Sudden onset hip tendinopathy after starting Ciprofloxacin

I was prescribed 500mg of Cipro twice a day for 10 days. I am 3 doses in and woke up last night with pretty significant pain on the outside of my hip and clicking in the joint. I’ve had no issues with any pain in the area within recent memory so I’m concerned it’s a tendinopathy caused by the Cipro. I’m going to contact the doctor who prescribed the Cipro to see about changing to another antibiotic, but I was looking for guidance on training. I know tendons require loading to heal but was wondering if it makes any difference if the issue was caused by antibiotics and rather or not it’s best to still train my lower body but with modified load/rom or if it’s best to rest the area in this case.

Sorry to hear about the hip pain. Ciprofloxacin are a type of flouroquinolones, which are a class of antibiotics that have been associated with tendon pain. Thus, it is possible that these are related. Given the onset, it seems unlikely to be a rupture and maybe not even a tendinopathy at all.

In general, cases of antibiotic-induced tendinopathy (but not rupture) resolve quickly. As always, management should be tailored to the individual. Complete rest is generally not useful for most instances of pain unless exercise is contraindicated.

I don’t feel comfortable recommending specific changes to your training program without knowing more about you, your symptoms, etc… If it were me, I think it’s reasonable to find movements, loads, tempo, ROM, etc. that are tolerable.

I can speak from personal experience that my right distal bicep ruptured in July 2018, exactly 6 weeks after completing a full prescription dose of Ciprofloxacin. It was a bizarre traumatic incident that caused it but I had been complaining to my wife about odd foot/ankle tendon issues just days prior.

At any rate, I caught my 850# motorcycle just prior to it hitting the sidewalk after the kickstand failed. As I was walking it back up from a full-squat position, the passenger backrest where the majority of the weight was centered on my right hand (and fully flexed bicep) caused the bicep to detach from the forearm near the elbow when the the backrest shifted slightly and then stopped suddenly. That little pop while my arm was fully flexed, caused the bicep to roll up like a window shade into the front deltoid area. Looked way worse than it felt at the time (probably due to slight shock), but the aftermath of two surgeries has been hell. BOTTOM LINE (in my mind): If you are an active weight lifter or weekend warrior athlete do NOT take Cipro unless your life depends on it. Studies have shown that it can affect the tendons (especially the achilles tendon) for up to 9 months after completing the prescribed dosage. My bicep ruptured exactly 6 weeks after taking my last Cipro. It has been hell since and my bicep will never be the same. Looks like a pathetic version of it’s former self and cramps often when loading or holding even a 20# - 30# grandchild. I bring this up, not to scare the hell out of everyone, but to shed light on the possibility of the complications with Cipro. Had I known then what I know now, I would have asked my doctor for another antibiotic. Instead I eagerly complied with my doctor’s orders to stop a nasty case of diverticulitis, which at the time was causing me a great deal of intestinal distress.

Yea, we would agree that the tendon rupture risk from flouroquinolones should not be overlooked by prescribers and patients alike. That said, I am not sure that the antibiotic played a significant role in your biceps tendon rupture given the traumatic mechanism. Nevertheless, I hope you and the OP feel better!