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IT Band Syndrome Help

Old 11-05-21, 05:08 PM
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John Young
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IT Band Syndrome Help

I have been cycling for 35+ years and recently I had got pain in the side of one of my knees. I looked online (I do have an appointment for a physio but it will not be for a while yet) and it seems its IT Band syndrome from the symptoms I have. As I said I do have an appointment with a professional but I had to do something to try and help in the meantime.

This first came on in September and I have done lots of stretching exercises and I thought it was helping as I managed to get out on a 12 mile ride last week (could hardly walk when it first happened) . But I then went out this week and got 9 miles before the pain started again so I feel I am back to square one and its SO FRUSTRATING - all I want is to be able to ride my bike again. The only difference between the two weeks is I started to ease off the stretches and exorcises from every day to once a week. Is that the problem did I stop to early doing the stretches even though I have been doing them for months now ??

Anyone else had IT band syndrome ?

How did you get back on your bike and how long ?

Last edited by John Young; 11-06-21 at 04:33 AM.
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Old 11-05-21, 06:54 PM
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I had this issue with running years ago, but oddly enough, cycling never resulted in the IT pain for me. I do stretch my hips good before I ride for any distance. One ankle on the knee, squat down a bit, and give the hip a good stretch.

Other than stretching, you can try a exercises that strengthen the hip flexors.
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Old 11-05-21, 07:04 PM
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I use a foam roller. It can be a bit painful at first. Hold spots for like a minute until they loosen.

I've also gone to PT where they do the Graston technique. They sort of lube it up with coconut oil and scrape the tissue with a blunt wedge. This helps break down the scar tissue.

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Old 11-05-21, 08:37 PM
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My wife as cycling onset IT band issues as I type. Like you she has been a life long cyclist, If you do some interweb searches on IT band cycling pain you will see that running and cycling are the top two causes. My wife has been going to a PT specialist to work on lessoning the pain. The first thing recommended was to STOP cycling - it just inflames the condition and makes it worse. The problem as explained is adhesion of the IT band creates irritation/inflammation and by using specific stretches and exercises you will be able to lessen the adhesion. Foam rollers are NOT recommended. Smashing the IT band does nothing to weaken the adhesion - it was thought it did, but research has debunked that.

Stay off your bike and find a physical therapist who specializes in IT bands. The sooner you get going the sooner you will be back - but don’t get your hopes super high about an instant fix - it may take a couple of months or more.
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Old 11-05-21, 10:35 PM
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If you can walk with no pain, you can ride a bike with no pain. The problem is probably with your fit. Did you recently install new cleats? Check your alignment. Your knees should be going straight up and straight down. IT band pain usually indicates a q factor issue.
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Old 11-06-21, 04:24 AM
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Originally Posted by BFisher View Post
I had this issue with running years ago, but oddly enough, cycling never resulted in the IT pain for me. I do stretch my hips good before I ride for any distance. One ankle on the knee, squat down a bit, and give the hip a good stretch.

Other than stretching, you can try a exercises that strengthen the hip flexors.
Yeah I have been doing loads of stretching - I must admit I did not do stretching before every ride before this happened so maybe that did not help
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Old 11-06-21, 04:27 AM
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Originally Posted by smashndash View Post
If you can walk with no pain, you can ride a bike with no pain. The problem is probably with your fit. Did you recently install new cleats? Check your alignment. Your knees should be going straight up and straight down. IT band pain usually indicates a q factor issue.
Yeah from what I have heard of others that is not always the case. Some people get this problem only when cycling but can do other things such as walking no problem as your legs are in a different position. Actually when this first happened I could not walk properly for about a week but lucky it does not seem to affect walking so much now so at least I have that. I have not changed anything on my bike its the same position etc I have used for years and years
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Old 11-06-21, 04:30 AM
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Originally Posted by rsbob View Post
My wife as cycling onset IT band issues as I type. Like you she has been a life long cyclist, If you do some interweb searches on IT band cycling pain you will see that running and cycling are the top two causes. My wife has been going to a PT specialist to work on lessoning the pain. The first thing recommended was to STOP cycling - it just inflames the condition and makes it worse. The problem as explained is adhesion of the IT band creates irritation/inflammation and by using specific stretches and exercises you will be able to lessen the adhesion. Foam rollers are NOT recommended. Smashing the IT band does nothing to weaken the adhesion - it was thought it did, but research has debunked that.

