IT Band pain (during ride)
 

I have been having tightness with what I believe is my IT band during rides. Basically at around an hour into a ride I start getting pain in my left IT band (about the 7-8 o'clock position of my left knee). I have been stretching my hip flexors and quads as well as doing squats, lunges, and leg raises. I read about weak hip flexors causing IT band pain, but it doesn't seem to be the case here. I also bought those foam yoga rollers and they really haven't done anything positive. I really don't have a single issue outside of cycling and feel great until I hit about the hour mark on a ride. From there on out the pain/tightness will slowly increase, but I find if I upshift to a high gear and get out of the saddle for a few seconds the pain is alleviated for some time and I can continue pushing until the pain slowly builds up again. I really haven't dicked with my bike fit until I started having the pain last fall, and before then I was riding 40-60 miles without issues. I also bought a set of Speedplay Zero pedals to replace the junky shimano SL style pedals that came on my bike. They have been a huge improvement, but have done nothing for my knee pain. I've been to an orthopaedic doctor a couple other times with knee problems and other than making my wallet lighter have done absolutely nothing, except repeat the rest, ice, elevation, and ibuprofin routine ad nauseum.

Sounds exactly like what I had in November, except mine was on the part of the ITB that runs along the outer knee. After doing the normal ice and blah blah blah routine, it didn't go away. I finally went to see my primary care doctor for a referral to an orthopedic or sports doc. He took a look at it and it turned out to be tendonitis and not ITB related. Only bad part about it being tendonitis was having to be off the bike for about three weeks. Might want to have that checked out if your doc hasn't already done so and ruled it out.

go see a doctor in sports medicine

This......

Or you could start doing a better stretch series, 3 times/day, starting now, all seated, all 3 X 20", each stretch a little deeper:

Hamstring stretch, legs together. Push your butt out. Legs straight, back of the knee on the floor, back mostly straight. IOW, don't just bend at the waist. Force the stretch into the hams.

Then do these two modified hurdler's stretches:
http://t0.gstatic.com/images?q=tbn:A...jIpctjgiDoHNND

Then a tailor's stretch.

Then grab one bent leg and try to pull your foot to your chest. Repeat with the other leg. Also known as a Figure 4 stretch.
Then repeat the seated hamstring stretch. You'll be amazed at how much further you can stretch.

Remember:
Don't bounce.
Don't overdo it. If it hurts, stop.

The stretches Carbonfiberboy posted won't help your IT bands.

I had IT band problems and went to an orthopedic surgeon about it, then months of physical therapy. Here's some of the stuff I learned:

You have to get a professional fit. Cycling with an incorrect fit causes certain muscles to get stronger faster than others, amplifying the problem, and causing ligament problems.
If the ligaments on one side of your knee are tighter than the others, your knee is out of balance, and grinding away cartilage.

You can't really "stretch" your IT bands with any of the positions you normally do, and your IT bands (just like your medial ligaments) go much higher and lower than your knee.

The best way to stretch them is to get a foam roller and roll them, 5 minutes per side, after every ride. It's stretching by pressure, kind of like kneading dough.
This is how you do it: http://www.youtube.com/watch?v=RoHBDim_fzk

It will hurt like hell at first, because they're very tight...but eventually they'll loosen up and feel great.

Just do it, please don't wait like I did, and end up off the bike for 6 months.

IT band pain will usually show up in the outer part of the knee. Believe me when it pinches (or whatever the heck it does) it will bring you down hard and your knees will collapse. Had it happen while running several times. Once it does you are done. That may be the issue but more often than not what hurts is not what is hurt. Also check out the psoas mucsle (ironically it does sound like sore a**). It effects my hip and front groin on my right side. It will bring a good ride to a halt quick to. Any number of things can be wrong back there and it is all common with cyclists. We get our hammies so tight that it starts to pull stuff out of whack. NO amount of chiro work will help for very long until you find the root issue. I stretch 2 times a day whether I'm riding or not and it helps.

Time to start stretching and using a foam roller.

