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Old 03-14-13, 12:44 AM   #1
Jaytron
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ITB woes

Hey guys,

Just looking for some tips. I had some pretty bad knee pain on Saturday, took a few days off and went for a lunch ride today (Wed). Everything seemed fine. I went to ride again after work and the outside of my right knee was in pain again.

Is this full on ITBS? From what I've been reading, this takes months to recover from. :C

Is there a difference between regular inflammation and full on ITBS?

Anyone go through this? I'm getting a bike fit tomorrow to see if that was the problem. Evidently 3 days wasn't enough time off the bike. Anyone else have a good starting point?
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Old 03-14-13, 01:13 AM   #2
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Get one of these... http://www.physiosupplies.com.au/fit...cm-x-90cm.html

Then do this... http://www.youtube.com/watch?v=ZjzlEYp12PA

Try to do it everyday, be aware that it will probably be EXCRUCIATINGLY painful the first time you do it, but it will get less painful the more often you do it.

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Old 03-14-13, 01:21 AM   #3
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Get one of these... http://www.physiosupplies.com.au/fit...cm-x-90cm.html

Then do this... http://www.youtube.com/watch?v=ZjzlEYp12PA

Try to do it everyday, be aware that it will probably be EXCRUCIATINGLY painful the first time you do it, but it will get less painful the more often you do it.

JMR
Will do. I have a muscle roller as well. Is this not sufficient?
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Old 03-14-13, 01:35 AM   #4
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Sounds like it could be the same thing... is it just a firm foam roller about 20cm in diameter?

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Old 03-14-13, 05:05 AM   #5
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Depends on what has actually caused your ITB inflamation, and if it is actually that. Rolling out your hips/ itb etc can be useful, but might not solve your issue.

I would strongly suggest you first determine if it is ITB (sounds like it, though), and then consider what the cause is. Knees are complex, so outer knee pain need not necessarily be inflammation of your ITB.

In getting to the cause, consider:
?ave you recently replaced shoes or cleats? ITB (and other knee) issues can very easily be due to foot positioning. Not necessarily even the toe in/ out, but also fore-aft cleat positioning changes. Just mm different from a previous set up can cause issues. Saddle position changes also changes the forces through the knee and can cause issues.

If you've ruled out equipment changes, think about body changes: Tight glutes are a big factor in ITB. Rolling your hips on those foam cylinders effectively stretches out the muscles you roll against (muscle less tight = ITB less tight = less friction against the bony bit of the knee = less inflammation). Static glute stretches can also make a big difference.
If you find stretching or rolling out your glutes/ ITB helps, then thats the 'cause', but maybe not the root cause. Sounds like this is a new pain, which suggests it'd be unusual for you to get tight glutes, so look at what activities you've done recently that are different - hiking/ running etc? - your body will get used to it just stretch more

If there are no different activities or equipment/ set up in your life, but you've upped your training level/ added a different level of intensity which has braught it about it may be worth speaking to a physio about it. often this means that your glutes are kicking in to compensate for another muscle which is weak and becoming fatigued. The glutes then 'overwork', and tighten up. A good sports physio will be able to identify what is going on and give necessary you exercises to sort the issue out.

ITB issues are self perpetuating - the illio-tibial band gets rubbed, so it gets inflammed. inflammed = presses more on teh knee, rubs more, more inflammed and possible damage and scarring if you keep on at it. And pain generally only on motion, so you can feel just fine inbetween. So get it nipped in the bud before you do any damage, or at least before a major inflammation is set up. Anti inflammatories in the mean time won't hurt.

good luck
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Old 03-14-13, 07:32 AM   #6
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Quote:
Originally Posted by JMR View Post
Sounds like it could be the same thing... is it just a firm foam roller about 20cm in diameter?

JMR
I have this thing, not quite a foam roller, but more of a hand held roller.



Quote:
Originally Posted by Velocirapture View Post
Depends on what has actually caused your ITB inflamation, and if it is actually that. Rolling out your hips/ itb etc can be useful, but might not solve your issue.

I would strongly suggest you first determine if it is ITB (sounds like it, though), and then consider what the cause is. Knees are complex, so outer knee pain need not necessarily be inflammation of your ITB.

