After a CT scan, I was diagnosed with a torn tendon in my thigh right next to the ischium. The tendon insertions and their transition to the muscles on the back of the thigh were also diagnostically conspicuous. In addition, an accumulation of fluid in this area was pressing on the sciatic nerve. Initially, I only had problems when running, but when cycling after training, my orthopaedist recommended that I only swim. Could the injury be caused by cycling and should I refrain from cycling for three to six months as recommended? Are there any treatment options other than the ones I am currently receiving, such as injections and radiotherapy? (Georg Bettenbühl, Warendorf)
Dr Christian Merkl: Your findings show changes that are typical of chronic inflammation of tendon insertions and muscles close to the insertion. In your case, the hamstring muscle on the back of the thigh is affected. Such changes often occur in runners and tennis players. Either they chronically overload their hamstring muscles or they overstrain and pull themselves when they are strained too suddenly, for example by braking quickly.
Such movements are atypical for cyclists, so they are rarely affected - if at all, the cause is most likely a muscular imbalance, i.e. an imbalance in strength between the flexor and extensor muscles. In addition, the hamstring muscles are almost always shortened. Unfortunately, athletes often fail to recognise the injury, which manifests itself in sharp shooting pain, pronounced local pressure pain or swelling. They often only consult a doctor after weeks, as initial healing successes are quickly apparent, but the symptoms persist as the injury progresses.
If you want to solve the problem, you should eliminate the muscular imbalance by strengthening the opposing muscles - hip flexors and thigh extensors. Physiotherapy with stretching and transverse friction on the affected muscle parts should also complement the treatment. I have had very good experiences with local acupuncture treatment or injections with anti-inflammatory natural extracts. Nevertheless, you will have to be patient - I think a treatment period of around six months is realistic. However, I would recommend that you continue to pedal loosely, as metabolic activity can have a positive effect on healing.