Stay off your bike and find a physical therapist who specializes in IT bands. The sooner you get going the sooner you will be back - but don’t get your hopes super high about an instant fix - it may take a couple of months or more.
Yeah I know there is no quick fix already - this started in September this year right when the weather was still lovely so it was so frustrating - I am so confused with the whole roller thing. Some people swear by it others say don't do it ???? I have a roller but only used it a handful of times because of this confusion. I have been doing other stretches for months now and as I said I did get a 12 mile ride last week so was really chuffed but then this week - Pain !!
t
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Old 11-06-21, 06:43 AM
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when I had mine I postponed the foam roller for 6 months. don't do that. it maybe awkward but it worked for me. not excessively, just a minute to two. only used one at the gym I visited every day. made it part of my pre workout routine. just do it

make sure you use correct form. I've seen giant diameter foam rollers & I prefer the smaller ones. it's just logistically easier to use. this size looks like the one I used & would recommend

I also recall doing these specific stretches
https://www.healthline.com/health/it...s#seated-twist

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Old 11-06-21, 11:22 AM
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When I had my Bought with IT Band inflammation I started doing specific stretches before and after riding. I did eventually have a surgery where the Doc smoothed out the end of the condyle where the band would rub but, in hind site that was really not necessary.
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Old 11-06-21, 03:00 PM
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I had IT Band syndrome when I first started riding in 2014. I found out I had my saddle too high. I lowered it, did physical therapy and it got better soon. I must admit I got medical attention and made the changes very soon. But I still do the stretching almost daily still. I don't want that coming back! Good luck.
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Old 11-07-21, 04:48 AM
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Originally Posted by rumrunn6 View Post
when I had mine I postponed the foam roller for 6 months. don't do that. it maybe awkward but it worked for me. not excessively, just a minute to two. only used one at the gym I visited every day. made it part of my pre workout routine. just do it

make sure you use correct form. I've seen giant diameter foam rollers & I prefer the smaller ones. it's just logistically easier to use. this size looks like the one I used & would recommend
https://youtu.be/jVvUW4SAMuk

I also recall doing these specific stretches
https://www.healthline.com/health/it...s#seated-twist

