Question from T. Mons: When I go up a hill on my road bike and get out of the saddle into the cradle position, I can only ride three to four revolutions of the cranks, then I immediately get a burning sensation in my groin and thighs and the feeling that I have no more strength. It can't be due to a lack of mileage, I cycle 60 to 100 kilometres twice a week. So what could be the cause and what can I do about it?
Dr Merkl replies: Groin pain can have many different causes: Hip osteoarthritis, abdominal wall hernias, muscle insertions or pain originating from the spine. According to your information, I suspect an inflammation of the so-called rectus femoris, a muscle that originates in the groin area and ends at the patellar tendon. This muscle flexes the thigh in the hip joint and stretches it in the knee joint. It tends to shorten, so that tendon insertions are often irritated or even inflamed. If you ride in an aerodynamic position, the tensile load is reduced by the flexion in the hip joint. When you stand up in the cradle position, there is greater tension on the tendon insertion. Pain can then radiate into the thigh, often accompanied by a feeling of weakness, as you have described. In addition, the rectus femoris nerve can be irritated, which then causes this burning sensation. Stretching the muscle, possibly with physiotherapy treatment, could help. Massages are also helpful, as is targeted treatment of the tendon insertion, possibly with anti-inflammatory medication.
