anotherbrian

After taking most of Nov and Dec off the bike, I went on a spirited group ride on Dec 30, and came home with twinges of pain in my right knee. I pushed harder than I think I should have, especially since I had been off the bike for awhile. The next day I hopped on my beater bike (subtlety different fit than the other bike, different shoes/cleats/pedals) and the pain went from dull to agonizing within a mile.

I spent the next two weeks off the bike, though walking a lot, and the knee pain didn't change. Since then, I've been ramping up the intensity on the bikes slowly, making minor adjustments on fit, and trying to stretch the ITB, but the pain is still there in the background.

A few days ago I bought a foam roller and started using that on the ITB, and yeow, it nearly drove me to tears. If the pain is indicative of how tight the muscle is/how in need the ITB is of stretching, that's probably part of my problem.

I went on a really easy ride yesterday with extra shims for the Specialized insoles in my pocket and started shuffling those around. After a few changes I found a setup with no pain at all.

Is it reasonable to adjust the fit to cure the problem while I'm already suffering pain? Am I likely moving the pain elsewhere (to where it hasn't been stressed yet), or did I solve the root issue?

I'd like to up the volume this week -- the Death Valley Double is two weeks away, and for better or worse I'll ride it if the pain seems to be going away. I'm doing the foam roller morning and afternoon, and I'm hopeful it is helping for the amount of pain involved, as well as some strengthening exercises I found for ITB issues.

Carbonfiberboy 

Where's the pain, exactly? No pain better than pain.
For ITB, I stretch. For me, it's tight hamstrings that cause it. You can't really stretch the ITB itself. My routine, 3 X day, all seated:

3 hamstring stretches for 20", each one deeper.
One foot to crotch, stretch to straight leg.
Hurdler's stretch.
Tailor's stretch.
Pull each foot to chest or as near as you can.
Repeat hamstrings.

look566 rider

If you have time, you should get a few massages in. All the stretching in the world won't completely fix you issue. Some Biofreeze may help as well.

anotherbrian

What I'd meant to ask was if I can make the fit adjustments on the bike so the pain isn't worse/is diminishing, should I proceed (cautiously or not) in upping the volume, or should I stay off the bike until I'm pain free and then see if the fit changes actually made a difference? I haven't taken any ibuprofen in days, and the pain doesn't seem any worse at the end of 1hr on the trainer than it did before.

The pain is at the front of the knee, mostly above, a little below. Walking down stairs would hurt, walking up wouldn't. In the car, with my knee mostly fixed, lifting my foot from the gas or brake (pivoting on my heel) hurt, while pushing did not.

Last year, aside from a single long steep climb I did without low enough gears, I don't recall having any knee pain that lasted more than the day. I didn't do a tremendous amount of mileage in total, but I ramped up through the spring and did five double centuries up through the fall.

After reading some threads from chronic ITB sufferers about using a foam roller (myofascial release?), I thought it was worth giving it a try. If the pain is indicative of how tight the muscles are, my hamstrings are like jelly while the (outer?) quad is a rock. Up till now all of my exercising has been on the bike, so I wouldn't be surprised if I have been working myself out of balance.

Carbonfiberboy 

Yeah, probably an imbalance problem. The fastest thing for this seems to be what are called high kicks. With your leg held rigid, kick as high as you can, 15 reps each leg, a couple times a day.

Otherwise, I'd raise my saddle. With your butt in its normal spot and your cycling shoe's heel on a pedal, rotate the pedal to BDC. Your knee should completely lock out without any hip rock and no pressure on the pedal. You might raise you saddle until you have about a 4mm gap under the pedal at that point.

To try to answer your question, when I have something like this, I only ride my rollers in a pain-free condition. IOW, if it hurts, I stop. If it doesn't hurt at all, I go outside, but again I ease off and come home when and if it hurts. No pain allowed. My guess is a month of riding easy to resolve it and go back to riding volume. Also do the stretches. Doubt that it's anything to do with your ITB though.

charbucks

I would wait until you're pain free. Knees aren't something to mess with.

I would also say that it doesn't quite sound like IT band. That usually presents with pain on the outside of the knee, not the front. Front of the knee pain from cycling could be a result of your seat being too low or too far back, so you could try adjusting the fit. Have you had a bike fit done?

In regards to the imbalance thing, that is definitely possible. If you still suspect the IT band, you could start with side leg lifts to strengthen your hip abductor muscles.

Finally, I went to a training session on foam roller usage, and the trainers stressed that you shouldn't just roll out one part of your leg - the whole thing is connected. We were taught to first roll the calves, then stretch, then the hamstrings, then stretch, then the hips, then stretch... basically, you need to roll out each part of the leg (4 sides on both upper and lower, plus hips) and stretch each muscle after rolling it. The IT band was the last area we did, and by the time you get there it's loosened up considerably. Also, they said to only roll about 6 inches at a time, working your way up and down the leg in little segments. The whole process took about half an hour.

jbroadway

I would start with the knees. Probably a combination of strain and poor arch support. The pain below the knee could all be caused by pronation of your foot (rolling out to in) because of poor support. I had the same issue after taking about that much time off...got new road shoes and pedals in that time too and had to end up adding quite a bit of support to help the pain I was getting while riding on the trainer. Once I put the supports in the pain faded quickly.

The upper knee pain may be from you pushing too hard, causing inflammation.