In getting to the cause, consider:
?ave you recently replaced shoes or cleats? ITB (and other knee) issues can very easily be due to foot positioning. Not necessarily even the toe in/ out, but also fore-aft cleat positioning changes. Just mm different from a previous set up can cause issues. Saddle position changes also changes the forces through the knee and can cause issues.

If you've ruled out equipment changes, think about body changes: Tight glutes are a big factor in ITB. Rolling your hips on those foam cylinders effectively stretches out the muscles you roll against (muscle less tight = ITB less tight = less friction against the bony bit of the knee = less inflammation). Static glute stretches can also make a big difference.
If you find stretching or rolling out your glutes/ ITB helps, then thats the 'cause', but maybe not the root cause. Sounds like this is a new pain, which suggests it'd be unusual for you to get tight glutes, so look at what activities you've done recently that are different - hiking/ running etc? - your body will get used to it just stretch more

If there are no different activities or equipment/ set up in your life, but you've upped your training level/ added a different level of intensity which has braught it about it may be worth speaking to a physio about it. often this means that your glutes are kicking in to compensate for another muscle which is weak and becoming fatigued. The glutes then 'overwork', and tighten up. A good sports physio will be able to identify what is going on and give necessary you exercises to sort the issue out.

ITB issues are self perpetuating - the illio-tibial band gets rubbed, so it gets inflammed. inflammed = presses more on teh knee, rubs more, more inflammed and possible damage and scarring if you keep on at it. And pain generally only on motion, so you can feel just fine inbetween. So get it nipped in the bud before you do any damage, or at least before a major inflammation is set up. Anti inflammatories in the mean time won't hurt.

good luck
I've done ALL of these things haha :C

I haven't upped my milage too much in the past month, but I did do a ton more climbing. (I hate it and typically avoid it) I'm also overdue for a fitment on both of my bikes. (Got new bikes, getting them fitted today).

Sounds like I need to start at square one... get the bikes fit. Stretch stretch and more stretch and see if the problem persists? How do I know when it's ok to start riding again?
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Old 03-14-13, 08:29 AM   #7
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Oh man..
yup, start at square one.
when to start training again is a tough question, and depends on how much inflamation there is already, how risk averse you are, what big events are coming up, etc. Definitely not before you've had your set-up sorted out.

I'd say give it at least a week of time off bike (and off running, climbing stairs etc), with anti-inflams, ice, and elevating the leg (all to get inflammation down). Compressing is risky. Dont strap the knee and walk about; you're just pushing the band up against the knobbly bit, which is what the essence of the problem is anyway. Strapping at night or when you are sitting still can also help reduce inflammation. the old 'RICE' addage that the runners talk about for injuries - rest, ice, compress, elevate.
And then stretch a lot.

When you are back on the bike, really listen to your body. Stop if it feels 'funny'. Dont even get to the sore stage, because that just means even more time off the bike.
But maybe you'll be ready to get back on the bike after 3 or 4 d rest. Everyone is different.
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Old 03-14-13, 08:42 AM   #8
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Thanks so much for the advice!

Yeah, between the advice you gave me and reading up on cycling related ITB problems... I basically did everything that would lead up to an ITB problem.



I guess it's good that I didn't attempt to ride through it.
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Old 03-14-13, 02:53 PM   #9
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Quote:
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When you are back on the bike, really listen to your body. Stop if it feels 'funny'. Dont even get to the sore stage, because that just means even more time off the bike.
Yes, this. Most athletes are at highest risk for re-injury when they don't feel pain from their injury because they assume they are completely recovered.
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Old 03-14-13, 02:58 PM   #10
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Yes, this. Most athletes are at highest risk for re-injury when they don't feel pain from their injury because they assume they are completely recovered.
Damn, that's what I did yesterday :C

That's probably why the pain is back.

Last edited by Jaytron; 03-14-13 at 04:02 PM.
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Old 03-14-13, 05:23 PM   #11
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Have you got a GOOD massage therapist nearby that specializes in myofacial release?

Note... you will probably have to either ask around (I there is someone that most of the pro/semi pro cyclists in the area use that is probably a good place to start), or try a few until you find one that can pinpoint and release the problem area. It may be a problem elsewhere and the pain is refering in your ITB area.

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Old 03-14-13, 10:45 PM   #12
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Have you got a GOOD massage therapist nearby that specializes in myofacial release?

