

[massiveboy]

Morning all, it seems our discussion is getting a few more people to the surgeons offices to check if all is OK - ha ha

 

well i am 8 days after surgery and so far so good, getting staples out this thursday and really looking forward to that as can feel them tugging and the dressings also pulling on skin as for the itchy feeling on scars!!!!!!!!!!!!!! GEEES

 

On further discussions with my Prof. he seems to think this started a long time ago, possibly during my rugby and heavy gym days eg. squats - leg press?? the cycling really got the ball rolling so to speak especially the TT bike as i spent quite a bit of time on that in the past --- NO MORE though.

 

I had both my internal and external arteries occluded with a total graft length of 9 cms in a V shape as they split from the main iliac artery.

 

P.A.K I have been cycling for 5 years now and over the last 3 averaging around 10 - 15 hours a week in both road and MTB. I noticed a problem after shova last year - i initally put it down to riding the tandem to much (in the front the drive chain is on the left), my left leg just felt weak and didnt recover as quickly as the right after efforts. after another 4 months of progresson into an acual painful feeling in my thigh I consulted my doc. She sent me for a CT scan which revealed nothing AND a Doppler test (AT REST) also revealed nothing. Thus she injected the thigh with cortisone and sent me on my way. I rested a week then started again with no difference in symptoms - now very frustrated i consulted Doc Craig Roberts (SA rugby team doc), he knew him from my rugby days thus knew he wouldnt do half measures. He looked at the doppler test and CT scans then did power tests and a number of other evaluations which revealed about a 15 percent difference in power between left and right (endurance power not explosive power) - thus i was sent to a bio for strengthening and hopfully getting a better balance.

 

Sani was approching and my partner and myself were really hoping for a top 50 finish in the race - which in the past 2 years was missed by seconds so was pretty do-able with the right prep. I got clever and followed the Prof Tim Noakes diet (the new one 70 grams of carbs a day and high protein and fat) in order to shed a few kgs, well i did shed 6 kgs in 1 month 79 to 73 and also ended up in hospital for 4 days absolutely stuffed, dehydrated, gastric distress, diarrhea amongst completey exhausted. this was 2 weeks before sani. Natually we finished outside the top 50 but **** I through my heart and soul into it as my partner was in very good shape, we were actually pretty well up there after day one and importantly the left leg was pretty good!! Half way through day 2 I felt the leg starting to complain again - very tight glute and big tension in my calf, I just couldnt keep pace - but after easing for a short time (1 min odd) after a hard effort, the tension subside and stretching helped the glute for inbetween efforts.

DAY 3 was the most painful on a bike I had ever had - my left leg was so tense i couldnt even do a proper pedal stroke, it would even shake uncontrollably as I just tried to push through and I swear with tears in my eyes.

 

After this I decided something had to be done - Chiropractors / MRI scans / nerosurgeons / nerve conduction tests / more CT scans / x rays /ankle brachial blood pressue tests (AT REST) - you name it I went for it- lucky I have the means cause med aid just said NO WAYS after all the tests picked up nothing irregular. On a visit to a specialist radiographer Dr Konig in Umhlanga some ground was broken. He told me to do 60 squats before doing another Doppler test ---- result 40 % less blood flow in left leg after exercise induced doppler test. He had heard of this condition in cyclists before thus sent me for a angiogram and just like that I had a confirmed diagnosis "occulsion of the left internal and external iliac artery".

 

The first Vascular Surgeon i visited a Dr Purak - said "it does not hinder you in everyday life so just stop cycling" - So what exercise should I do Dr??? -- " just go to gym for 20 odd mins a few times a week and maybe some light walks" - for how long Dr?? " for ever just stop cycling what is the problem" I prompty told him to F%&K off and walked out !

 

Prof. John V Robbs did the surgery for me.

 

Sorry such a long winded story but I am at home recovering to got time on my hands!!!

 

Bigelo go for it -- it is NOT painless and pretty bloody uncomfortable with some impressive war wounds, everyday is better bit by bit. I am 35 years old and had 5 previous operations on various rugby injuries and this is the most uncomfortable !! but if I compare last week to this week the improvement is remarkable and you know what its over and now I can hopefully look forward to normal effort generated pain as opposed to resticted blood flow pain!!

 

and a solid Joberg 2 C with my sani/ normal event partner - hopefully I can repay him after the frustration of this year.

 

I am off the pain meds now moving around with a slight bent over look, but happy as a pig i did it. CUT THE INGUNIAL LIGAMENT

[massiveboy]

Good luck Chris! Both sides will be a bit more uncomfortable for sure, but well worth it!

 

Its more common then you think. We already have 3/4 guys who will have the op within a month!

 

I cycled 15 to 25 hrs a week for the past 4-5 years.

 

Its pretty hard to determine as in the case of Bigelo, I also had it in both legs. So you get the feeling the lactic acid doesn't leave your legs and your leg(s) get numb. But it only happenens at high intensity so one thinks not enough intensity training, but in reality they just don't get enough blood! Over the years the frequency of bad races increases and the leg(s) stay numb for longer after a hard effort.

 

A simple ABI test (Ankle Brachial Index) where they measure the pressure before and after excercise will show if you have it.

 

Keep us posted Chris!

How you doing FL -- still cant believe you can ride already after 2 odd weeks, last week i thought i was pregnent my tummy was so swelled.

 

much better now though.

 

did your Dr give you any blood thinners?

