Multi-discipline champion Pauline Ferrand-Prevot revealed on her Instagram
pages yesterday that she's been diagnosed with iliac artery endofibrosis, a painful condition that's generally not common but also isn't unheard of among endurance athletes. The condition is affecting both of her legs and will require surgery, with Ferrand-Prevot expecting to be on the sidelines for around four months. You can see her full Instagram post below.
Ferrand-Prevot is a powerhouse in mountain, cyclocross, and road circles, having been the first athlete (male or female) to be a World Champion in all three disciplines simultaneously. Her 2014 and 2015 seasons were phenomenal, but injuries over the more recent years have slowed her down some, especially a tibial fracture that put a damper on her 2016 Olympics.
By the sounds of it, Ferrand-Prevot had been struggling to diagnose her issues, and a quick Google search reveals that IAE is often misdiagnosed or missed completely. A big reason for that is that vascular problems aren't often suspected in fit athletes, even though high blood flow, repetitive hip flexing, and an athlete's position on the bike are all known factors. The result is damage to the layers of the artery wall and decreased blood flow throughout the legs that can translate to unprecedented weakness.
You can no doubt see how that would be an issue for an elite cyclist, and although Ferrand-Prevot has had some impressive results during the past year (including 2nd at the European cross-country Championships, four World Cup podiums, and a National cyclocross championship win), she hasn't been able to ride to her full potential.
IAE hits each person differently, but what can Ferrand-Prevot expect in the future? A fifteen-year-long study by three Stanford University MDs in 2016 looked at eighteen patients between 2000 and 2015 who underwent operative intervention, with all of them being high-performance endurance cyclists, triathletes, and long-distance runners. Here's what the paper had to say: ''Primary patency was 93% at one year and 82% at latest follow-up. Whereas 82% of patients were able to return to their prior level of physical endurance, in a long-term follow-up survey, 50% of these patients experienced some recurrence of symptoms.
Although she could be dealing with some symptoms down the road, it sounds like there's a good chance that Ferrand-Prevot will return to full strength. Here's hoping that's exactly what happens.
FWIW I’m a vascular surgeon in the army, and I see a lot of the rarer things that affect young people—soldiers are professional athletes in many ways, so there’s some definite overlap. I hope you can get to a quick and accurate diagnosis and effective treatment soon. I’ve dealt with my own issues that have kept me off the bike and it just sucks.
As well, the fatigue and shortness of breath, sweating too much were from not being in great shape. I didn't realize how much I was sitting and assumed that all the hike a bike to get my DH rig up mountains was enough exercise. Sadly it is not. It makes sense that it really showed up riding more park this year.
Thank you for the information and reassurance, and I wish you luck in dealing with anything and everything keeping you from riding.
I had a physio look at me pedalling on the bike and he quickly noticed the problem, but he was afraid not much could be done.
So I bought 2 different cranks (170 & 175mm) and 2 different pedals (20mm Xpedo Detox and 11mm Xpedo spry) to compensate the leg discrepancy, and haven't had pain ever since.
Of course it depends were the size difference is, mine is on the femur.
It probably also wasted a lot of energy.
I also have orthopedic soles in my shoes, and I can clearly feel when I don't have them, I lose my balance very easily.
Though I feel my left leg is always more tired/tight, as it gets more weight on it, and my left foot is one size longer.
15mm sounds like a lot! My physio thinks a good insole and better body awareness/form will fix it. Creative solution too, with the different sized cranks and pedals.
On the plus side, great to find a potential solution to so many aches and pains that doesn't involve surgery or pain killers. Glad to hear you could take care of the knee pain!
Also, feel like kind of a dick because my comment was classic pinkbike: almost nothing to do with the article. It's not about me!
Pauline Ferrand-Prevot good luck, I hope you sail through this challenge and get back to full health, sounds like a scary situation and we're all rooting for you. I hope the specialist has answers and you can make a concrete plan to move forward.
She is the only professional cyclist(male or female) to hold 3 rainbow jerseys in Road, XC, and CX all at the same time.
That's an amazing threshold of pain and I hope she gets both legs 100% soon!
Maybe she might get bad coaching that make it easier on the other women in 2019. Oh yeah, she dating Julian Absalon so thats a negative on the bad coaching.