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ITBS - My road to recovery

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ITBS - My road to recovery

Old 12-28-06, 09:32 AM
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scot
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ITBS - My road to recovery

There are multiple modes to IT Band Syndrome. Some in the hip, some above the knee, and then there is mine where the pain is actually on the outside and slightly below the knee. Basically at the top of your shin muscles.

I have had my bike fit, changed seats, switched to speedplays, changed angles, iced my knee, stretched, road more, road less, massage and a bunch of other stuff. Nothing really worked. I even had to give up riding with the reston rider group, and I was making GREAT personal progess.

I finally gave up and went in search of a doctor. Celebrex, ice, stretching and low mileage. Well lets just say that celebrex (and ibuprofin for that matter) don't work well for me. Sure, the inflamation goes down, but intestinal ulceration and blood... not so good.

So I gave up riding... for a while. Back out after a month and bingo, more pain. So now what?

I looked around at a ton of resources, called a ton of doctors and finally found one that supposedly specializes in phycial re-habilitation and stated they are cycling experts (not really, but lets not get ahead of the story here.) When I got there, they looked at me, I had my cycle clothing in hand, and bike in the car. No need (which I do disagree with) to get me on the bike, it was just time to check my stiffness and muscle balance.

First I am a neutral pronator. When you are talking about specialized body geometry equipment, I am in that "2%" they are talking about and using it is bad for me (made my ITBS worse). I am also "duck footed" so I walk with my toes pointing outward. This puts my muscles in an odd position. Realistically all the strength involved in my leg extending or contracting is based on the inside of my legs.

When twisting my feet, they will rotate outwards over 90deg from straight forward, but only 15 deg internal. Same with my leg to hip. Neutral is probably 20% on one foot, 15% on the other.

What this does is that if I were to do a forward lunge, my foot goes forward, points outward, lands evenly, then as a move downward to the "lunge" portion, my knees go inward towards my core, while my foot goes outward. When I bike, guess what... I do the same thing. At least when I am fatigued or pushing hard.

Its that motion, over and over that puts your IT band into an odd position and as an odd support.

So, the fix? Easy. Exercise, stretch, and make sure my legs stay steady while riding, knee over foot. Let me just stress this though, by exercise, I mean lots and lots and lots of muscle strengthening excersize. Things like one leg mini squats, where I hold my feet straight forward and my knee overtop of my foot, which keeps my leg straight but only going down a few inches at a time (im up to a step height now). One legged balance exercises, wall backed squats, leg raises with light weight (front, side, inside and back), crab walks using stretchy bands (embarrasing but difficult as hell), sitting with the band around my knees while trying top pull my knees apart, and a ton of other stuff. You need a doctor to help find out which are best.

In the past month I have been minimally biking (20-30mi per week) and strength training for two months, two to three times a day. It is a total PITA, but so far no more pain in the IT Band!

Now to my annoyance, while I am doing well so far, it still bothers me that the doctors didn't look at me on the bike and they don't really understand fit issues and how they can be a complication. They really understand the human body, but not how cycling affects it, at least not when talking about a 25-30 mile a day habit. The VAST majority of people (including doctors) out there think 25 miles is a LONG, LONG distance. When I said I did 40-50 per day on the weekends before the pain made me stop, they thought I had to be training for a race and were confused as to why I would want to do that on a regular basis.

So while the exercise is working, the bike fitting I had done is also crucial to making the package correct for me. If it don't fit, you could just end up with a different problem! In conclusion, if your doctor is like mine with minimal fit understanding, I would either stress that they need to get on the ball about bicycling or you need to just go get fit by an expert like I did.

Please note, this is not medical advice. I am not a doctor. If you are having a similar issue, just take from this that there is hope! Go find a good doctor, maybe show him/her this piece, and get to exercising. You might have different muscle imbalances and need different stretches or exercises.
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Old 09-10-09, 09:44 PM
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i know this was posted a long time ago.
if you get this msg how has it been long term?
i getting a bit miserable and and searching for some good news, hope you have got some.
i have very flat/splayed feet, which isnt actually the reason i cant ride. its the knee pain ITBS.
cheers max
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Old 09-10-09, 11:45 PM
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abstractform20
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use a foam roller. 27 dollars at 24hr fitness.

amazing. do it twice a day, for at least 10 m inutes
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Old 09-11-09, 08:54 AM
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Originally Posted by abstractform20 View Post
use a foam roller. 27 dollars at 24hr fitness.

amazing. do it twice a day, for at least 10 m inutes

+1

Get it, use it, suffer like the rest of us. Trust me it hurts at first but will get better with time.
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Old 09-11-09, 09:27 AM
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milliron
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I had pretty bad ITBS issues for a while. Couldn't run more then a mile or I'd get severe knee pain, longer rides resulted in lower back pain. Fixed by taking a month off and 10 min of stretching, twice a day. My PT told me that the key is to hold each stretch for at least 30 seconds. After a month of that, I slowly ramped back up & kept up with stretching both before and after exercising. No issues.
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Old 09-16-09, 12:46 AM
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Got a cortisone shot yesterday.
got the roller and stretching regularly (have been for a while)
fingers crossed
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Old 09-16-09, 08:43 AM
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I posted on my IT band issues a couple weeks ago and got good information. Bought a foam roller at Target for 19.00, use it about 10 minutes each morning and the knee pain has not resurfaced. Good luck.
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