IT Band misery

MPC1967

After riding thousands of miles in recent years the spectre of IT band pain hit me hard on a ride in mid June and I haven't really ridden since. I had changed my cleats a couple of days before which I am sure caused the issue. Since then I have had a proper bike/cleat fit and am having physio with deep painful massage of the band every week. I foam roller daily and have been given exercises to build the glutes and quads up.
Two months later I can still only manage 20-25 mins on the bike before the outside of my knee starts to develop a numb ache. I feel like a caged dog as the summer has almost slipped by and I cant get out on my bike. Has anyone any advice on what may have worked for them please? All the posts I have read seem to be a few years old. Any guidance greatly appreciated

bondurant

I took several weeks off in order to let things calm down. Daily stretching, then when I started riding again, stretching before each ride. It occasionally (twice) has started to play up since and I just stop the ride and get the train home or very gently spin home.

webboo

What happens if you persist despite the numb ache, does it get any worse.

alihisgreat

What are the exercises you have been given for your glutes/quads?

If you're not doing the right exercises with the right form, you're going to be aggravating the issue more.

I saw a few physios with an ITB issue but it was only the 3rd who actually gave me what I needed.. which was a super targeted exercise for the medial glutes and now i'm seeing progress.

CleeRider

I had a similar experience - changed my cleats and bang! The pain was there! I tried all sorts of exercises, stretches, foam rolling, rubber bands etc. for over 2 years. Everything failed!! I was gutted!

I finally found something that works for me. It's not a cure as such but it allows me to go cycling for as long as I like.

I do the following stretch for 5 minutes before each ride and I'm good to go. If I do a long ride the pain might appear after 40 or 50 miles (rare) so I get off the bike and repeat the stretch for 5mins and then I'm good to go for another 50 miles!

I say it's not a cure because my tightness is always there and I will also often do this stretch first thing in the morning and last thing before bed as I can often feel tightness. I'll often hear a cracking sound too when I start the stretch as the band clicks back over the bone on the outside of the knee - probably not a good sign but I have no other ideas.

The stretch appears between 3:30 and 6:50 on this video (I only do that particular stretch):
https://www.youtube.com/watch?v=x30rjVT-TLo

I've been free of pain for over 2 years!
Good luck and hope it works for you!

MPC1967

Thanks all for your comments. Its good to know many of us go through this purgatory. I will definately try that stretch you suggest. Thank you.

as regards the exercises I've been given as follows;
Glute strenthening = laying face down on bed and raising leg up behind vertically and holding for 5 seconds for 10 reps.
Quad strengthening = Sitting against wall dorsi flex the foot back from ankle and squeeze quad at same time. Hold for 5 seconds for 10 reps. Now extending this by raising leg a few inches off the ground and holding there for 5 seconds.

Not tried to push through the numb ache yet...a bit cowardly I know.

webboo

MPC1967 wrote:

Thanks all for your comments. Its good to know many of us go through this purgatory. I will definitely try that stretch you suggest. Thank you.

as regards the exercises I've been given as follows;
Glute strenthening = laying face down on bed and raising leg up behind vertically and holding for 5 seconds for 10 reps.
Quad strengthening = Sitting against wall dorsi flex the foot back from ankle and squeeze quad at same time. Hold for 5 seconds for 10 reps. Now extending this by raising leg a few inches off the ground and holding there for 5 seconds.

Not tried to push through the numb ache yet...a bit cowardly I know.

If I didn't push through the numb ache in my back, elbow, tricep, shoulder and neck I wouldn't get to the end of the drive.

CleeRider

No point in pushing through the numb ache - your IT band is rubbing on the bone and the area is only going to become more inflamed and sore. Get off the bike and try the stretch for 5mins.

MPC1967 wrote:

Thanks all for your comments. Its good to know many of us go through this purgatory. I will definitely try that stretch you suggest. Thank you.

as regards the exercises I've been given as follows;
Glute strenthening = laying face down on bed and raising leg up behind vertically and holding for 5 seconds for 10 reps.
Quad strengthening = Sitting against wall dorsi flex the foot back from ankle and squeeze quad at same time. Hold for 5 seconds for 10 reps. Now extending this by raising leg a few inches off the ground and holding there for 5 seconds.

Not tried to push through the numb ache yet...a bit cowardly I know.

adam0bmx0

I posted this a while back but had a miserable time with my IT band.