Thank you very much I will check these out
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Old 11-07-21, 09:17 AM
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I had a big issue with ITBS about 15 years ago. It's probably a little different for each, but what helped me was:
1) Stretches suggested by a sports physical therapist (the roller one, dip lunges, and stair steps)
2) Lowering the saddle and moving it back (you lose a little power, but better to ride slower than not at all)
3) Not riding if there is pain (I did very short loops so I could be back in a couple flat miles if needed)
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Old 11-07-21, 10:16 AM
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My caveat: This is the internet and I'm not an MD...
I have a tendency for very 'hard' muscles, meaning they're always very hard feeling and not very pliable...
This has a tendency, when the muscles get really stiff to put pressure on the IT (among other things) and consequently cause mis-alignment in the knee.
The IT band is the Largest Ligament'Facia in the Body. It DOES NOT Stretch... It can get irritated at the connection to the hip or knee.
Inflammation at the connections is a more difficult issue to address.
But if the problem is mostly in the underlying muscles being too hard (which is usually my issue...) getting them to relax and become less inflamed will help.
What works for me...
Self-massage of the legs - I do this regularly, even when I don;t have any issues. There are some good resources on learning this on the web - but also some really bad/wrong resources. - more on that later.
I do use a 'roller' - I prefer Hand-held not one you lie down on. mine is not foam, but is spaced,nubbed disks rotating on a handle - really is up to what you like for giving the needed pressure.
I Tolerate Ibuprofen well - so I have a use routine for it. Discuss with your MD as to it's suitability and use.
I do quite a bit of stretching - AFTER a ride or any heavier or extended exercise period - I also have/do some basic yoga routines which help a lot with the overall stretching.
As noted - key is the cleat alignment in 'rotation'/yaw .
Even if you haven't changed your 'position', your body does change over time. If you haven't ridden for some time and now riding more frequently and harder, your overall flexibility may have changed. AS noted by others, a change in saddle height might help... often lowering just a bit helps. MAKE CHANGES IN V-SMALL INCREMENTS and keep it there for some time/rides before making additional changes! A saddle height adjustment is 3 to 5 mm is quite a bit. Might also need some change in fore/aft - 2-3mm is reasonable...
CONCERNS/CONSIDERATIONS about any massage or 'pressure' methods (like rollering)
The Larger veins in the body have one-way valves, which keep the blood from backing up and only allow blood flow TOWARDS the heart. You never want to cause such back pressure as to cause rupturing of these valves. SO, heavy massage or pressure should always be done in a direction towards the heart - meaning UP the length of leg, not down towards the feet.
Think about what happens when you 'roller' your leg muscles... Especially an issue where you have large veins close to the body surface - like the lower leg.
Pressure across the muscle is not a problem, percussive pressure/therapy or soft kneading of muscle are usually not a problem.
Do everything in 'increments', soft easy stretching to start, then let the body slowly soften into further stretches, same for massage.
If you're gonna ride, ride easy, lower gears, comfortable cadence, no big gears, no heavy spinning, no big mileage, until you feel the problem has eased enough.
Then, Every thing in INCREMENTS!
Hope it all gets better for you.
Ride On
Yuri
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Old 11-08-21, 10:14 AM
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Originally Posted by John Young View Post
Yeah from what I have heard of others that is not always the case. Some people get this problem only when cycling but can do other things such as walking no problem as your legs are in a different position. Actually when this first happened I could not walk properly for about a week but lucky it does not seem to affect walking so much now so at least I have that. I have not changed anything on my bike its the same position etc I have used for years and years
Fair enough. I used to struggle with IT band inflammation. Lots of stretching, rolling, soreness in the knee etc. But fixing my cleat alignment almost entirely eradicated that.
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Old 11-08-21, 11:00 AM
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i had it a couple of years ago training for a marathon, read all sorts of scary stories on the internet and thought i was doomed for life. the reality of it is that everyone is different, for myself i stopped running for a week and did a lot of stretching and foam rolling and exercises and i have been good to go ever since then, doesn't mean what i did will work for you or anyone else it is just what worked for me. i suck at stretching before or after activities, i feel like it is taking up time that i could be doing something else, shame on me for that. in the end time away from the activity will help it heal, i don't know that there is any guarantee on how much time it will take, it depends on the person and the severity of the injury. this is just my opinion and i am a nobody. i do wish you a speedy recovery though.
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Old 11-08-21, 04:39 PM
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Originally Posted by ckelly_22 View Post
i had it a couple of years ago training for a marathon, read all sorts of scary stories on the internet and thought i was doomed for life. the reality of it is that everyone is different, for myself i stopped running for a week and did a lot of stretching and foam rolling and exercises and i have been good to go ever since then, doesn't mean what i did will work for you or anyone else it is just what worked for me. i suck at stretching before or after activities, i feel like it is taking up time that i could be doing something else, shame on me for that. in the end time away from the activity will help it heal, i don't know that there is any guarantee on how much time it will take, it depends on the person and the severity of the injury. this is just my opinion and i am a nobody. i do wish you a speedy recovery though.
"it depends on the person and the severity of the injury. this is just my opinion and i am a nobody. i do wish you a speedy recovery though"

