Arterial compromise

• Arterial compromise:

  • Disease of an artery
  • Functional kinking of the external iliac artery from repeated movements e.g. hip hyperflexion or hypertrophy of surrounding muscles compressing the artery
  • This reduces blood flow to the soft tissues distally.
• Arterial compromise - Who does it affect

  Athletes involved in repetitive hip flexion: Footballers, long distance runners, cyclists
• Arterial compromise - Symptoms:

  • Weakness, cramping, pain with unilateral exercise. Felt in the hamstrings, quads, adductors or abductors and glutes
  • Pain resides with rest
• Arterial compromise - Objective findings

  • Reduced pulse distally (femoral, tibial, dorsalis pedis)
  • Temperature differences per limb
  • Ankle-brachial plexus index before and after maximal effort of exercises
• Arterial compromise - Treatment:

  • Sporting population likely to require surgical stenting
  • Minimise repeated hyperflexion / sustained flexion
  • Modify sporting technique to avoid pulling up from pedals – this causes psoas hypertrophy