bikerjp

I've been having some minor knee pain mostly on my left side and primarily during cycling. I had a bike fit last April and despite some significant movement of my saddle, shim under my right shoe (left leg longer), and moving my feet/pedals out as far as possible the issue has not really improved. I finally saw a doctor and x-rays revealed my knee cap is rather far to the outside. He said this could be due to tight IT bands and referred me to physical therapy. Unfortunately, my insurance won't cover this so I'm looking for a low cost solution.

I did buy new pedals with a longer axel to get my feet out a bit more. My fitter seemed to want to use more washers but couldn't do it safely so the longer axel seemed a reasonable move.

I've also searched the net quite a bit. This article seemed really good but can't say I really understand it all. The benefit to PT is having someone teach you the right way to do this stuff. The videos in that link to a pretty good job though.

So, in short, does anyone have any info or links that have worked well? Thanks.

therhodeo

Step #1 - Buy $15 foam roller
Step #2 - Use $15 foam roller on IT band
Step #3 - Wipe away tears from your eyes
Step #4 - HTFU and get back to using your $15 foam roller on your IT band

bikerjp

I've heard this one a lot, but this isn't really a stretch, is it? Is this better than the stretch in the link I posted? Why or why not?

LansingWes

I've just started this routine: It's got some IT Band stretching.

motorthings

Check/massage/roller ALL of the muscles in the chain, glute medius, glute maximus, piriformis, tfl, etc and get them loosened up too. I had what seemed like ITBS for a long time, until realizing it was my glute medius that was causing all the tightness (that ran down into my IT band).

Often the problem is not where the pain is, and all the foam rollering in the wrong place won't do you much good. I love the foam roller, but only when applied to the right area.

Wesley36

I have posted this link a number of times on BF, but there is a reason. Recent studies suggest that IT band problems have less to do with tightness than weakness in hip muscles. The hip strengthening exercises to correct these weaknesses are simple, and the only equipment needed is one resistance band, which should cost much less than a foam roller. I struggled with IT band problems, foam rollered and stretched religiously, and it helped but never solved the problem. 10 days of these exercises and my IT band problems were OVER. Gone.

Strengthen the Hips to Fight IT-Band Syndrome | Healthynomics

generalkdi

Foam rolling has done miracles for me!

bikerjp

Thanks for the info and links.

This sounds interesting and kind of makes sense. Do you think the foam roller thing works in conjunction with this or is the roller not that great of an idea (despite its popularity)?

Wesley36

I dunno, truth be told, the foam roller has been neglected since I started with hip strengthening.

I do think that a foam roller can be an effective way to release knots, much like massage. Hurts so good.

achoo

/thread

And make it a FIRM foam roller. Not one of the soft ones for wusses.

Because after you've done it for a while, the soft roller will be totally useless.

bikerjp

I ordered some elastic bands to try and strengthen first. Might try a roller next. I see lots on Amazon. Can anyone link a durable but cheap one?

back4more

Stand and cross right leg over left, keep left leg straight bend right leg and hold for 30 count - repeat on other side. Cross legs, feet together and touch toes, hold for 30 count. Cross legs other way and repeat.

bikerjp

Thanks, but trying that I'm not seeing what it's doing. Probably doing it wrong. Is there a name for this I can search to find images?

Elvo

One legged squats and rolling my IT band on a 12 lb fully inflated medicine ball worked wonders for me.

Darth Steele

awesome, thanks for sharing

I have been using this Eight stretching exercises for cyclists - BikeRadar

loky1179

I had IT band problems - I went from running a marathon pain free, to not being able to run 1/2 mile, because of IT band pain. The thing about stretching your IT band is that it is not an easy stretch. I did one session with a massage therapist who was knowledgeable with "Active Isolated Stretching". Aaron Mattes, the book's author, is kind of a stretching guru. Aaron Mattes' Active Isolated Stretching » Stretching USA

The massage therapist could tell right away my right IT band was way tighter than my left IT band. I could tell; she just grabbed my ankle and saw how far my leg would move across the center line of my body. She stretched me out REALLY good; but like you, I couldn't afford this.