Note... you will probably have to either ask around (I there is someone that most of the pro/semi pro cyclists in the area use that is probably a good place to start), or try a few until you find one that can pinpoint and release the problem area. It may be a problem elsewhere and the pain is refering in your ITB area.

JMR
I'll definitely ask around thanks for the tip!

Got back from my fitting... my seat was much too high, my bars too low, and my cleats too far in. HAH
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Old 03-15-13, 01:37 AM   #13
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That will all help... you will probably need some work on the already aggrivated muscles/tendons though.

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Old 03-15-13, 11:57 AM   #14
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I haven't read all of the posts, but I had similar issues my first season. This stretch knocked it right out:

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Roadies can run tempo all year as that's what humans were designed for. If you want to be a cheetah, lay around and lick your paws more.
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Old 03-15-13, 12:02 PM   #15
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Also read this: http://www.cptips.com/knee.htm
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Roadies can run tempo all year as that's what humans were designed for. If you want to be a cheetah, lay around and lick your paws more.
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Old 03-15-13, 12:09 PM   #16
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Thanks everyone! You guys are all awesome.

The pain is already subsiding with all the stretching/rolling. I'm going to be sure to take at least a week off this time though, and slowly work my way back up.
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Old 03-15-13, 01:13 PM   #17
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I haven't read all of the posts, but I had similar issues my first season. This stretch knocked it right out:

How long were you off the bike for?
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Old 03-15-13, 07:19 PM   #18
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How long were you off the bike for?
It never took me off the bike. I just had general tightness and soreness in the ITB.

I'd also consider evaluating your cleat positioning.
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Roadies can run tempo all year as that's what humans were designed for. If you want to be a cheetah, lay around and lick your paws more.
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Old 03-16-13, 09:31 AM   #19
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It never took me off the bike. I just had general tightness and soreness in the ITB.

I'd also consider evaluating your cleat positioning.
Yeah my fitment session with my coach moved my cleats inward (to push my feet outward) and lowered my saddle. I was waaaay off on my road bike.
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Old 03-18-13, 05:21 AM   #20
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Yeah my fitment session with my coach moved my cleats inward (to push my feet outward) and lowered my saddle. I was waaaay off on my road bike.
For anyone unsure about their set up, and not in a position to get a professional fitment done, this website is excellent:
http://www.stevehoggbikefitting.com/...leat-position/

I particularly used the cleat positioning section (as per the link). Its pretty thorough, though, and requires some time to go through everything and understand what is being said, but worthwhile if you're doing it yourself.
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Old 03-18-13, 07:51 PM   #21
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Any tips for how to get back on the bike and start training again?

The 10% rule simply seems like it'll take way too long to get back up to 180mi weeks... especially since I've only really taken a week and a half off.

I've heard other things along the lines of "two weeks easy for one week off" If this is this case, it seems more doable, but it's pretty vague on how to properly increase your milage this way.
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Old 03-19-13, 02:15 AM   #22
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The reason behind slow come-backs is to prevent re-injury or an initial injury/ illness from too-much-too-fast, without giving the body a chance to adapt.
Applies more for longer lay-offs or for people starting to increase from a lower base, where they actually need to build up again.

The cardio systems start to 'detrain' after about 2 weeks of no training. Muscles etc take a lot longer to detrain (i.e. atrophy - but also longer to build up)

So since you are already fairly highly trained, and you are unlikely to have dropped off a lot of fitness in ~ 10d. Your biggest concern is re-injury, rather than 'overdoing' it. (if you'd been off ill, different story, as that knocks the system in different ways). shouldnt be a problem if cause is resolved and there is no residual inflammation or tightness

Your 10% increase will not be from a base of 0, anwyay, if you go this route. You're probably pretty much at the same point you were, just nice and rested. So maybe try 100mi in your first week back to be conservative and take it from there.

Main thing is to listen to the knee.
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Old 04-06-13, 11:10 AM   #23
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I don't know if this will inspire some of you but I just made myself a leg roller.
I was a bit surprised when I saw the price tag on these so I just had to try something with a 4'' PVC tube, yoga mat scrap and some red adhesive cloth sheet for the ULTIMATE pro look. Haha!








It works great and for $15, I can't complain.
Cheers!
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Old 04-06-13, 02:27 PM   #24
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Nice!
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