Effects of altering cycling technique on gluteus medius syndrome

Objective: We discuss how altering the cycling technique of a cyclist recei ving periodic chiropractic care helped in the management of gluteus medius syndrome. Clinical Features: A 24-year-old male amateur cyclist had numbness and ting ling localized to a small region on the superior portion of the right butto ck. The area involved demonstrated paresthesia to light touch sensory evalu ation. The cyclist had received chiropractic adjustments 2 days before the onset of the symptoms. One week earlier, the patient began riding a new bic ycle with different gearing than his previous one. Manual-resisted muscle t esting created soreness in the lumbosacral area and buttocks. Trigger point s were identified in the right gluteus medius. Standing lumbar spine flexio n was 70 degrees, limited by tight hamstrings. Intervention and Outcome: Because the patient was already receiving periodi c chiropractic care, no passive therapy was used. Patient education regardi ng the difference in gear selection in bicycles of a higher quality was pro vided. He was instructed to train in lower gears than he had previously use d and to maintain a cadence of 70 to 90 revolutions of the pedals per minut e. After 2 days, the paresthesia on the right buttock resolved. The trigger points were only mildly tender with minimal residual soreness of the invol ved muscles. Conclusion: Management of gluteus medius syndrome by altering the cadence a nd gear development fur a bicyclist is discussed. Either frank or cumulativ e injury to the gluteus medius muscle is the typical etiologic factor for t his syndrome. Repetitive strain of the patient's gluteus medius muscle as a result of poor cycling technique appeared to be the cause here. Knowledge of bicycle fitting, training techniques, and bicycle mechanics appeared nec essary to resolve the problem.