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How Long to Rest IT Band Knee Injury?

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How Long to Rest IT Band Knee Injury?

Old 10-25-08, 03:46 PM
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recneps345
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How Long to Rest IT Band Knee Injury?

I had to take a month off of the bike due to a surgery. One of the first times I got back on the bike, I ended up injuring my IT band(lateral lower part of knee). I took a week or two off thinking that would fix it. Well, when I got back on the bike it started bothering me again about 20 miles into my ride. So, I took off another week. Last week I rode three times and the knee never gave me too much trouble. I still couldn't go 100%, but it felt pretty good. Today, I get 20 miles into my ride and the knee starts ailing again. The weather is so beautiful, so I don't want to take off more than a week. I just took an Ibuprofen. Has anyone else had any experience with this type of injury. If so, advice would be appreciated. Thanks.
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Old 10-25-08, 04:04 PM
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When I had an IT band injury, I took a month off and then got back into riding VERY gradually. I mean starting with easy 10 mile rides, then adding about 5 miles per week. Also, make sure your fit is correct or the problem will come right back. I suggest moving your saddle back and down.
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Old 10-25-08, 05:49 PM
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Hi, im a personal trainer, and come across this alot as well as having experienced it myself, the single most effective way of ensuring this problem goes away and stays away is flexibility work. Obviously rest it up if you inflame it but once the inflamation is gone do some serious work on lengthening your IT bands otherwise this will keep on happening as it did with myself. I had this problem but resolved it with regular flexibility work but after a hamstring injury (playing rugby) which meant i didnt stretch for a few weeks the problem reared its head again as soon as i got back on the bike because my IT bands had tightened up again. Have you ever heard of Self Myofascial Release?
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Old 10-25-08, 06:06 PM
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Use lower gears. ITB problems often come from trying to push too hard a gear. It's really important to spin at higher revs especially in recovery.

You need to rest it, but also stretch it. Place the ankle of your ailing leg on the knee of the other leg, and gently but firmly press down with your hand on the ailing knee. You probably won't feel much in terms of stretch, except maybe around the hip. Hold the stretch for 10 seconds. For the next one, push just a little harder. Do the stretching daily.

If the problem persists you may need to consult a physical therapist. There is a method they use to "snap" the band and pretty well permanently solve the problem (at least, according to an Iron Man competitor I know who had similar issues).

Check your foot position on the pedal, and the tightness of your cleats. Loosen the cleat a little so you release easier while in recovery mode.

If your foot appears to rotate away from the pedal, you may (a) have shoes with uppers that no longer provide adequate support or (b) have a natural inclination to drop your foot outward and may need wedges or an orthotic insert to correct it.

My advice comes from experience in touring and randonnees.
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Old 10-25-08, 06:25 PM
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Bike fit.

Beth
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Old 10-25-08, 09:31 PM
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Stretch stretch stretch.

Also, for me, the foam roller and ice were a godsend. But if you're not stretching regularly (I've got a regimen in the A.M. I literally do in the shower, and before and after workouts to keep it under control), you're only delaying another flare up, not fixing it. Rest alone won't cut it, at least in my experience.
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Old 10-25-08, 10:17 PM
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I don't know if this applies, but I had IT band problems hurting my hip when hiking. It never bothered me biking. The problem is just how many recommendations you see online. I finally picked a few and I think it worked for me, because I hiked 2 14,000 foot peaks and it never bothered me. Here's what I did:

1. Stretch it every day.
2. Before bed I would do side leg lifts.
3. I would do the Walt Reynolds's ITB Special (look it up)
4. Strenghten the gluteus medius by standing on a stair facing the side and dipping the bottom leg down and up without bending the knees.

As I said, that seemed to work for me. YMMV.

Perhaps the most important thing (I don't know for sure) was taking Ibuprofen BEFORE/DURING the activity that caused problems. For me it was always the day after a grueling hike that I'd have pain. Maybe the above steps did nothing and taking the Motrin was what really helped, I don't know. The pain was pretty intense before though so I doubt that's it.

