Hamstring Tendonitis and Cycling question

[drekkly]

I believe I have developed hamstring tendonitis and I believe the cause is cycling. Too many miles and too high a saddle position. This happened 3 months ago and the problem is still there. I can bike gently for about 30mins before the discomfort comes on. I say discomfort as it is that really rather than pain. If at any time I push it hard it comes on straight away. I can run for about 3/4 miles on it no problem. I have had an ultra sound which didb't show up anything but I can feel a small lump/adhesion on the tendon near where it joins below the knee. This small lump seems to be where the soreness is if I press in on the knee. The worst thing for me to do is to squat for any period of time. For example I was squatting on it the other day whilst undertaking some bike maintenance and this caused a lot of soreness which meant I was only able to run a mile afterwards. This adhesion is obviously too small for an ultrasound to show up - possibly an MRI might see it? Either way if it is there and I believe it is the cause of the discomfort - how do I get rid of it? At the moment I am doing single leg squats and lunges and also attaching a weight to my foot and doing sitting leg raises to try and stretch the tendon out. However I am no further forward with my rehab.

Any advice? Maybe some deep tissue massage on the area? Are we looking at surgery to remove this adhesion?

Similar Threads:

• ACL reco. hamstring graft results is hamstring tendonitis?
• Hamstring tendon rehab - balancing recovery with development question
• RSI/tendonitis question
• Recurring hamstring strains, adductor tendonitis and hernias
• Calf strain or Hamstring Tendonitis

[physiobob]

Inside or outside of the knee? Might just be a small bursitis type issue as the hamstrings rub on the bone at the insertion points. If so it is a mechanical issue and the bike setup needs to be checked. Tight ITB (therefore gluteals) need releasing and strength to balance out any over dominance that they are playing. No to surgery. No to other invasive techniques. Rest, frictions, biomechanical correction and time. Lots to consider on the biomech front.

[drekkly]

Inside or outside of the knee? Might just be a small bursitis type issue as the hamstrings rub on the bone at the insertion points. If so it is a mechanical issue and the bike setup needs to be checked. Tight ITB (therefore gluteals) need releasing and strength to balance out any over dominance that they are playing. No to surgery. No to other invasive techniques. Rest, frictions, biomechanical correction and time. Lots to consider on the biomech front.

Thanks Bob. It's on the outside of the knee. Getting a full bike fit tomorrow so that's that sorted. But then still need to get rid of the bursitis. You say rest but how much? I had 17 days off the bike but not real improvement. Are we talking total rest ie no running either?

[Aaron Ebejer]

I think Periodization is key here; when it comes to how much activity you should do and how much rest you can should have.

Its also going to be trial and error on your part as you will know when your overdoing it. Try 2 days on 1 day off at first and see how you get on, decrease your overall mileage and slowly build up whilst getting the corrective therapy for the issues mentioned above by Physiobob. I would also recommend using the RICE protocol after training and during pain:

• Rest
• Ice
• Compression - Not necessary in this case
• Elevation

Most importantly, don't forget to stretch.

[physiobob]

I don't think REST is the actual answer, more like reduced irritating activity and introduction of non-irritating activity (better bike setup) with perhaps some soft tissue work to keep symptoms in check and progression to an overall, gradual reduction in pain. Remember that these types of issues are wear and tear and don't occur overnight (although discomfort will happen overnight). So at a state of irritation the connective tissue is often chronically compromised and so will take months to return to a more normal state, 3 months at least. Let us know how the bike fit went and also if you are using clips, which can also be adjusted if required.

[drekkly]

I don't think REST is the actual answer, more like reduced irritating activity and introduction of non-irritating activity (better bike setup) with perhaps some soft tissue work to keep symptoms in check and progression to an overall, gradual reduction in pain. Remember that these types of issues are wear and tear and don't occur overnight (although discomfort will happen overnight). So at a state of irritation the connective tissue is often chronically compromised and so will take months to return to a more normal state, 3 months at least. Let us know how the bike fit went and also if you are using clips, which can also be adjusted if required.

Well the bike fit went very well so I'm now set up to pedal as efficiently as possible. Nothing was badly wrong but I had a physio assesemnt beforehand where I was told I was weak around the glutes, hip flexors on the LHS (where the sore knee is). So she thinks this has caused the knee problem rather than a specific bike set up error. I have lots of core exercises to do - straight leg raises, the clam, squats, lunges etc which should hopefully strengthen that side and start taking the strain off the knee. AS you say it's going to take time though. Its been 3 months since it first came on but I guess I was doing anything about it - so maybe another 3 months??!

I'm wondering about running - i run 2/3 times a week - about 10miles total so not much but should I ditch this and just concentrate on the biking? I don't want to lose fitness and the running is helping this. It doesn't hurt when I actually run? But I guess it's aggravating it?