More often than not the legs get stronger faster than the core. Check out the warrior and pointer dog stretches. I still stretch my ham strings out but those help me compensate for a core that is weaker than my legs. I didn't used to work on core much but now that my legs have gotten stronger I am regretting it.

Also get yourself a stretch strap. You can get a OTPT strap form Amazon for around $12 (where I didn't want to wait and I paid $35 for the same one)

I get lots of tightness in my piraformis, it band, & hip flexors. I recommend (as you seem to have been doing) is do myofascial release (foam roller, "the stick", lacrosse/tennis ball), some good stretches, and integrate some weightlifting into your routine.
It is not an overnight fix, it will take time, pain/frustration, and rest.
here are the stretches i like best:
http://www.endurancesports.com/images/ibsstretch.jpg
http://www.sparkpeople.com/assets/ex...nd-Stretch.gif
http://www.exrx.net/Images/Mechanics/IliotibialBand.gif
http://www.endurancesports.com/images/piriformis.jpg

and start off slow, especially with the myofascial release, it can be extremely painful but the pain will eventually lesson and you will become more comfortable applying the appropriate amount of pressure.

Just to add another possibility to consider: if you are slightly bowlegged like me, you could try moving your cleats inwards. This moves your feet farther apart but brings your knees closer. And it helps your feet, knees, hips line up better. This one change made such a big improvement in ITB comfort for me.

As others have pointed out, you can't stretch your IT bands. What feels like IT band problems are usually other knee problems which are causing swelling which then manifests as IT band or bursa issues. Rolling temporarily decreases the swelling. Stretching the muscles and ligaments surrounding the knee, especially the hams, works best for most folks. If nothing else it does no harm, though more than likely to fix a person right up in a week or so. All the stretches in the comments so far look good. There are many ways to do the same thing.

It's usually recommended to lower the saddle slightly for pain in the back of the knee.

I thought tightness of the it band pulls the knee & hip out of place, are you saying its opposite?
I am no doctor so I could be wrong. I believe the foam rolling stretches & breaks up scar tissue reducing the "pull" on the outside of the knee & hip

Could be cleat alignment.

Toes pointed inward too much used to cause me IT band problems.

No. The IT band is this great thick thing. AFAIK it doesn't get either shorter or longer, except through surgery. ITBS is actually the inflammation of the bursa underlying the ITB at the knee joint. There's no scar tissue. The roller deflates the bursa. I have used The Stick for that. Bought the travel version and took it on our tour, but didn't need it.

IME the best thing for cyclists is to improve the flexibility of the entire knee joint and take ibuprofen, 600mg 3 X day until pain is gone. That's always worked for me in a couple of weeks. In unresponsive cases, a doctor can inject cortisone into the bursa to deflate it.

There are also complicated courses of PT discussed here and there, trying to get a relatively unused muscle to fire or to fire at the right moment. These treatments seem to be directed at runners. I haven't needed to do that, maybe because I do weights almost year-round. Which is not a bad idea. In any case, my PT friend recommended those stretches. Her suggestions have always worked for me.

I also get pes anserine bursitis, which is on the inside of the knee. Again, stretching fixes it.

The stretches pointed out above are great and I would make a point of doing them AFTER cycling. In my experience, it is better to stretch afterwards than before. The foam roller is your friend, but it will feel like your worst enemy. Using this both before and after to help loosen up the fascia. The tightening of the fascia is part of what ends up leading to IT band pain. The other thing to do is to build up supporting muscles - particularly the gluteus medius and minumus - which can be done with therapy bands. A fitting might also help to ensure there isn't something wrong. If your knees are floating inward or outwards on your pedal stroke, I would guess that might contribute to it as well. In any case, I would limit your mileage to under the amount where the pain is appearing and slowly work your way back up after doing some of the rehab mentioned. That is what I did when I had it from running and although it took time and was painful I was able to get through it. Patience and limiting your daily mileage to below where you are experiencing the discomfort is key.

The advice above telling you to go see a sports medicine person is good as well.

Stretching and a couple weeks of concerted spinning--small gears and no hard climbing--worked for me.