Acute ITB pain during rides

Bar Shaker

I have been getting bad ITB pain during rides, after anything between 1 hour and 3 hours in the saddle.

I have reverted my bike set up to the Retul fit settings (I messed around with my saddle height a bit last year) and everything feels normal on the bike. I have new shoes, but apart from the (SPD) cleats being a tighter fit to my pedals, they feel normal, comfortable and correctly aligned. My foot stance has always been neutral/very slightly heel in.

I have had physio but this has achieved nothing. An hour in the spin studio has no effect but I haven't tried longer.

I am off to see a knee specialist at the end of the month but wondered if anyone has suffered a similar fate and what their problem was caused by.

bikey gonzalez

I have had itb problems for decades and have reduced distances because of it, recently I heard that fitting spacers on the pedals to give a wider stance which eases the pressure of the itb on the knee, after about a month of use they are working great and not causing any problems. They are made by specialised and cost about £20

adam0bmx0

bikey gonzalez wrote:

I have had itb problems for decades and have reduced distances because of it, recently I heard that fitting spacers on the pedals to give a wider stance which eases the pressure of the itb on the knee, after about a month of use they are working great and not causing any problems. They are made by specialised and cost about £20

We all have different stance widths, so while that may work for you, it wont for others. I have a narrow stance, so my Retul fit involved adjusting cleats as close to the cranks as possible.

I've got my first bought of IT band pain. I had 3 1/2 weeks off the bike (long holiday) got back and went out on a hard ride, everything fine (but slower). I then jumped on my winter bike 3 days later for a turbo session, did some interval training and my left knee funny.

Went for a hilly ride and the pain set in, had to get home and could hardly put pressure through the leg, iced it once home, had to have the day after off work as too painful to walk on.

I stupidly carried on commuting to work with it still being a bit painful, did this for two weeks. I've now not ridden for 3 1/2 weeks and it still feels a bit funny. Done alot of reading and have been doing alot of re-hab, stretching and foam rolling.

Still gutted its not 100% though so might go to someone to check it out.

Bar Shaker

I've had some ITB stretching by my physio. This was very painful but I didn't see any benefit. Perhaps I rode too son afterwards.

My problems did start around Christmas, after barely riding for 3 months.

The interesting thing about my problem is that I am almost back to normal after a few hours and I feel completely back to normal when walking around the following day.

Grill

Retul is notorious for putting the saddle too high (had to lower mine 30mm on my TT bike). That's typically the cause of ITB pain. If there's only pain when you ride and the roller doesn't find any serious hot spots then it might be an issue of float. If it's only on one leg then there's a good chance that the pain is being caused by asymmetry. Easiest way to sort this is to move your cleat forward on your shorter leg (shimming i=should always be a last resort).

Interestingly I have massive asymmetry and Time/Mavic pedals work wonders for me as the have lateral float which allows for a wider q-factor on one leg without messing with the cleat position.

theotherjake

I had bad ITB pain for most of last summer, after a bike fit I lowered the saddle, no change. Then took 3 weeks off the bike and now have zero ITB pain. For me it was a case of lowering the saddle by 0.5 cm to make a difference between pain and no pain.

bisoner

I had ITB issues last year. Unfortunately, mine went on day 1 into a 4 day Majorca cycling trip.

Mine was simply down to a too high saddle. The physio found the specific spot on the side of my knee which was damaged (soft tissue thankfully) and advised me to do an intense massage on the spot until numb. Ice and elevation to help accelerate the healing. I was advised to not ride for 4 weeks. No ITB issues since.

As well as saddle being too high, I was advised by the consultant to strengthen the glutes and use the foam roller to stretch out the ITB - these will help prevent a re-occurrence.

velogee

After a BG fit I had on off issues on my right knee which was caused by running years ago (I no longer run). I have dropped the saddle 1cm, and take a lot of time to stretch and foam roll. No problems so far...

cswitch

I was handed a dose of ITB by a crap fitter who put my saddle up way way too high - and looking back probably too high for the most 'pro' of riders. Lowering helped but I had to have it lower than what would have been ideal for many many months or it would come back. A couple of years later and it's now entirely gone and seat is now at an optimum height (which is actually quite high). Just take your time with it and hopefully you can find a position that doesn't aggravate it whilst it eases.

sloppyschleckonds

The headtube of the Boardman Elite SLR 9.2S is very short, how many spacers are you running?

Bar Shaker

Thanks guys some good advice there. I had lowered my saddle as I felt myself pedalling on tip toes to reduce the pain and concluded that saddle height may be a problem. I think I needed to rest to get over the injury and then see if the new saddle height cured the problem.

On reflection, I think the new shoes may have actually caused the problem as they would have effectively raised the saddle height due to the thinner soles. The new shoes are Sidi dragon 3 with very thin carbon soles. If I was already on the limit and the shoes increased my leg stretch by another 5mm then this could have caused it. The shoes are the only change to what was otherwise perfect comfort.

I have a rather unintentional rest at the the moment, as I badly broke my left leg snowboarding a few weeks ago. I won't even be walking for 3 months, let alone riding! Hopefully the ITB will be fully recovered when I do start riding again.

Grill, thanks for the tip about moving the cleat forward, I will try that.

Sloppy, yes it is very short and my bike fit (when I bought it) did not remove any spacers.

