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IT Band and fit

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IT Band and fit

Old 07-31-20, 12:40 PM
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IT Band and fit

Iím aware of the general seat height suggestions when there is pain on the front of the knee vs. behind the knee.

What about IT Band issues? I do well with rest and stretching and rolling it out, but I havenít read any bike fit specific suggestions

Iím a tall rider who tends to ride vintage 25Ē/26Ē frames if that matters
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Old 08-01-20, 11:54 AM
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Nor have I. AFAIK, it's all about stretching, even though one cannot stretch an IT band. IMO IT band issues mostly aren't. I use these stretches to keep my knees healthy: IT Band pain (during ride)
I never roll. Don't think it's a good idea.
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Old 08-01-20, 03:33 PM
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I had IT band issues that I finally got taken care of via a fit analysis. I was already pretty close in saddle height, but had dropped it to try and deal with some slight leg length + cleat setup differences. The fitter/PT guy had me walk up and down a hallway barefoot to see how my non-bike biomechanics worked. I'd been having a left leg IT band injury and soreness that just wouldn't go away with stretching or rolling. Where the band anchors into the knee was the primary source of pain and strain--affecting connective tissue below that anchor point.

Two cleat wedges bumped up the outside of my left shoe, thus eliminating the outer knee strain due to lateral (inside/outside) imbalance. That has worked out really well. Some occasional strain from different muscles, but when a saddle height gets bumped up an inch and a bunch of other changes happen, different muscles get used that haven't been before/before as much. It feels so great to actually put a few miles in, and with speed, than before!
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Old 08-06-20, 10:38 AM
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Early on I used to have IT band irritation, as RiddleOfSteel noted above, for me it was about cleat position. Once I got this sorted out and learned how to stretch it, I was fine. That was more than 25 years ago, and I have never had a re occurance.

Have someone who has fitting experience help with your set up. It does make a difference.
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Old 08-06-20, 05:26 PM
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Originally Posted by Carbonfiberboy View Post
...even though one cannot stretch an IT band.
Actually, there are plenty of stretches you can do to stretch your IT band. A simple Google search will bring up plenty of sites with good information. I like this one:

https://www.healthline.com/health/itb-stretches

They show several different techniques (including rolling) which are all very helpful for relieving IT band issues.
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Old 08-06-20, 09:15 PM
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Originally Posted by BoraxKid View Post
Actually, there are plenty of stretches you can do to stretch your IT band. A simple Google search will bring up plenty of sites with good information. I like this one:

https://www.healthline.com/health/itb-stretches

They show several different techniques (including rolling) which are all very helpful for relieving IT band issues.
That's bro science. It's been around for so long that people take it for fact. The ITB is a long chunk of hard fibrous tissue and you better hope it doesn't stretch because its main function is to prevent your femur from bowing outward when one leg is loaded as it is when walking, running, or cycling. What one can stretch is the muscle which tensions the ITB, the tensor fasciae latae or TFL. For more information on this complex support structure, see:
https://www.sportsinjurybulletin.com...the-mysteries/

For stretching information, google "tensor fasciae latae stretches."

One will quickly see that the ITB usually has nothing to do with knee pain, a very common error. Knee pain felt on the side of the knee is usually due to a bursitis, an inflamed bursa. Knee bursa become inflamed when the tendons which they cushion become too tight and press on the bursa too hard. The stretches I recommended above are designed to stretch the muscles attached to these tendons which then fixes the bursitis fairly quickly. However as we see in post 3, it is possible to tear the ITB's attachment point, which is good reason to see an orthopedist.

Rolling squishes the fluid out of the bursa, which temporarily fixes the issue but it's not good for the bursa and is not a long term fix, which daily stretching is.

"IT band issues" have nothing to do with saddle height, though for sure the cleat wedges in post 3 would do a good job of taking the strain off the ITB. Nice work on the part of the fitter! An ITB anchor point injury would be a serious issue. In any case, one sees why stretching and rolling wouldn't help with that injury.
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Old 08-07-20, 02:16 AM
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While most of the time with IT band pain it's not the band itself that is hurt, the pain is nevertheless caused by the IT band. To the best of our current knowledge, the pain comes from the fatty tissues under the band on the lateral fermoral epicondyle as they get irritated and inflamed by pressure from the band that comes with repeated flexion and extension of the knee. Most of the time it's not buristis though, because most people have no bursae under the IT band (though apparently in some cases a bursa can form in response to stress with IT band injuries).