Last edited by cooleric1234; 10-26-08 at 07:55 AM.
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Old 10-25-08, 11:12 PM
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Originally Posted by peterbennett9 View Post
Hi, im a personal trainer, and come across this alot as well as having experienced it myself, the single most effective way of ensuring this problem goes away and stays away is flexibility work. Obviously rest it up if you inflame it but once the inflamation is gone do some serious work on lengthening your IT bands otherwise this will keep on happening as it did with myself. I had this problem but resolved it with regular flexibility work but after a hamstring injury (playing rugby) which meant i didnt stretch for a few weeks the problem reared its head again as soon as i got back on the bike because my IT bands had tightened up again. Have you ever heard of Self Myofascial Release?
+1000. stretching is the key. I use a foam roller to do some Myofascial Release work. And good old fashioned yoga or some simple stretches really help a lot. And if you are coming off an inflamed IT band then come back slowly. It will suck at first because you won't feel like you are working but take your time. Plus now that it is getting colder its the perfect time to rehab up.
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Old 10-26-08, 04:30 AM
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Stretch BIG TIME! That's what did it for me.
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Old 10-26-08, 04:53 AM
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+1 on the stretching.

But don't do it immediately. Wait until the inflamation has gone down. If you can feel burning during or after stretching then stop and rest/ice it for longer. Once you can stretch without pain then gradually build up the miles again.

Foam rollers are great as mentioned, but absolute AGONY at first

Keep up the stretching even when you are pain free.

I was off the bike for a couple of months in total as I initially tried to ride through it, and then kept coming back too hard.
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Old 10-26-08, 10:03 AM
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Coming back in just to say I also agree with the stretching comments. Not sure how I forgot to mention that, but I stretch after every workout, and after my IT band problems, added 3 new stretched to my routine.
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Old 10-26-08, 11:04 AM
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I've had IT band problems before and like everyone says , stretch! Mine came from running on the road not paying attention to the slope. For me I had to take 3 months off, no run, and gradually build back up. It sucks because it's one of those things you just can't ignore.
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Old 10-26-08, 11:46 AM
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Originally Posted by RoadToNowhere View Post
Bike fit.

Beth
+1

If you search ITBS, I have posted some thread when I had a Felt bike.
I tried many things that suggested by here users but always I had a pain after 30 miles.

After I changed my bike to BMC, it never came back. the only thing changed is bike and BB.
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Old 10-26-08, 12:04 PM
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I'm coming off a hamstring injury and can relate to your problem. I devoted about an hour every day for the past 6 weeks to recovery and rehabilitation. I walked for 45 minutes every day and stretched for about 15 minutes. Then when I got back on the bike I started with less than 10 mile rides at less than 10 miles per hour. You have to be careful with these types of they can get worse.
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Old 10-26-08, 12:06 PM
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Thanks for the help. The weird thing is that it doesn't hurt at all, unless I am 15 miles into a ride. I did forget to stretch yesterday. I just took it easy my first ten minutes on the bike. It doesn't even hurt when I try rubbing it with firm pressure. It also doesn't feel like I can do anything to stretch it. I guess I will just stick to trying to stretch it more and taking it easy for a while. Thanks again for the help.
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Old 10-26-08, 02:00 PM
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Originally Posted by recneps345 View Post
Thanks for the help. The weird thing is that it doesn't hurt at all, unless I am 15 miles into a ride.
Makes perfect sense. My doc described it as a repetitive motion injury. It also took me about an hour or two for it to start hurting. Over a year later, I still feel it getting a little sensitive during a long ride if I forgot to stretch the day before.
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Old 10-26-08, 03:16 PM
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I had an IT band problem for a long time. Once I got really dedicated to fixing the problem, I'd say it took 3 months to be back to 100%. Like everyone else has mentioned, stretching is important. I also found that doing leg raises and leg curls at the gym helped a lot. It's a bad problem to have because it takes a long time to fix, but if you don't do it right, it'll stay with you for a long time. I had pain for about a year before I REALLY started trying to fix the problem.
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Old 10-26-08, 03:57 PM
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Great news! I stretched everything very well for 30 minutes or so before my ride. I went out for a 20 miler, and I felt great. Not even a twinge. I am stretching it right now, while I watch football. Thanks for the help.
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Old 10-26-08, 04:47 PM
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I developed this problem while running in the off season last year. My advice to you is to stretch as much as you can. Stretch when you wake up and before bed. Stretch before and after every ride. Take a few minutes a few times a day to stretch while at work. It makes a huge difference, believe me. Mine are fine now *knock on wood*. It did, however, take a long time for them to heal. Like 5-6 months. I asked a doctor and was told that IT Bands are notorious for long healing times. Hope this helps.
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Old 10-26-08, 05:08 PM
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Originally Posted by peterbennett9 View Post
Hi, im a personal trainer, and come across this alot as well as having experienced it myself, the single most effective way of ensuring this problem goes away and stays away is flexibility work. Obviously rest it up if you inflame it but once the inflamation is gone do some serious work on lengthening your IT bands otherwise this will keep on happening as it did with myself. I had this problem but resolved it with regular flexibility work but after a hamstring injury (playing rugby) which meant i didnt stretch for a few weeks the problem reared its head again as soon as i got back on the bike because my IT bands had tightened up again. Have you ever heard of Self Myofascial Release?
+1 on the flexibility work, had the same problem 2 summers ago and stretching it out really helped.
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Old 10-27-08, 09:08 AM
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I'll say it again. From experience...

