My pilonidal cyst scar hurts mostly after work out. whatcould be the cause of it? is there any treatment for it?

Are you asking why?: Pilonidal cysts come from inward-growing hair penetrating the very thin skin of this area. The midline is an embryological "seam" where the two halves of you fused during development. The skin is so thin there that the curly hair can burrow through into the underlying fat and create a cyst. Because this is a "germy" area, painful flare ups of infection are common. Antibacterial soap +/- surgery!

Early or late?: Scar tightness and pain would be fairly common the first few month after closure. If it has been longer, then pay attention to how you are putting pressure on the area and consider following up with your surgeon.

Drainage or excision: If it is infected, it may require drainage. If pain is recurrent you may achieve relief with excision. Meet with a general surgeon to discuss.

Pilonidal Cyst: You may have a nerve caught up in some scar tissue or there may be some residual cyst that is still causing irritation. Best to consult with your surgeon to see if additional surgery or physical therapy to break up the scar tissue may help.