Love that sentence my sentiments exactly. Ive had multiple Knee, Leg, injuries attributed to repetitive motion. I believe most people have a leg length discrepancy that will eventually show itself when the body finally says enough. same with we all have weak side strong side, I cant tell you how many times after certain rides my left leg felt beat up even a slight form of atrophy, while my right was feeling normal. I always thought it was because my right side was my strong side my left side was always injured. What really helped my IT band issue was stop riding and, with weights, building up my left leg that was probably at least a good month then ease back into. And that is where ckelly_22's quote comes in.
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Old 11-09-21, 02:56 AM
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Originally Posted by ckelly_22 View Post
i had it a couple of years ago training for a marathon, read all sorts of scary stories on the internet and thought i was doomed for life. the reality of it is that everyone is different, for myself i stopped running for a week and did a lot of stretching and foam rolling and exercises and i have been good to go ever since then, doesn't mean what i did will work for you or anyone else it is just what worked for me. i suck at stretching before or after activities, i feel like it is taking up time that i could be doing something else, shame on me for that. in the end time away from the activity will help it heal, i don't know that there is any guarantee on how much time it will take, it depends on the person and the severity of the injury. this is just my opinion and i am a nobody. i do wish you a speedy recovery though.
Thank you - Yeah I am taking time away from cycling and I hope it heals
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Old 11-09-21, 03:00 AM
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Originally Posted by cyclezen View Post
My caveat: This is the internet and I'm not an MD...
I have a tendency for very 'hard' muscles, meaning they're always very hard feeling and not very pliable...
This has a tendency, when the muscles get really stiff to put pressure on the IT (among other things) and consequently cause mis-alignment in the knee.
The IT band is the Largest Ligament'Facia in the Body. It DOES NOT Stretch... It can get irritated at the connection to the hip or knee.
Inflammation at the connections is a more difficult issue to address.
But if the problem is mostly in the underlying muscles being too hard (which is usually my issue...) getting them to relax and become less inflamed will help.
What works for me...
Self-massage of the legs - I do this regularly, even when I don;t have any issues. There are some good resources on learning this on the web - but also some really bad/wrong resources. - more on that later.
I do use a 'roller' - I prefer Hand-held not one you lie down on. mine is not foam, but is spaced,nubbed disks rotating on a handle - really is up to what you like for giving the needed pressure.
I Tolerate Ibuprofen well - so I have a use routine for it. Discuss with your MD as to it's suitability and use.
I do quite a bit of stretching - AFTER a ride or any heavier or extended exercise period - I also have/do some basic yoga routines which help a lot with the overall stretching.
As noted - key is the cleat alignment in 'rotation'/yaw .
Even if you haven't changed your 'position', your body does change over time. If you haven't ridden for some time and now riding more frequently and harder, your overall flexibility may have changed. AS noted by others, a change in saddle height might help... often lowering just a bit helps. MAKE CHANGES IN V-SMALL INCREMENTS and keep it there for some time/rides before making additional changes! A saddle height adjustment is 3 to 5 mm is quite a bit. Might also need some change in fore/aft - 2-3mm is reasonable...
CONCERNS/CONSIDERATIONS about any massage or 'pressure' methods (like rollering)
The Larger veins in the body have one-way valves, which keep the blood from backing up and only allow blood flow TOWARDS the heart. You never want to cause such back pressure as to cause rupturing of these valves. SO, heavy massage or pressure should always be done in a direction towards the heart - meaning UP the length of leg, not down towards the feet.
Think about what happens when you 'roller' your leg muscles... Especially an issue where you have large veins close to the body surface - like the lower leg.
Pressure across the muscle is not a problem, percussive pressure/therapy or soft kneading of muscle are usually not a problem.
Do everything in 'increments', soft easy stretching to start, then let the body slowly soften into further stretches, same for massage.
If you're gonna ride, ride easy, lower gears, comfortable cadence, no big gears, no heavy spinning, no big mileage, until you feel the problem has eased enough.
Then, Every thing in INCREMENTS!
Hope it all gets better for you.
Ride On
Yuri

