IT Band Injuries & Cycling

RAMONJKD

Hello there,

I wanted to get peoples thoughts/experiences with knee pain/ITB pain caused by cycling. I have had to stop long distance running this year as pain in the outside of my knee became more frequent through running. 5-6 miles is usually okay but anything over that seems to agravate my knee whilst running, although the pain tends to go after a day or two.

I am used to cycling 30-50 miles on a fairly regular basis. However, my concern is that I am organising a charity ride from Kent to Cornwall later in the year which will see us riding 75 miles a day for 4 days. I sometimes get a hint of the knee pain on longer rides and am worries how it will hold up over 4 consecutive days. I assume that cycling can't be anywhere near as bad on the knee as running. I am going to try and stretch my legs and strengthen them as best I can and have just ordered a foam roller so I can start to regularly stretch my IT Band.

The ride is for something very personal to me so I am determined to complete it, just a bit worries about the knee pain flairing up. I told my wife that as my feet are clipped in I may just have to ride with my left leg if it gets bad on the way!

bianchimoon

I too get this problem, usually after 50 miles, tho on saturday on a 50 mile training run it started after 25 miles, i sort of had a solution with the last pair of shoes, where i could put the cleats towards the middle of the shoe, on the foot of the affected leg that seemed to help it, good luck in your ride

RAMONJKD

Thanks for the reply. What do you usually do, just pedal through it?

bianchimoon

first time it happened was halfway through a c2c ride, i took co-codamol and carried on, it just seemed to ease after that and was ok for most of the ride, next time, even the co-codamol didn't help much (again another c2c ride) just carried on was thoroughly miserable tho' did a 100 miler late last year again same problem, moved cleats to middle of shoe and that helped make it bearable. Since then have got new sidi/look keo combination, and after 25 miles yesterday all started again, no more adjustment available in the cleat, so am looking at going back to old shoes spd for longer rides or like yourself hoping for some wisdom from this site to help sort it

SantasLoneCruzer

You've pretty much answered your question yourself "foam roller". It's going to hurt somewhat to start with, but it does get easier (less pain). As well as using that on your ITB, stretch your glutes, hamstrings and hip flexors on a regular basis and it should put you in good stead.

Make sure you've plenty of miles in your legs too, the only other time my ITB flared up was when I 12Hr MTB raced Solo with not enough miles in the legs

Good luck.

RAMONJKD

Thanks for the info.

My fitness levels are pretty good but I think i sometimes tend to do more than my muscles can cope with. I think that it makes sense to gradually build up the miles to give my legs a better chance. I've entered 4-5 different events from april onwards including two 100 milers so plenty of training ahead!!!

danowat

IMO you shouldn't just "pedal through it" ITB issues don't tend to go away on their own.

Lots of foam roller work helps hugely, also I find ham and glute stretching helps, I'd also suggest looking at bike positioning and cleat/shoe/pedal position.

I had massive ITB issues that curtailed my running dead, but I've done rides off 6hrs and more without any issues.

RAMONJKD

Well, got the roller.....

I assume that pain is a good sign when using them as Its pretty painful to use, but feels really good afterwards. In your opinions is this something that I should perhaps do every other day just to give my body a break in between?

TheBullet

I had a problem with my ITB a couple of years ago. At the time I couldn't cycle any more than 10 miles before it started to hurt. I still finished a few 100 mile sportives but they weren't enjoyable because of the pain.

Eventually I went to see a chiropractor who told me I had sunken foot arches which made my knees bend inward and rub the ITB.

The result was specially made insoles and a bit of physio and that fixed it. I have ben riding pain free ever since and have now completed many, many sportives and loved them.

My advice is go and see a specialist and also check your bike setup.

Good luck.

danowat

Yes, foam rollers hurt like an MF

Pep

in my case foam roller was okish, but quad roller much much better.

See a good physio. Most likely he'll presribe ITB, quad, tights, and gluteous stretching.
Also, quads and especially gluteous strentghening.
And most important correct biomechanics, so must check the bike fittings and perhaps shoes/ wedge/ insole.

ITB can ALWAYS be beaten, but it takes huge amount of patient work, and often much time. Just bullying it it's not the way to beat it.

bugsrabbit

This is the problem i,m trying to deal with at the minute. I cycled for most of last season with left knee pain and only took advice from a chiropractor when nagged from the wife. He diagnosed uneven muscle development, my inner quad to small, this didn,t cure the pain. I then tried a sports physio and he diagnosed a fallen arch and ITB band tightness. I,ve been given stretching exercises and purchased a foam roller.i then had my bike fitted by Adrian Timmis (excellent guy), he fitted inserts and shoe wedges for the flat foot.How long would you expect recovery to be?

Meritt

I've been struggling with the same problem over the last decade, it has required constant attention including: Self-massage, a remedial weights programme, arch supports, wedged cleats and a change to my pedalling style. If you can do some work on your VM it'll help but don't stop doing the exercises & massage when the problem recedes as in my experience it'll soon return. There's loads on the web if you google patello faemoral syndrome and many different suggestions on how to cure it.

rocksteadyeddie

danowat wrote:

Yes, foam rollers hurt like an MF

This. The more it hurts the better a job it is doing. And boy does it hurt.

Pep

Meritt wrote:

but don't stop doing the exercises & massage when the problem recedes as in my experience it'll soon return.

My experience is the same. But it's very difficult to remain diligent once the problem has gone (or seem to have gone?).

Meritt wrote:

There's loads on the web if you google patello faemoral syndrome and many different suggestions on how to cure it.

Wait a second. ITB and patella syndrome are different injuries.
But causes and treatment are often very similar if not same.

Meritt

Human nature I guess, quick to complain when something's wrong but when do we ever give thanks for being healthy?

ITB tightness can be one of the causes of knee pain/PF syndrome.

Pep

Meritt wrote:

ITB tightness can be one of the causes of knee pain/PF syndrome.

+1

bridgefit

Foam rolling is great for working on the quality of muscle tissue and getting some of those knots untied. I would reccomend contacting a good sports therapist/physio or even a good personal trainer with experience in corrective exercise with a view to having a through analysis done.

Very often if the hip flexors are shortened the body can not effectively recruit the glutes. Glute weakness can contribute to poor stability within the hip, if the glutes cant do their job stress gets taken up elsewhere (IT band as one example). Weak glutes/tight hip flexor also contribute to the position the pelvis is in and can lead to internally rotated femurs (thigh bone), therefore increasing pronation of the foot.

Definately do not work through an injury hoping it will go away.

http://www.fitnesstrainingexpert.com

DaveLeeNC

I have much experience with ITB issues. But it may or may not be applicable here. But in case it is helpful ...

It started out for me as a running injury and it was in the hip area rather than knee area (ITB runs from the hip to the knee). The doctor actually suggested that I substitute biking for running for 6 weeks while the injury healed. Biking was not a problem for me.

After weeks of 'rest' (but biking) and some physical therapy appointments, there was no change. He gave me a cortisone shot and 4 days later all was fine (and I could run again).

I have had two reoccurences of this issue and in both cases they were after extended periods of not doing the stretch shown in this URL.

http://tinyurl.com/6hvdzg3

Maybe this is helpful - maybe not.

dave