As an update, while the ligament still 'pops' over the bone in the knee, it does not cause me any issues, Ive done 500km's + in a week, long back to back rides and rides with 3000m + of ascent, so yea, doesn't cause me any issues.\

I also don't do the hamstring strengthening workouts anymore, just maintain a stretch routine after a ride:

I ruined mine on the left knee in 2013, this was due to having a month off and then going out on a hard ride without building up strength in the knee etc.

It was very sore halfway through the ride but gritted my teeth and finished un-able to pedal basically.

I then decided I would continue to cycle to work (only 2 miles/8mins) each way for the next few weeks. It didn't get better.

So bit the bullet and used public transport, plus started seeing a cycle specific physio. Gave me stretches/exercises. I laid of any cycling for a month or two, then gradually started going out on the bike, between 10-20 miles. Still was flairing up.

This continued for about a year! I could just not get it to be comfortable and would be an issue post ride.

I continued all my stretching, but what I finally solved it with was doing glute and hamstring specific strength training, i.e stiff leg deadlifts.

Doing those and a bit of additional cleat fiddling has finally got to a point were i can cycling consistently and not suffer any pain/aching.

The ligament still 'pops' over the side of the knee when flexed to a certain angle, but causes no issues. Finally!!

MPC1967

Thanks for your comments. It gives that ray of hope that it is possible to return to distance rides. I can really relate to your comment about being unable to pedal as the last 10 miles of the ride where it flared up I had to cycle with one leg!

Anonymous

my physio prescribed me a foam roller (a former semi-pro cyclist). Check with yours to see if its a solution?

You lie on your front with all your weight (supported on your elbows) and roll your quads up and down over it (the more painful it is, the tighter the knots in the muscle!) making sure you cover each of the tendons either side of your leg. Breathe deeply to keep oxygen circulating as you can be gritting your teeth in sheer agony. Gradually the pain in doing the above exercise retracts and also the pain in my knee.

I use the 'trigger point' roller which does a great job but Jesus Christ it hurts.

MPC1967

Tried the pre-ride stretch kindly suggested by Cleerider on Aug 28th. Wow! Firstly tried an easy 45 mins...fine, no pain then 60 mins...fine, no pain then completed 1 hour 45 mins today for 25 miles with no pain. So far so good. Thank you so much for giving me back my cycling life! Still foam rolling and stretching so maybe a combo of all these things have contributed but the stretch has been revolutionary!!

CptKernow

I had a bout of IT issues a while back.

I tried to figure out why it came on kind of suddenly. Figured out it was due to working in a different position - my hip flexors were more bunched up. Bought a balans chair and that particular issue went away.

Make sure you stretch your hip flexors and glutes. Rolling the glutes (med - side/top) also helps. This was intensely painful first few times but now I barely feel it.

CleeRider

MPC1967 wrote:

Tried the pre-ride stretch kindly suggested by Cleerider on Aug 28th. Wow! Firstly tried an easy 45 mins...fine, no pain then 60 mins...fine, no pain then completed 1 hour 45 mins today for 25 miles with no pain. So far so good. Thank you so much for giving me back my cycling life! Still foam rolling and stretching so maybe a combo of all these things have contributed but the stretch has been revolutionary!!

That's brilliant news. Wasn't sure if it only worked for me. It took me 2 years to figure it out! From experience I would forget foam rolling and stretching - other than this one. Do it before and after rides plus first thing in the morning and last thing at night - only 5min at a time is necessary for me.

MPC1967

CleeRider wrote:

MPC1967 wrote:

Tried the pre-ride stretch kindly suggested by Cleerider on Aug 28th. Wow! Firstly tried an easy 45 mins...fine, no pain then 60 mins...fine, no pain then completed 1 hour 45 mins today for 25 miles with no pain. So far so good. Thank you so much for giving me back my cycling life! Still foam rolling and stretching so maybe a combo of all these things have contributed but the stretch has been revolutionary!!

That's brilliant news. Wasn't sure if it only worked for me. It took me 2 years to figure it out! From experience I would forget foam rolling and stretching - other than this one. Do it before and after rides plus first thing in the morning and last thing at night - only 5min at a time is necessary for me.

Yes seems to be working well thanks. Pushed the distance up from 25 to 30 miles yesterday (in saddle for 1 hour 55 mins). Felt a few little twinges on the outside of the knee from about 28 miles onwards. Maybe I added too much too quickly and enthusiasm got the best of me. Did you have to build the distance back up gradually?

