Training & Nutrition - ITBS issues

I have seen a physical therapist about my iliotibial band problems about one year ago. The ITB is extremely tight and gets inflammed during and after biking. I feel it right over my hip area. I was given some stretches for this area, and exercises using an elastic Theraband that would strengthen the hip area. (Slip one end of the band around your foot, the other around a table leg. While standing, lift leg in front of you, behind you and on outer side and inner side across your other leg, do 100 of each) I've continued the stretching, but dropped the Theraband exercises when biking season is in. I thought that biking has strenthened me more than those therabands would (although I can't exactly get the side leg lift move in from biking). Perhaps I need the side moves?

Well, I've decided to give my body a rest because the IT band pain gets annoying. I haven't biked in 6 days. I've been stretching my hip area thoroughly in the morning and evening (with some intermittent stretching at work) with a slight warmup prior to stretching. Just sitting throughout the day, I can feel the band getting tight. So then I get up and do some stretches at my desk.

The IT band right over my hip is still hurting. I cannot take any anti-inflammatories because I am allergic to all the NSAID drugs. Tylenol does nothing for me.

I wondering if there's anything else I could be doing? Do I need more rest? Bike more? Should I see the PT again? Should I do the side leg lift exercises again? :confused:

Rest is always good. I have IT band problems (running related), but closer to the knee. When it started bothering me on the bike, I talked to the guys where I bought my bike. They said to lower the saddle, and it worked wonders. Drop it just a little and adjust accordingly. They said no more than 1/4 to 1/2 inch at a time. I don't think I even dropped it 1/2 inch total. For what it is worth, my doctor (a former racer) said this was good advice.

I have never had inflamation of my ITB but my left kneecap is further out pointing than my right by that leg's ITB. This has caused a weakness to muscles in the front and inside of my kneecap and thigh. I stretch, stretch.

I sounds like you may need to rest. You might try to ice the sore areas after every ride, religiously.

Some people have told me that a good massage therapist can work wonders at loosening this band and any attachments that maybe keeping it tight; you might want to investigate this. And if massage seems expensive, call around. The masseuse at the local ladies spa is 10$ more a half hour than the one at the hotel club where my husband plays raquetball.

Also, when I had the physical therapy, they gave me exercises to strengthen all my leg muscles, but what I have found to be helping is to concentrate on using the muscles in the backs of my thighs and especially the muscle of the quadriceps group that is on the inside front of my knee, the VO or vastus oblique I think it is called. Cleated pedals have helped me vastly with this.

Oh, you might want to look into the use of a food supplement called MSM (methylsulphonylmethane). It is not a NSAID as far as I know and can be helpful in reducing inflamation.

Ask your doctor or pharmacist.

Thanks for the suggestions.

I just did a quick search on MSM on webmd.com. It says that because it's a supplement it's not regulated by the FDA, so you never know what you're getting. It also says to take caution when exercising and taking this supplement. I don't like the sound of that. I was told by the doc to take SAM-e 3x a day. That's like a $1 a pill, and not regulated either.

So I rested one week, and I only think it got tighter and more painful. Yesterday at work was really bad. I went for a ride last night. It was hurting at first, but then by the end I think it loosened up, and I was able to give it a really good stretch when I got home. I also iced the areas (both hips hurt) to help with the inflammation. I think that helped a little.

I was getting the ultrasound massage from the PT at first, but it hurt alot. As she gently rubbed the "wand" over my hip area, it felt as if my hip bone were razor sharp and my IT band was being sliced by the bone. Not good at all. She stopped with the ultrasound.

I will try icing after and heat before exercising and start up those theraband exercises again. If that doesn't work I'm going to a PT again.

I'll try lowering the seat too.

HOLEY FREAKING CRAP!!! I JUST HAD THIS INJURY!! right in my hip. it sympathize.

I went to PT just like you did. mostly, they attributed it to my extremely inflexible hip and thigh muscles. I was away from biking for about a week, and away from running for about a month.

I suggest stretching at least three times a day. it sounds excessive, but it is necessary. hamstrings, quads, hip flexors, inner quad, and of course the Hip.

try this one. (stretching left hip) lie on your back, and pull your left knee to your chest, then pull it to the right. if someone is there to help, have them hold your left hip down, so that it doesn't lift off the ground. repeat for the other side.

All I can say is stretch, rest, stretch, and stretch some more. I didn't ice a whole lot...It made the inflammation go away, but it also felt like it tightened up my hip joint. I never did get that ultrasound, but i did get massages at PT. They gooped up my leg and rubbed it down. I was dissapointed however, that it was not one of the attractive, mid 20s girls there, instead a huge guy in his forties...

Also, about what Phatman said about stretching:

I remember reading about a woman cyclist in england that had ITB troubles and she was stretching 6 times a day--so stretchin seems to be a thing for good. I found this when I did a Google search for the VMO muscle (vastus medialis oblique).

And even though you don't know what you'll be getting in supplements, some companies are better when their products are analyzed. Unfortuneately I cannot remember which ones.

Here is a stretch I do and it seems to stretch the hip, the out side of the hip and the ITB, especially when the leg is pulled straighter when stretching:

I will describe the stretch for the left leg.

Sit on the floor or on the edge of a soft chair. Pull your left knee up to your chest, rotating at the knee to end up knee to chest and calf across chest. Put your left arm around the leg (on the thigh, on the thigh-side of the knee) and pull into your chest while pulling the left ankle into your chest and then up toward your shoulder. Then try to straighten out your leg. Shift and rotate gradually till you feel a pull through the buttocks around the hip joint and down the outside of your thigh. You probably want to be warmed up to try this unless you are naturally flexible.

Reviewing what Phatman described, his stretch and the one before are basically the same but mine is probably a little more extreme and harder to do.

I have the same problem, also because my left knee is like foehn's. I think a lot of people have this problem. I'm sort of knock-kneed as well. I discovered some really good stretches and exercises for ITB syndrome and they DO help. Also stretch those hamstrings. The good thing is that you don't have to give up the bike. They suggest that for a while, reduce your mileage and try to stay on the flats as much as possible. Climbing can aggravate it. Here's a site you can check out:

<http://www.csuchico.edu/phed/atc/Projects/ITband/ITBFS.html>

AND

<http://www.nismat.org/ptcor/itb_stretch/>

Hi,
this may be improper fit. It could be something as simple as a saddle adjustment, as in Heresy's case. For me, it was Q. Q is the distance between the pedals. I needed a wider distance, a bigger Q. Do your knees ever splay out when pedaling?

Originally posted by wabbit
http://www.nismat.org/ptcor/itb_stretch/[/url]>

At this site I read that they recommended orthotics.

I found an over-the-counter, 3/4 length, heel and agressive arch support helps my knees alot. I ride with these and find I am able to use that VMO muscle (mentioned previously) more easily.

I have high arches and was noticing as I refereed this morning without any insoles in my shoes at all that my knee hurt worse when I relaxed my foot arch and felt much better when I flexed my arch up. I will be getting some insoles with high, agressive arch and metatarsal support soon. My knees have always bothered me when my shoes have broken down and it has always bothered me to wear flat shoes. As a result of this I wear Birkenstocks almost daily, except for the reffing and cycling.

You might want to try arch-supporting insoles. Try some of those found at good sporting goods stores.