From my research prompted by my own IT band injury, this can most definitely be affected by saddle height, in most cases by the saddle being too high. IT band is stretched the most (that is, it is pressing on the epicondyle the hardest) when the knee is at around 25 degrees of flexion. If the saddle height is such that the knee repeatedly goes through this angle of flexion, irritation in the area can occur. One typical scenario is that the saddle is a little to high, the rider favours one leg so they rock the hips to shorten the reach to the pedal on that side, and IT band pain develops on the opposite side where the leg overextends. More often than not, this affects the left knee since most people favour the right leg.

Of course, it is not as simple as saying "saddle too high = IT band pain". Lots of other factors come into play, both on and off the bike. With that said, it is still a good idea to check saddle height and possibly decrease it to help resolve the symptoms.
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Old 08-07-20, 10:45 AM
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Originally Posted by Fiery View Post
While most of the time with IT band pain it's not the band itself that is hurt, the pain is nevertheless caused by the IT band. To the best of our current knowledge, the pain comes from the fatty tissues under the band on the lateral fermoral epicondyle as they get irritated and inflamed by pressure from the band that comes with repeated flexion and extension of the knee. Most of the time it's not buristis though, because most people have no bursae under the IT band (though apparently in some cases a bursa can form in response to stress with IT band injuries).

From my research prompted by my own IT band injury, this can most definitely be affected by saddle height, in most cases by the saddle being too high. IT band is stretched the most (that is, it is pressing on the epicondyle the hardest) when the knee is at around 25 degrees of flexion. If the saddle height is such that the knee repeatedly goes through this angle of flexion, irritation in the area can occur. One typical scenario is that the saddle is a little to high, the rider favours one leg so they rock the hips to shorten the reach to the pedal on that side, and IT band pain develops on the opposite side where the leg overextends. More often than not, this affects the left knee since most people favour the right leg.

Of course, it is not as simple as saying "saddle too high = IT band pain". Lots of other factors come into play, both on and off the bike. With that said, it is still a good idea to check saddle height and possibly decrease it to help resolve the symptoms.

Which is a bit weird in that the pes anserine (subsartorial) bursa on the inside of the knee is not shown. You could be right about the connection to saddle height, though I've never seen that problem. But could be, rocking the hips like you say.
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Old 08-07-20, 01:12 PM
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Originally Posted by Carbonfiberboy View Post
That's bro science.
That's the point where I became skeptical of your post, because anyone using that term is usually pushing their own brand of "bro science." Nothing in the link you provided said that the IT band cannot be stretched; it actually went in-depth only on the function of the IT band and the parts around the IT band that should be stretched. I'll stick to believing the dozens of medical institutions that provide advice on IT band stretching, and throw your "advice" out with the rest of the trash.
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Old 08-07-20, 01:37 PM
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according to the pt/bodywork professionals I have talked to, there is a consensus that stretching helps not becuase it is stretching the IT band, but instead because it stretches the muscles connected to the IT band., primarily the glutes.
in my experience, stretching the glutes help relieve any IT issues...that and rolfing (no rollering)
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Old 08-07-20, 05:36 PM
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Originally Posted by BoraxKid View Post
That's the point where I became skeptical of your post, because anyone using that term is usually pushing their own brand of "bro science." Nothing in the link you provided said that the IT band cannot be stretched; it actually went in-depth only on the function of the IT band and the parts around the IT band that should be stretched. I'll stick to believing the dozens of medical institutions that provide advice on IT band stretching, and throw your "advice" out with the rest of the trash.
Tee-hee . . .https://www.painscience.com/articles...me-stretch.php

The iliotibial band itself is just too tough to be stretched. Even smaller tendons that are easy to pull on are extremely difficult to elongate, requiring long hours of painful stretching such as dancers and gymnasts do. But the ITB is the longest and most massive tendon in the human body. Itís also not free to move like most tendons: itís anchored along the length of the femur.7 Imagine bolting a 2-foot strip of thick tire rubber to a plank of wood in several places. Now try to ďstretchĒ it! You might be able to apply some tension to it, but itís certainly not going to elongate significantly.
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Old 08-10-20, 02:43 AM
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Originally Posted by Carbonfiberboy View Post

Which is a bit weird in that the pes anserine (subsartorial) bursa on the inside of the knee is not shown. You could be right about the connection to saddle height, though I've never seen that problem. But could be, rocking the hips like you say.
This comes back to how much of human anatomy is still not very well known (reminds me of the new knee ligament that was discovered in 2013). In any case, it is (or was) generally assumed that there is a bursa underneath the IT band since that's a logical place for a bursa to be found, but some fairly recent research found no bursae there (source, source, source). Yet other fairly recent research did find an inflamed bursa when treating IT band syndrome (source). I guess in the end it comes down to semantics, and the main point that I think we agree on remains the same: it's the tissues underneath the IT band, not the band itself, that get injured.
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