Stretch all you want, but if you're putting in a lot of miles on a bike that doesn't fit properly, you will have IT band/knee/hip/back/shoulder problems.

And btw, I am a big proponent of stretching/yoga, etc. My body wouldn't function without it.

Beth
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Old 10-27-08, 08:35 PM
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Originally Posted by RoadToNowhere View Post
I'll say it again. From experience...

Stretch all you want, but if you're putting in a lot of miles on a bike that doesn't fit properly, you will have IT band/knee/hip/back/shoulder problems.

And btw, I am a big proponent of stretching/yoga, etc. My body wouldn't function without it.

Beth
I have been riding it set up like it is for years, and I have been fine. I also recently got looked at at my bike shop.
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Old 10-28-08, 01:03 AM
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Fit has nothing to do with it. ITB problems come from other factors, as I and others have detailed.
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Old 10-28-08, 06:05 AM
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Originally Posted by Rowan View Post
Fit has nothing to do with it. ITB problems come from other factors, as I and others have detailed.
Wrong.

Fit can have everything to do with the stresses placed on the IT band.

Adjusting the fit and improving the pedal stroke under the watchful eye of a skilled tech can mean the difference between stabbing will-not-quit knee pain from a seized up IT band at 40 miles into a ride, and a relatively pain-free long ride.

With all due respect, don't discount personal experience, Rowan.

Beth
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Old 10-28-08, 06:32 AM
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I can guarantee my personal experience and solutions. I suggest you are the one discounting personal experience, Beth.

The issues relating to ITB are more lateral ones. The ones that are covered by things such as Q-factor in the cranks, twist at the ankle (toes pointing in or out, dropping away of the outside of the ankle), and even the simple act of unclipping from stiff clipless pedals. Seat angle, saddle integrity, and pelvis assymetry can have an influence. If you want to categorise those as "bike fit", sure, go ahead.

But the most frequent cause of ITB problems is "mashing" in too high a gear for extended periods, particularly uphill or with a load, such as when touring. For me, it probably comes from the slight twist in pushing down and forward from the hip.

The primary solution for ITB issues is to spin at a higher cadence. Then it becomes a process of elimination as to the other factors.

The OP has said his bike measurements/fit have not changed over a long period. Are you suggesting that his personal experience in his bike fit and previous freedom from ITB pain should also be dismissed? He doesn't even mention knee/hip/back/shoulder problems except for ITB.

My personal ITB issues come and go, and depend very much on how much I mash, and how much attention I pay to stretching and my posture when doing other things such as sitting in front of my computer.

I ride five different bikes, and all are set up in a very similar way. One is a fixed gear, another is a touring bike; they are the ones that I run the most risk from ITB issues, for obvious reasons. My ITB issues have subsided substantially in the past five years -- but I am aware of the occasional twinge and take it easy on the pedals.

Your original post just stated "bike fit". It gave no clue to what aspect of bike fit. Your second and third posts don't further the discussion much further.

Maybe, it's with all due respect... to your bike fitter.
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