[Flemish Lion]

Hi MB,

 

Good to hear you are making steady progress.

 

Yes, I'll be on disprin for 3 months in total.

 

I'm almost feeling 100%, which worries me as I need to remind myself to keep the heart rate down and not run up the stairs etc.

 

I stopped playing soccer after 2 ACL reconstructions (snapped front ligament) to my right knee and also removed some cartilage there... moved to cycling to avoid injuries only to have this iliac problem... will it ever end

[massiveboy]

Morning gents,

 

just to let you know recovery is going well and staples are out, what a relief !! Prof. very happy with procedure, he showed me some photos of the artery wrt. the tissues inside - jussus I am actually quite happy I managed to ride this long and through the pain!!! hope it will make the mind stronger aswell.

 

Bigelo< yes the first 2 odd weeks are simply nasty but everyday is better and better - you will be fine - good luck.

 

I am able to start some easy swimming from middle of next week but only on the bike as of the 12th Dec.

 

FL how you doing?

[mvrooyen]

I am also going for the operation tomorrow with Dr. Levien at Sunninghill Hospital. He did Yolandi Speedy as per previous posts. Mine is a bit different....and luckily not as severe as some of the posts I have read. Took Dr. Levien quite a while to establish where the blood flow is being disturbed. I started getting the symptoms in March, both legs, only got worse. Still manage to push the envelope and pull off some reasonable results. Dr. Levien will cut arteries on both side of groin area, place the stents, and split the ligaments. Should be able to train again within a week, but I decided rather to be on the safe side, rest 2weeks, jog for a week and then get back on the bike. Cannot wait to bike pain free again!!!

[massiveboy]

gees, sounds like this a busy Dr this Levien.

 

All the best, but stents? must be pretty different than mine cause prof. Robbs said he would never put stents in a cyclist??

 

I am not back on the bike yet but very itchy - 2 more weeks , thought whilst i am down might aswell kill 2 birds with one stone - thus had a vasectomy this morning!! alot easier than the vascular surgery -- from leaving home to back home in 1.5 hours.

 

I am now a full on poster boy sports model ?!?!

[Flemish Lion]

Hey MB, you must be the same dude I tweeted with earlier today

 

I visited Dr Livien this am and he is very happy with my progress after doing an ultrasound. It was nice to see the artery with full flow, see the patch and the cut ligaments. When I asked what the danger is of releasing these ligaments he said minimal as they should still be able to perform their support role, a hernia could be the worse outcome which is much better than the outcome when not releasing them!

 

I can now go up to 80% of max HR (4 weeks after op) and full out mid December.

 

I'm also taking it easier than prescribed, just in case.

 

Good luck Mia!

[massiveboy]

yebo same guy - FL

 

think someone should ask Jeroen Swart to do a Super Cycling piece on this thing as it appeares to be bigger than I ever imagined?

 

thought i was one of a kind and would have to travel far and wide to get treatment - obviously not!

 

everyone keep the followers informed of your various progresses.

 

Personally I am still taking it easy, will start swimming next week then 12th Dec will be my first 30 min easy spin.

[Flemish Lion]

Indeed, so many cyclists / triathletes must be suffering from the same syndrome not knowing what is slowing them down!

 

I sent Jeroen and AM a tweet

[Part time Biker]

Hey Guys

 

Glad to hear everyone is recovering well. i had my op on wednesday, was in theatre for 4h15. Dr shortened my left artery by 2.5cm and left by1.5 cm then removed a clot from the artery in the left groin, this was the main cause of my leg going woody, there was no need to patch the groin artery as it was clean except for the clot. I was up walking yesterday and in ward today, Dr very happy with how the op went and how recovery is going, hopefully will be going home tomorrow. all the best for you guys, take it easy.

[mvrooyen]

Hey!

 

My operation went super on Wednesday. Dr. Levien very happy and wants me back on the bike in 3weeks. Was a bit worse than expected, left side 50% pinched, right 30%. I reckon a lot of cyclists reckon they are over trained. Every one told me I was over trained, even though I have trained the same hours for the past 18months....and have been super good at rest and recovery. I live by if I dont feel like training, then I rest.

 

I reckon Dr. Levien is going to be one very very busy guy next year as this is getting more known!!

 

Good luck on all of you that's recovering! 2013 is going to be our year on the bike!!

[massiveboy]

Nice to hear, I am sure you are very relieved it all over now?

 

I put myself through a vasectomy last week tues, while you down might as well do it proper! wasnt to bad though 10 min under local - very sharp.

 

Started swimming this morning was such a relief just to do something again - very happy.

 

mvrooyen how long were you in hospital for? How big are your cuts?

 

Ja i think we could start a illiac syndrome club??

[mvrooyen]

Def immediate relief . Have 2cuts on both groins, around 5cm each. Was in hospital ( High Care) for 2evenings. Spend most of my weekend just laying around watching tv. Today(6th), first time I went driving, just close buy, just a bit of discomfort, but at least no pain. Next 2weeks will be crucial. @massiveBoy, I agree, rather take thinks super slow than messing it up super bad .

[Flemish Lion]

Good to hear!

 

Mia, from what you describe it sounds like Dr Livien has released both inguinal ligaments, but no patching was required and hopefully the iliac arteries will recover?

 

All is well on my side, I just need the weather to play along a bit so I can get some decent base miles in

[massiveboy]

how we all doing after our relevent surgeries ???