• Amanda Spratt of Australia and Team BikeExchange (Getty)Source: Getty
Amanda Spratt has been diagnosed with iliac artery endofibrosis, a condition that will require the three-time national road race champion to undergo surgery in the off-season as she seeks to return to peak condition.
By
SBS Cycling Central

12 Oct - 9:06 AM 

The results hadn't been coming for Spratt in 2021, at least not to her normal consistent level on the climbs and favourable terrain. The 34-year-old couldn’t quite understand what was happening, a tough time of questioning herself from the star of the sport.

“2021 has been a pretty tough year, both physically and mentally," said Spratt. 'I could feel that something wasn’t right since late on in the 2020 season but there were always other reasons or answers I could think of at the time. I would put any bad performances down to things like my bike set-up or small illnesses."

“I have been racing for so many years. I know that I am the type of rider that excels in the hardest races. When everyone starts to get tired in a tour, I only get stronger. This is one of my biggest strengths. Yet this year I noticed that I couldn’t back up each day."

The evidence grew with each race that something wasn't right, with Spratt's moment of realisation coming during the focus for the season, the Tokyo Olympics Road Race, where she and the Australian team had a bad day, Tiffany Cromwell the highest-placed finisher in 26th and Spratt not finishing the race.

"My performances got worse and worse and if I reached the finale of a race, my legs were the first to explode," said Spratt. "I had bad sensations that I haven’t had before and in the end, the Tokyo Olympic Games road race was the tipping point.

“In that race, I had great legs. Until I didn’t. I couldn’t even push 200 watts anymore. It was of course an event that I had been training relentlessly for; a major goal of the season. The come down after the Olympics was incredibly difficult because I just couldn’t understand what had happened or why. I pride myself on my professionalism and covering every little detail.”

“After the games, the Australian Cycling team doctor, Dr Kevyn Hernandez, concluded that I needed to get checked for artery endofibrosis. Thanks to him and to Team BikeExchange, my appointment was fast-tracked and in mid-August I had some conclusive answers which confirmed that I have iliac artery endofibrosis. After looking at the case, doctors explained that if I wanted to continue as a professional cyclist then surgery was my only option."

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The diagnosis brought an end to the speculation about reasons for her drop-off in results and performance, but there's a hard road ahead in both surgery and the recovery for the Australian climber.

“Iliac artery endofibrosis is just one of the many causes of exercise-related leg pain and loss of performance,” Team BikeExchange's doctor, Steve Baynes, explained. “It is found in a number of athletes who undertake endurance training, especially where the training involves repetitive hip flexion and rotation. It is also likely to be linked to the anatomical pathway of the important leg arteries which can become ‘kinked’ in some individuals. So, because of these and other mechanisms, the artery becomes stiff and loses its elasticity with resultant reduction in flow just when the muscles need more supply during training and racing.

"This is a significant surgery which can involve releasing the arteries along with bypassing the narrowed segment with a vein graft. It requires very careful post-operative rehabilitation and the return to full training will be after five to six months.”

Spratt's gratification to have some reason to attribute her performance drop to was some solace after a tough season, but she acknowledges that it will be a long way back to the top of the sport for her. Thankfully, she has a pair of former teammates who she can talk to about the procedure, with the duo both having undergone the exact same operation during their careers.

“I definitely felt relieved to have an answer. For myself, but also for those closest to me who put so much time and effort into helping me try and be my best. It’s definitely been a struggle to race this year and to not know why I couldn’t be at my best,” said Spratt.

"It is always a relief when there is a conclusion, an answer, for all the questions but with this comes the realisation that it is a serious condition and an operation that requires important recovery time with no guarantee of success.

“I know it’s a very serious surgery with a long recovery but thankfully there are many good examples of riders who have come back from it in full force. I don’t have to look far for inspiration with my current teammate Sarah Roy and former teammate Annemiek van Vleuten, having both undergone the same procedure that I will this off-season. I’ve spoken with both of them, and I know their help and guidance will benefit me hugely in the recovery period.”

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It’s been a hard road for Sarah Roy (Mitchelton-Scott), not settling for less than her best and having to fight to get the proper diagnosis for a condition that was hampering her on the bike.

The 34-year-old has been one of the mainstays of the Australian elite core of riders in Europe since joining the top level races in Europe in 2006, before becoming one of the foundation members with Orica-AIS in 2012. Her best performances have come later in her career, with podium finishes at the Giro Rosa, podium finishes at the world championships in consecutive years, as well as three wins in a row at the Tour Down Under.

“During 2018 and 2019 I felt like I started to show myself and those around me what I am really capable of," said Spratt. "This injury has made me realise that I still have so much I want to achieve in this sport. I’m not ready to give up and I already see many big goals coming up in the next few years.

"The Tour de France Femmes and the Wollongong World Championships are two realistic goals for me. I also can’t wait to be back racing an Australian Summer with good legs in 2023. For now, it is time to digest this diagnosis and as I prepare for my surgery, I know I will be surrounded by the best team, and I am excited to see what I can achieve with the team next season.”