Thank you - there is some good info there and I do actually have one of those rollers with handles and is like a ribbed rubber thing. I do like using it to as its easier to pinpoint the exact areas where it feels a bit tight or tender
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Old 11-09-21, 11:38 AM
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Originally Posted by John Young View Post
Thank you - Yeah I am taking time away from cycling and I hope it heals
Just make sure you find the cause, or it will come right back every time you start riding again.
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Old 11-09-21, 12:25 PM
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Originally Posted by urbanknight View Post
Just make sure you find the cause, or it will come right back every time you start riding again.
Yeah you are so right - I have been doing various stretches as I waited for my physio appointment but its hit and miss if I get pain or not. I went out did 12 miles no pain. Next week I went out and did 9 miles and got pain ??? I am now letting the last pain incident heal before more stretching and my physio appointment next week so hopefully they will give me some guidance - its so frustrating as this has been going on since September. The only plus-side is its winter here now so at least I have that. I would still be out normally but if I am injured I would rather it be in the winter
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Old 11-13-21, 07:54 PM
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Originally Posted by John Young View Post
Yeah you are so right - I have been doing various stretches as I waited for my physio appointment but its hit and miss if I get pain or not. I went out did 12 miles no pain. Next week I went out and did 9 miles and got pain ??? I am now letting the last pain incident heal before more stretching and my physio appointment next week so hopefully they will give me some guidance - its so frustrating as this has been going on since September. The only plus-side is its winter here now so at least I have that. I would still be out normally but if I am injured I would rather it be in the winter
I think the point urbanknight and I are trying to make is that stretching, ice, foam rolling etc. are NOT solutions to IT band pain. Those just treat the symptoms. Even if stretching for 2 hours a day somehow mitigates the pain, how likely are you to stick to that? How likely are you to push your limits and go for a long, hard ride that you've never done before?
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Old 11-14-21, 02:42 AM
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Originally Posted by smashndash View Post
I think the point urbanknight and I are trying to make is that stretching, ice, foam rolling etc. are NOT solutions to IT band pain. Those just treat the symptoms. Even if stretching for 2 hours a day somehow mitigates the pain, how likely are you to stick to that? How likely are you to push your limits and go for a long, hard ride that you've never done before?

The only problem is stretching is all I can do really. Even when I see a physio I assume they might get hands on but they will probably just give me exercises to do
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Old 11-16-21, 05:38 AM
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I have only a hazy idea where the IT band even is, but if I were in your situation, I would call up local professional sports teams, especially cycling clubs, and find out who their orthopedists are. They will be top notch, experienced in your complaint, and biased towards continued use, not discontinuing the activity.
Good luck.
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Old 11-16-21, 10:43 AM
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Having dealt with knee pain for many years, it took a long time before I "diagnosed" the problem and found a working solution.

This is my routine and so far it's allowed me to continue hiking and do long rides without worrying about how I feel the next day...
  • Stretches (pre-exercise is a MUST, post-exercise and recovery days are good too) - Roll/massage just the upper and lower connection points of the IT band hard, then I do about 3 or 4 different stretches per leg.
  • Orthotics (to support my flat feet) - Shims/wedges/insoles may also help depending on the individual. You can Google how to make all these on your own.
  • IT specific exercises. Your IT problems won't go away, you need to strengthen the muscles around the IT band.
Sounds like a lot of effort but I just enjoy a video on my phone during the stretches and workouts, which I do concurrently with other exercises.

You won't find a consensus on what works or doesn't work. Each individual is different. I used to think orthotics were garbage, I tried them on their own for years and my pain just got worse. The stretches on their own also don't work. My solution required a 3 prong approach and lots of trial and error along the way. You just have to find different stretches and routines that work for you (some require flexibility or equipment that you don't have) and weed out all the bad advice mixed in with the good stuff if you're researching this topic online.

I found this video very informative about the underlying condition:

https://www.youtube.com/watch?v=68ds...Prof.Bellemans

Last edited by diverge52rider; 11-18-21 at 08:55 AM.
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