Anal fissure despite an active schedule.

Hi, It seems I've got a tear in the anus and its very painful to defecate. It seems to be further tearing when I strain to do so making the next round even more painful. After an online consultation with the physician, I was advised 10ml Duphalac tonic, Smuth ointment twice & sitz bath thrice a day. Besides,I was also advised high fiber diet, more fluid intake & exercising.I took the tonic & applied cream for 2 days, but I couldn't do sitz bath. The condition has worsened. I have an active schedule as I work out for 1 and a half hour each day (50 surya namaskar & 4k rope jumping) since more than 10 years. I also have 3 tbsp chia seeds along with a fruit each morning and avoid oily food.I also take over 4 l of water each day.I wonder how it happened in the first place & what to do now. Visiting the physician is the last resort. I'll start doing sitz bath today onward. Could it be missing out on this step that worsened the situation or do i need to change the medicine?