Paper calls for endofibrosis to be classified as “an occupational disease” for professional cyclists

A research paper outlines the risks of failure to diagnose – what is a rare disease for the wider population – in professional athletes and cyclists

Image shows Pauline Ferrand-Prevot cycling.
(Image credit: Getty Images - Luc Claessen / Stringer)

A research paper has just been published calling for endofibrosis to be classified as “an occupational disease in the case of professional athletes or cyclists”, after the two cyclists of its case study were presented with the possibilities that their professional careers might be over.

Endofibrosis is an uncommon disease in which “the lumen of the artery becomes progressively occluded due to a thickening of the arteries intima.” Essentially, the flexed position on the bike and the long periods of high intensity effort can cause a fibrous tissue build-up, which narrows the artery and can lead to pain, weakness, numbness, cramping and/or swelling of the thigh. 

But although the disease is uncommon across the population as a whole, the prevalence amongst professional athletes is materially higher. Tereza Mazurava et al highlights this in their paper, 'Endofibrosis as a Causative Agent of the Peripheral Artery Disease: A Report of Two Cases for Professional Cyclists', published in Cureus' Journal of Medical Science here.

The issue here is that although the condition is treatable, as endofibrosis is a “progressive disease”, the condition gets worse over time and delays in diagnosing the disease serve to exacerbate the problems. 

In the first of two case studies that Tereza Mazurava et al describe, a 29-year-old female professional cyclist with no previous medical history presented with “symptoms such as pain in the right leg, numbness and paresthesia in rest.” She was soon diagnosed with endofibrosis and presented with the possibility of having to step down from the pro peloton. 

Fortunately, she was able to go down the surgical route and after two months was able to return to cycling, continuing her professional career.

In the second case study, it was a similar story, with the 31-year-old female cyclist returning to professional riding in as little as six weeks. 

But it’s not always so simple. Ineos Grendaiers' Pauline Ferrand-Prévot winner of World Championship titles across road, cyclocross, mountain bike and gravel – alongside many other victories – has had a much more arduous journey.

Image shows Pauline Ferrand-Prévot cycling.

(Image credit: Getty Images )

In 2018, Pauline Ferrand-Prevot announced that she would have to take a break from competition for four months due to the condition. Although she returned to race at the top level in 2019, she announced in early 2020 that the endofibrosis had returned – although less severely than her original diagnosis. Yet it still required another round of surgery.

As the first World Gravel Champion, claiming the title in October of this year, Ferrand-Prevot has continued to perform at the highest level.

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