MPC1967

Thanks for the tip re rolling the glutes, deadlifts etc. Appreciate everyone's advice here :-)

CleeRider

MPC1967 wrote:

CleeRider wrote:

MPC1967 wrote:

Tried the pre-ride stretch kindly suggested by Cleerider on Aug 28th. Wow! Firstly tried an easy 45 mins...fine, no pain then 60 mins...fine, no pain then completed 1 hour 45 mins today for 25 miles with no pain. So far so good. Thank you so much for giving me back my cycling life! Still foam rolling and stretching so maybe a combo of all these things have contributed but the stretch has been revolutionary!!

That's brilliant news. Wasn't sure if it only worked for me. It took me 2 years to figure it out! From experience I would forget foam rolling and stretching - other than this one. Do it before and after rides plus first thing in the morning and last thing at night - only 5min at a time is necessary for me.

Yes seems to be working well thanks. Pushed the distance up from 25 to 30 miles yesterday (in saddle for 1 hour 55 mins). Felt a few little twinges on the outside of the knee from about 28 miles onwards. Maybe I added too much too quickly and enthusiasm got the best of me. Did you have to build the distance back up gradually?

As I mentioned in my first post, if I feel it coming on, I'll get off the bike and do the stretch on the roadside. 5mins will give me another 40-50 miles to finish my ride.

As you get used to doing this stretch however, you'll find you can go further on just the pre-ride stretch. I can do around 50miles with no twinges.

surfgod

The only cure for IT band issues is a wider Q-factor. If you have wide hips, then you really need a wider stance for correct hip, knee ankle alignment...

Longer speedplay spindles, Ward industries manufacture custom length spindles for look pedals, Shimano dura -ace and ultegra SPD- pedals are available with +4mm spindles, Kewin also make several length spindles for their pedals, issi mountain bike pedals are available with three different length spindles,

buckmulligan

surfgod wrote:

The only cure for IT band issues is a wider Q-factor. If you have wide hips, then you really need a wider stance for correct hip, knee ankle alignment...

Longer speedplay spindles, Ward industries manufacture custom length spindles for look pedals, Shimano dura -ace and ultegra SPD- pedals are available with +4mm spindles, Kewin also make several length spindles for their pedals, issi mountain bike pedals are available with three different length spindles,

I'm intrigued by this. I'm a triathlete and I've had on-and-off IT band issues whilst running for the past 18 months but it's very rarely been an issue on the bike.

The wider Q-factor idea is very similar to utilising a wider running stance, which is advocated in certain cases of IT band pain where running in too narrow of a stance (i.e. one foot landing in front of the other) is causing a lateral-medial imbalance, where the lateral muscles in your upper and lower leg are overworking to stabilise the off-centre footfall.

I spend more time on the bike than I do running and although I don't experience any IT band issues there, I'm wondering if using a wider Q-factor on the bike might help reduce the stress on the lateral leg muscles and prevent issues when I'm running?

Anyone have any experiences with this?

rampax

surfgod wrote:

The only cure for IT band issues is a wider Q-factor. If you have wide hips, then you really need a wider stance for correct hip, knee ankle alignment...

Longer speedplay spindles, Ward industries manufacture custom length spindles for look pedals, Shimano dura -ace and ultegra SPD- pedals are available with +4mm spindles, Kewin also make several length spindles for their pedals, issi mountain bike pedals are available with three different length spindles,

I have been experimenting with widening my "stance width" to alleviate ITBS, after trying all manner of stretches, rollers, massages and bike fittings (none of which cured it).
I am using Kneesavers pedal extenders. Several other companies make very similar products.
So far so good. I have not even had a twinge of ITB pain this year, but it is still early days, as I find ITBS tends to be cumulative, so it happens more when I am doing a lot of miles regularly.

pippi_langsamer-2

I got struck down with ITBS years ago. Started, and thereafter almost to the mile, I'd hit the 50mile mark and bang- it was like someone was slowly pushing a hot poker into the side of my right knee.

Physio diagnosed me with a fairly substantial leg length discrepancy which was skewing my pelvis on the saddle, and creating the pressure/ band rubbing. He prescribed a strict stretching regime- daily, and pre/ mid and post bike. Also shimmed my right leg considerably. Touch wood, not bothered me since...