Pain Between Hamstrings and Glutes After Cycling: Causes and Solutions

Pain at the junction of the biceps femoris and gluteus maximus?

Hello Doctor, I rode my bicycle continuously from July 28 to July 31.
I rode for two hours each of the first two days, including some mountain biking, and then about an hour each of the last two days without mountain biking.
Since then, the soreness in my quadriceps and gluteus maximus has gradually improved, but I still experience intense soreness in my hamstrings during stretching, located between the hamstrings and gluteus maximus, about one centimeter below the ischium.
I started cycling occasionally in May, but I didn't ride much until July.
Therefore, there was a month gap between my last ride and this one.
If I rode too intensely, my quadriceps and gluteus maximus have fully recovered, so why is there still soreness in the area between the hamstrings and gluteus maximus? This is especially noticeable during stretching and climbing stairs.
I usually apply heat and have seen an orthopedic doctor for medication, but there hasn't been much improvement, and it's still very sore after a month.
I would like to ask Dr.
Wang what this issue might be.
Thank you, Doctor.

Yu, 20~29 year old female. Ask Date: 2023/08/31

Dr. Wang Zhaomin reply Rehabilitation

This consultation platform cannot provide a diagnosis or treatment for chronic muscle strains or partial tears, which may lead to long-term muscle soreness.
However, other neurological or soft tissue lesions may also be possible.
Please visit an orthopedic or rehabilitation specialist for an accurate diagnosis and appropriate treatment plan.

Reply Date: 2023/08/31

More Info

Understanding pain between the hamstrings and glutes after cycling can be quite complex, as it involves various factors related to muscle strain, overuse, and biomechanics. Based on your description, it seems that you have experienced significant discomfort in the biceps femoris (part of the hamstrings) and the gluteus maximus after an intensive cycling session. Let’s break down the potential causes and solutions for your condition.

Possible Causes of Pain
1. Muscle Strain: The most common cause of pain in the hamstrings and glutes after cycling is muscle strain. When you engage in prolonged or intense cycling, especially on inclines, your hamstrings and glutes work hard to propel you forward. If these muscles are not conditioned for such activity, they can become strained, leading to pain and discomfort.

2. Delayed Onset Muscle Soreness (DOMS): After a period of inactivity, such as your break from cycling, your muscles may not be prepared for the sudden increase in activity. This can lead to DOMS, which typically peaks 24 to 72 hours after exercise. The soreness you feel, especially during stretching or climbing stairs, could be a result of this phenomenon.

3. Muscle Imbalance: If your quadriceps (the front thigh muscles) are stronger than your hamstrings, this imbalance can lead to overuse of the hamstrings during activities like cycling. This can cause pain in the hamstrings and glutes as they compensate for the lack of strength in the opposing muscle group.

4. Tendonitis: Overuse can also lead to tendonitis, which is inflammation of the tendons connecting muscles to bones. The pain you feel near the sit bone could be related to the hamstring tendons being irritated due to repetitive cycling motions.

5. Nerve Compression: Sometimes, pain in the gluteal region can be attributed to nerve compression, such as sciatica, which can cause pain that radiates down the leg. This is less likely but should be considered if other symptoms are present.

Solutions and Recommendations
1. Rest and Recovery: Allow your muscles time to recover. Avoid activities that exacerbate the pain, and consider cross-training with low-impact exercises like swimming or walking to maintain fitness without straining the affected muscles.

2. Stretching and Strengthening: Incorporate gentle stretching of the hamstrings and glutes into your routine. Focus on flexibility exercises that target these areas. Additionally, strengthening exercises for the hamstrings, glutes, and core can help improve muscle balance and reduce the risk of future injuries.

3. Heat and Cold Therapy: Continue using heat therapy to relax tight muscles and improve blood flow. Cold therapy can be beneficial immediately after cycling to reduce inflammation and numb sharp pain.

4. Physical Therapy: If the pain persists, consider consulting a physical therapist. They can provide a tailored rehabilitation program that includes specific exercises to strengthen weak areas and stretch tight muscles.

5. Gradual Increase in Activity: When you return to cycling, gradually increase your intensity and duration. This will help your muscles adapt to the workload without becoming overly fatigued.

6. Proper Bike Fit: Ensure that your bike is properly fitted to your body. An improper fit can lead to biomechanical issues that may exacerbate muscle strain and discomfort.

7. Consult a Specialist: If the pain continues for more than a few weeks or worsens, it may be wise to consult an orthopedic specialist or a sports medicine physician. They can perform a thorough evaluation and may recommend imaging studies if necessary to rule out any underlying conditions.

In summary, the pain you are experiencing between your hamstrings and glutes after cycling is likely due to muscle strain or imbalance, exacerbated by a sudden increase in activity. By implementing a combination of rest, stretching, strengthening, and proper bike fitting, you can alleviate your symptoms and prevent future occurrences. If symptoms persist, seeking professional medical advice is crucial for a proper diagnosis and treatment plan.

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