Detection and treatment of claudication due to functional iliac obstruction in top endurance athletes: a prospective study

Schep, Goof; Bender, Mhm; Tempel, G van de; Wijn, Pff Pieter; Vries, WR de; Eikelboom, B.C.

doi:10.1016/s0140-6736(02)07675-4

Cited by 102 publications

(137 citation statements)

References 12 publications

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“…Despite this, the only information available on the magnitude of the problem among cyclists is a suggestion that 20% of all top-level cyclists may suffer from the condition. 8 However, as this was based on a study by a group of surgeons that regularly treat the condition, 28 it may be subject to sampling bias. Having only identified two athletes who had received surgery for flow limitations, our results suggest a far lower prevalence than this.…”

Section: Discussionmentioning

confidence: 99%

Overuse Injuries in Professional Road Cyclists

2010

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This file was dowloaded from the institutional repository Brage NIH -brage.bibsys.no/nih Clarsen, B., Krosshaug, T., Bahr, R. (2010). Overuse injuries in professional road cyclists. American Journal of Sports Medicine, 38, 2494Medicine, 38, -2501 Dette er siste tekst-versjon av artikkelen, og den kan inneholde ubetydelige forskjeller fra forlagets pdf-versjon. Forlagets pdf-versjon finner du på ajs.sagepub.com: http://dx.doi.org/10.1177/0363546510376816This is the final text version of the article, and it may contain insignificant differences from the journal's pdf version. The original publication is available at ajs.sagepub.com: http://dx.doi.org/10.1177/0363546510376816Original Article: Purpose: To register overuse injuries among professional road cyclists with special focus on anterior knee and lower back pain.Study Design: Descriptive epidemiology study Methods:We attended training camps of seven professional teams and interviewed 109 of 116 cyclists (94%) on overuse injuries they had experienced in the previous 12 months. Injuries that required attention from medical personnel or time loss from cycling were registered. Additional information on anterior knee pain and lower back pain was collected using specific questionnaires. Results:We registered 94 injuries; 45% were in the lower back and 23% in the knee. 23 time loss injuries were registered; 57% in the knee, 22% in the lower back, and 13% in the lower leg. Fifty-eight percent of all cyclists had experienced lower back pain in the previous 12 months, and 41% of all cyclists had sought medical attention for it. Thirty-six percent had experienced anterior knee pain and 19% had sought medical attention for it.Few cyclists had missed competitions due to pain in the lower back (6%) or anterior knee (9%). Conclusion:Lower back pain and anterior knee pain were the most prevalent overuse injuries, with knee injuries most likely to cause time-loss and lower back pain causing the highest rates of functional impairment and medical attention.Clinical Relevance: Future efforts to prevent overuse injuries in competitive cyclists should focus on lower back pain and anterior knee pain. Road cycling has been a part of the Olympic Games since their inception in 1896, and the sport's annual centrepiece race, the Tour de France, is currently one of the world's most popular sporting events. Despite the history and popularity of the sport, surprisingly little attention has been paid to the epidemiological study of overuse musculoskeletal injuries among competitive cyclists, although anecdotal reports suggest that certain injuries such as patellofemoral pain [16][17]25 and lower back pain 24 may be prevalent.Several studies have investigated overuse injuries among participants of non-competitive recreational cycling events. 11,22,29,31 These investigations have unanimously found knee injuries to be prevalent, affecting between 24% and 62% of subjects, whereas reports of other injuries such as lower back pain and neck pain, are more variable, with prevalence rates of 3-31% a...

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Section: Discussionmentioning

confidence: 99%

Overuse Injuries in Professional Road Cyclists

2010

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“…Severe tortuosity may lead to arterial kinking (acute angulation) which causes artery occlusion and is associated with severe symptoms including transient ischemic attack, stroke [60], hemiplegia and other cerebrovascular deficiencies [6,9,62]. Tortuous carotid arteries are often reported in hypertensive patients [4,6,63].…”

Section: Etiology: Association With Vessel Diseases and Clinical Consmentioning

confidence: 99%

“…On the other hand, tortuosity increases the resistance to blood flow and severe tortuosity can obstruct or even occlude blood flow [33,62]. Lumen shear stress and wall stress are also altered in tortuous arteries [127] (fig.…”

Section: Mechanical Changes In Tortuous Arteriesmentioning

confidence: 99%

Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms

Han¹

2012

J Vasc Res

395

355

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Tortuous arteries and veins are commonly observed in humans and animals. While mild tortuosity is asymptomatic, severe tortuosity can lead to ischemic attack in distal organs. Clinical observations have linked tortuous arteries and veins with aging, atherosclerosis, hypertension, genetic defects and diabetes mellitus. However, the mechanisms of their formation and development are poorly understood. This review summarizes the current clinical and biomechanical studies on the initiation, development and treatment of tortuous blood vessels. We submit a new hypothesis that mechanical instability and remodeling could be mechanisms for the initiation and development of these tortuous vessels.

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“…Conversely, competitive cyclists may have symptoms of thigh claudication during exercise as a result of external iliac artery endofibrosis, despite having a normal pulse examination and normal anatomic imaging at rest. 3,4 The classic symptoms of claudication are calf muscle aching, fatigue, or cramping, although it can also involve the buttocks, thigh or hip. The hallmark features are symptoms that are reproducibly elicited with physical activity and are alleviated during rest with abatement during a period of 10 to 15 minutes.…”

Section: Intermittent Claudicationmentioning

confidence: 99%

Surgical Intervention for Peripheral Arterial Disease

Vartanian

Conte

2015

Circulation Research

107

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The prevalence of peripheral arterial disease (PAD) is increasing worldwide, with recent global estimates exceeding 200 million people. Advanced PAD leads to a decline in ambulatory function and diminished quality of life. In its most severe form, critical limb ischemia, rest pain, and tissue necrosis are associated with high rates of limb loss, morbidity, and mortality. Revascularization of the limb plays a central role in the management of symptomatic PAD. Concomitant with advances in the pathogenesis, genetics, and medical management of PAD during the last 20 years, there has been an ongoing evolution of revascularization options. The increasing application of endovascular techniques has resulted in dramatic changes in practice patterns and has refocused the question of which patients should be offered surgical revascularization. Nonetheless, surgical therapy remains a cornerstone of management for advanced PAD, providing versatile and durable solutions to challenging patterns of disease. Although there is little high-quality comparative effectiveness data to guide patient selection, existing evidence suggests that outcomes are dependent on definable patient factors such as distribution of disease, status of the limb, comorbid conditions, and conduit availability. As it stands, surgical revascularization remains the standard against which emerging percutaneous techniques are compared. This review summarizes the principles of surgical revascularization, patient selection, and expected outcomes, while highlighting areas in need of further research and technological advancement.

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Detection and treatment of claudication due to functional iliac obstruction in top endurance athletes: a prospective study

Cited by 102 publications

References 12 publications

Overuse Injuries in Professional Road Cyclists

Overuse Injuries in Professional Road Cyclists

Twisted Blood Vessels: Symptoms, Etiology and Biomechanical Mechanisms

Surgical Intervention for Peripheral Arterial Disease

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