The problem is, is that this is not an easy stretch to do. It helps to have someone help you, with your hips strapped down as you bring your leg across the centerline of your body. Since most of us don't have a helper, use of a rope or strap is the next best thing. See video. You cannot do this stretch without a rope or strap.

https://www.youtube.com/watch?v=ojSO5qLGY5Q

It worked for me. I went from not being able to run 1/2 mile at the beginning of August, to running my PR best marathon 2 months later.

bikerjp

Thanks for that. Good resource. His website has some other stretches that look good too.

ursle

Stretching when warm is one thing stretching when cold is another, a good way to rip something away from something, stretching all in all isn't nearly as effective as rolling, you can roll cold, you can roll after a work out to relax the muscles, all the muscles work together, and yes it's hard to roll the muscles inside the hips, but pulling on them from everywhere else is a good start.(I spend most of my rolling time on my hips and lower back and shins)

TRIGGER POINT The Grid 2.0 Orange Foam Roller, 26 in. - Eastern Mountain Sports

This sucker is a fiberglass tube with foam around it, last's longer, gives a better "point" to roll on, the soft rollers melt as mentioned.
Not saying having someone show someone how to properly stretch the hips out is bad, just don't do it cold.

BikeAnon

I can honestly say that therhodeo's advice is exactly what I did, and it changed my life.

I could run half-marathons, and ride 100 miles. Then, one run... it was over. After that, no more running for me.

Physical theapy, stretches... no help. Cleat wedges, pro fitting, even a pedal-extender, that allowed me to rotate my heel in more.... no help. At one point, I even took an entire year off. No running (well, I never run anymore) and no cycling at all.

After that, cycling was possible, but I had to very carefully build time, then effort. One ride too hard at the beginning of a year could wreck months of riding.



Then one day, I watched some youtube video, and thought... "let me go buy a roller". When I did the first roll (step #2 from therhodeo's list) I cried (see step#3 ). Literally. I thought "there is no way people can actually do this".

One roll, down and up. Misery.

The next day, I applied step #4 . That very day, I was done with step #3 for good. I was "cured". In one day.


I'd been living with this for 6-7 years. "Miracle" is not an understatement.



Will this be the case for everyone? Maybe not. But for the cost of a roller and 15 minutes of time.......

achoo

She's a wuss. HTFU and keep those feet off the ground.

sfrider 

IT band stretches and a big fat roller.

seajaye

what pretty much everyone above said.

IT band issues kept me off the bike between sept 2012 and feb 2013. my longest ride had been 75 miles but during the worst of it (before i realized i had IT issues), i would develop severe pain after about 15 miles of riding. i luckily got to do PT jan and feb 2013, and was back on the bike. a yoga mat, my printouts of exercises from PT, and 'the stick' became my best friends. pain free metric century in april '13, my first century with a touch of discomfort in june '13, a 200k brevet in sept '13 that actually flared it up a bit (i stretched and took it easy and was back to 100% in a week), and i just completed a pain-free 200k brevet this past saturday. i'm really excited that i was able to keep my IT band woes at bay this past weekend, and it's encouraging as i am looking to do longer distances now...my knee was really the only thing holding me back.

for me, the most important thing was keeping up with my stretches and exercises given to me by the physical therapists, the kind of stuff you can do at home. i admittedly have gotten a bit slack with doing them all, but i do try to complete a few choice ones as soon as i get home from a ride. or on longer rides, while standing around at a rest stop, doing some stretches then.

Dodgson

For what it's worth, I've also had a very good experience with foam rollers. I also do hip-strengthening exercises (ie. squats), but it wasn't until I started regular foam rolling (and quitting the aggravating activity for a few weeks) that my IT band problems disappeared. MY IT band only ever flared up when running, not cycling, but I'd imagine the recovery process would be the same.

gamby

You'll definitely see God the first time you foam roll from the hip to the knee for IT issues. As others have said, it loosens up after awhile and eventually stops hurting (or becomes "good" pain that you end up liking).

The foam roller kept me running through the winter relatively pain-free (at least from the old IT band issues--instead, I got tightness in my left calf and soreness in my right Achilles, reminding me that I'm not a runner).

Good luck with it, OP.

Carbonfiberboy 

The interesting thing to me about the above IT band posts is that of course one cannot stretch one's IT band. It's a long length of fibrous tissue, and it does not stretch. The whole idea of it, mechanically, is that it does not stretch. Of note is that certainly foam rolling won't stretch anything. However, whatever people are doing with the rollers, etc., obviously works. So what, physiologically, are they really doing? Perhaps deflating a bursa? That seems most likely, and would certainly hurt.

In any case, the OPs problem has nothing to do with IT bands. If the doctor really said this, he's uneducated. The OP's problem is simply mal-tracking of the patella. It is relatively easily resolved by stimulating the vastus medialis obliquus or VMO. This muscle will pull the kneecap back toward the center. This malady is common among cyclists who only push down on the pedals.

It's worth noting that two of the exercises in the article linked in post #6 are normally done on the bike by properly activating the hams and glutes.

Here are some further resources for the OP's problem:
https://www.bikeforums.net/training-n...l#post16081392

and some good stretches for everyone. Best done at the lunch break on a social ride or after a ride:
https://www.bikeforums.net/road-cycli...l#post15372967