Bill Black

Imncrease the strength of your hamstrings (biceps femoris) and gluteals and almost invariably ITB inflamation/pain disappears.
Best,
Bill Black

Roberto di Velo

I was just wondering what had worked for other people with IT Band problems?

I started getting ITB pain at the start of the summer, as I pushed up my mileage and climbing. Since then I've had lots of foam rollering, physio, a bike fit (including a change of seat and seatpost) and lots of hip flexor exercises. Pain started out over the left knee and has now switched to the right one!

Pain isn't so bad now, but that's probably because I've cut down my mileage so much. Any suggestions? I know there are fitters who work alongside a physio, but I'm concerned about the cost, particularly as been planning to get a new bike in the New Year.

typekitty

+1 on the foam roller. I used to get terrible pain when running and the foam roller was a complete lifesaver.

davoj

Roberto di Velo wrote:

I was just wondering what had worked for other people with IT Band problems?

I started getting ITB pain at the start of the summer, as I pushed up my mileage and climbing. Since then I've had lots of foam rollering, physio, a bike fit (including a change of seat and seatpost) and lots of hip flexor exercises. Pain started out over the left knee and has now switched to the right one!

Pain isn't so bad now, but that's probably because I've cut down my mileage so much. Any suggestions? I know there are fitters who work alongside a physio, but I'm concerned about the cost, particularly as been planning to get a new bike in the New Year.

I had a lot of ITB pain in March, it was my first time having this problem, as per above it was the professional bike fit that set my saddle wait to high which caused the problem, also i wasn't stretching enough and hamstrings and lower back needed a lot of work. It was probably a combination of all of the above but after resting for 3 weeks and stretching every day for 20 min since , I have had no reoccurrence of the injury.

awallace

Ive just recently been to the doctors as ive had knee pain for 18 months. She referred me to an NHS physio who has diagnosed ITB. Ive now got exercises and stretching to do as it has been a result of a weaker left hip / thigh.

It was slower than going straight to a paid for physio but cant fault the service. If you have a pain that's limiting you just see someone. I self diagnosed and peer diagnosed and had all sorts of issues!

diy

I would add another +1 on foam rolling, though the ITB is pretty tough to try to release. I'd add some ITB specific stretches as part of your cool down stretch. Not wanting to teach anyone to suck eggs but a full stretch after every decent ride is really important - cycling is really bad for shortening the muscles unless you work to stretch them out.

One I find good for the ITB is crossing one leg behind the other and stretching over to get a decent stretch all the way down. There is a lot of opinion out there on good and bad ITB stretches, so I'll leave you to find one that works. Personally I think anything that does not involve squashing or twisting the ankle or knee too much is good.

Roberto di Velo

typekitty wrote:

+1 on the foam roller. I used to get terrible pain when running and the foam roller was a complete lifesaver.

diy wrote:

I would add another +1 on foam rolling, though the ITB is pretty tough to try to release. I'd add some ITB specific stretches as part of your cool down stretch. Not wanting to teach anyone to suck eggs but a full stretch after every decent ride is really important - cycling is really bad for shortening the muscles unless you work to stretch them out.

One I find good for the ITB is crossing one leg behind the other and stretching over to get a decent stretch all the way down. There is a lot of opinion out there on good and bad ITB stretches, so I'll leave you to find one that works. Personally I think anything that does not involve squashing or twisting the ankle or knee too much is good.

Cheers for the responses. I am being a bit more diligent with the foam roller, and fingers crossed I do seem to be seeing some improvement; pushed the mileage up over the weekend with no ill effects.

Just a quick query - when do people use the roller? Before the ride, afterwards, as part of a general stretching routine, all of the above?!?

saprkzz

Lots of good advise on here.

I had an ITB issue last year, thinking that rest would do it good. In the end I had 3 months off the bike, had 7 visits to a sports physio, and had my ITB stripped by someone else. (don't recommend this).

I was chatting to a guy who recommended foam roller for 1/4 hour and 30 minutes of stretching per day using 7 different stretch positions. Doing this got me back on the bike within a week and roughly 3 weeks was upping my mileage. I now do more miles a week than I ever have after having a fantastic summer back on the bike.

I do still feel "tight" on some rides, but as long as I get home and stretch properly, the next day feel great.
Hope this helps

edit to add, I used the foam roller in the evenings, after a warm up on the spinning bike... I also have a bar roller (from ebay), I use this straight after the rides along with my stretch routine.

Bar Shaker

I had just broken my leg when I posted above. 4 months off completely cured the problem and lowering my saddle by 15mm means the problem hasn't come back.

I am now riding over 100 miles a week faster than I did a year ago, when fear of triggering another ITB ache ruined my riding.

Lower your saddles a bit guys.

During treatment in March, my physio did a series of intense ITB massages. This is painful but does help. You could never replicate this with a foam roller, even with someone else putting all of their weight on it.

For a much more intense rolling, we use The Stick. They are available on Amazon and work well.

typekitty

Roberto di Velo wrote:

Just a quick query - when do people use the roller? Before the ride, afterwards, as part of a general stretching routine, all of the above?!?

I do it the night before a big ride and after the ride (usually after a shower and stuff). Maybe during the week if it's feeling tight / I have pain.

Good point on the shortening of muscles; might look into going back to pilates or yoga to help stay supple.