First, I have read loads of information about IT band on this forum and elsewhere so I am asking mostly for response to a specific question. MY IT band problem is really bothering me on the bike. I have read that slightly lowering the seat and adjusting cleat position outward slightly often helps. Has anyone had luck with either or both of these ideas?
Yes, I am using ice, stretching, NSAIDS. and trying to rest it.
I am doing Vineman (actually Aquabike) and time is short.
It’s an overuse injury, so rest is the only thing that is going to fix it. However…
Have you tried massage or some kind of myofascial release? A foam roller can do you some good.
Are you fit properly to your bike? Proper footwear? Etc?
My fit is excellent. I will try the foam rollers.
Any suggestions on how long to rest it before I try riding again? It started bothering me on Tuesday, rest till Saturday and the pain was still there.
Race day is just about 4 weeks. I know it depends on the person.
When I had ITB (from running…before I did tris) I was told (by a sports Othopedic Surgeon) that unlike most running injuries, DO NOT BIKE. I took up swimming.
Knowing me, I will get an overuse injury from swimming too much.
I haven’t tried running on it.
I will start back on the trainer and see how long before it hurts, but am not sure if I should wait a day or a week or 2 weeks.
I had problems with my IT band and the resulting knee pain. I tried stretches and bike adjustments. I have had zero problems for months now. The solution was a very painful, but effective massage. He leaned into the side of my leg with his elbow bearing down on the length of the IT band. It only took a minute or two as part of a deep tissue massage, and 2-3 visits. It was like a miracle for me. Good luck.
My wife loves inflicting pain of that sort, I have her give it a try.
You said a couple of session, how much time between seesions?
Welcome to the fraternal order of ITBS.
applause
Stick with your regiment of stretching, strengthening, NSAIDs, and foam rolling (SSNFR). But add in a major dose of rest.
I’m in the middle of rehabing a partially torn popliteus and associated ITBS. My PTist (whom used to be an orthopedist, then a sports medicine doc for some pro teams) told me at the beginning that once the IT band is so irritated and tightened that biking is irritating the band, it’s major. The reasoning he gave me was this:
biking, compared to walking/running, is not very sensitive to biomechanical flaws, so an athlete is very well protected from injury while biking due to alignment flaws or muscle imbalance below the rib cage. It would require a terrible fit on a bike to create ITBS, but biking is a good litmus test for how bad the ITBS has become. There’s all sorts of further explanation he gave me which is technical and not worth repeating.
The unfortunate news is that the only cure for the pain is rest. So all the advice you’re reading about:
-increasing the band’s flexibility
-increasing flexibility of the TFL muscle
-releasing adhesions and trigger points in the underlying quad muscle, piriformis, plus in all the other hip rotators and stabilizers
That advice is aimed at preventing this from happening again, but will do nothing for the current pain and tightness.
Give it 2 weeks of ZERO running, biking, and kicking while swimming, in addition to your SSNFR regime (everyday, twice is better, three times is ideal). You won’t suffer any fitness loss, so don’t fret. If after those two weeks you still feel the pain setting in during biking, you need to take extended time-off and (this is the important part so excuse the bold) LET IT HEAL. Time-off could be 1 month or 6 months, it all depends on how strict you are about not testing the leg and being patient.
If it makes you feel any better I was stupid, kept training, f*cked my knee, and had to withdraw from two olys, three 1/2s, and IMMoo.
A seat that was to low is what started mine,my Dr told me to make sure my seat was not to low,i went home and raised my seat on all of my bikes and have not had many problems since,
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I had one session, went back 4 days later, and the last session was a week later. It work for me. It did tighten up again after 2-3 months and one more treatment did the trick.
I have had good results in keeping my IT band issues under control by keeping my seat post a little lower than what it should be. You might want to try experimenting with seat post height. I remember reading something about if the seat post is low enough then the IT band does not rub against the bursa and cause pain. There might be a good position where the seat post is low enough but not too low as to affect your form.
I really appreciate the help.
