Hamstrung by tendonitis | Cycling UK

Hamstrung by tendonitis

Tendonitis: a pain in the backside
Tendonitis: a pain in the backside
Tendonitis: a pain in the backside

Hamstrung by tendonitis

I have been diagnosed with hamstring tendonitis. It started a year ago, two weeks after a tour that was longer, more hilly, and more heavily laden than my usual. The symptoms are right buttock pain, particularly when sitting on a sofa or driving, cycling up a hill, or walking up a hill. I am 61 and have been cycling for 27 years, always with care to use low gears on hills and to avoid strain, and I have thoroughly enjoyed it. However, I wonder if my cycling days are over? Despite a steroid injection (which made it worse), and extensive physiotherapy, every time I try to resume cycling the pain returns, often after a delay, and I then cannot sit, drive or sleep. For the past two months, I have avoided cycling altogether. Should I just be philosophical, accept that I’ll never get back on the saddle again, and give away all my bikes?

Raymond Walker

The hamstrings are a group of muscles that pass down the back of the upper leg, from the ischial tuberosity (sitting bones) of the pelvis, to just below the knee. They help to bend the knee and the straighten the hip. Tendons are the fibrous bands of connective tissue which join muscle to bone. Tendonitis refers to inflammation of these and usually arises from excessive repetitive movement. Hamstring tendonitis is also commonly seen in runners.

You describe symptoms of high (proximal) hamstring tendonitis, which usually causes pain in the buttock, sometimes radiating down the back of the thigh. In common with other types of tendonitis, treatment typically involves rest, ice and physiotherapy. Anti-inflammatory drugs, such as Ibuprofen, may help in the short-term (as long as there are no contra-indications to taking them). In more resistant cases, a steroid injection around the area (not directly into the tendon) may be employed, and this is usually done under ultrasound guidance to ensure correct placement.

However, it sounds as if you’ve already tried most, if not all, of these. I wonder whether you have looked at your bike set-up? Saddle adjustment may help, usually lowering the saddle slightly.

It would be a real shame if this condition alone resulted in the end of your cycling days, but I can see how frustrating it must have become. There is still a chance that it will improve given sufficient time. Consider extending your prolonged rest from cycling, perhaps for up to six months, before trying once more. Make sure you do your hamstring stretches (which I’m sure your physio has taught you) before riding.

Matt Brooks

Cycling GP

This Q&A was published in 'Cycle' the magazine for members of Cycling UK. To contact the experts, email your technical, health, legal or policy questions to editor@cyclinguk.org or write to Cycle Q&A, PO Box 313, Scarborough, YO12 6WZ

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