Like most athletes, the idea of “rest” and time to “heal” is what I will struggle with. Especially with my big race in 4 weeks.
Thanks!
Hi,
A race in four weeks is a good reason to rest it. Really, if you keep woking on it your pain will increase, and your race will suffer.
I was able to do some water running - keeping the offending leg straight, and lots of swimming with a pull bouy to keep me honest. One thing to note though, be very gentle pushing off the wall. A big push off is basically an explosive deep knee bend against a lot of (water) pressure, and that can throw you back a bit in your rehab.
On your original question - I added over the counter orthotics to my cycling shoes to try to support my feet more. My ITBS had a lot to do with running while overpronating - so now I have orthotics in all my shoes.
Take it easy, get the massage, see a physical terrorist to start some targeted strengthening and some (often covered by insurance) massage.
I would also strongly recommend getting a QuadBaller roller instead of a foam roller. I think it does a much better job, is easier to target, is easier on my back (since my hip isn’t 5" off the ground, and is easier to bring with you when travelling or to work. Yes, it costs a bunch more, but the difference is less than one paid massage session.
I ran a marathon too early on an un-recovered ITB, and paid dearly for it (basically had to hop on my good leg up all the hills). I’m pretty lucky I didn’t blow out my good knee.
Unless tri is your profession, keep things in perspective! It will get better, but the more abuse you lay on it, the longer it will take to heal.
Mike
My has been bothering on the bike and on the run, but it started on the bike.
I have been seeing a sports chiro and he has me specific hip and core exercises which seem to be helping. I also moved my cleats slightly forward which seemed to alleviate a lot of stress.
I have also been rolling my body weght over a foam (harder foam) cylinder. It actually is for pilates and feels quite good…well painful but good.
Good luck.
B
Not sure if this makes any sense at all so…
Is it possible that wedges/shims could help? My thought is that if you have a significant amount of varus/valgus in your foot, then it is moving with every pedal stroke and possibly causing lateral knee movement.
Another possiblility could be a leg length issue.
I hope that someone else with more expertise than me will pipe in on this…
Good luck and fwiw, the foam roller has helped me tons and I believe saved me a bunch of $$$.
ITBS is a results of an overly tight TFL (tensor fascia latae) muscle. The TFL is on the outside of your butt. The IT band attaches to it ending at the knee, so when TFL is tight, it hurts on the outside of your knee.
If it’s cycling-related, raise your saddle slightly–what this does is force the ITB to stretch out a little bit.
You need to work on your TFL. You have a tight ass. Go to http://tpmassageball.com/ and read all about ITBS and how to treat it.
Note: you will be treating the ACUTE problem. Someone who develops ITBS probably has hip mechanic issues, so you should work with a PT or on yourself to figure out what is the root problem. If you like, PM me and I’ll email you a bunch of information on taking care of this and other stuff.
The reason why people think the foam rollers help ITBS is not because they are STRETCHING the ITB–it’s because the vastus lateralis muscle is right underneath the band, and that may also be tight. The ITB itself is just fascia, and it has little blood supply, therefore thinking you are stretching “it” is futile.
Also, from personal experience, ITBS can manifest only on the bike when in fact it’s being caused by a RUNNING problem. It just depends on what the trigger muscle is.
So best is to treat the thing holistically. A little rest might be needed, but working on the TFL itself will really speed things up.
For me, when my TFL is tight, it’s a signal that my QL (quadratus lumborum) is also tight, and the glute medius might be weakened.
If you have some $$ have a biomechanical evaluation done to find out how everything is working together on yourself.
Hey this isn’t FASTSPLITS Karl is it?
Karl- below I am pasting in some of my $.02 on ITB issues. Since yours bugs you on the bike (more often it bugs people running) you may also want to try and rule out other casues. How tight are your hamstrings? Specifically at the insertion behind the knee. Stretch your hamstrings gently but obsessivley especially when they are warm.
Go to a good sports PT who does iontophoresis… you will be amazed at what this does. Most insurances cover it too. It is basically an antiinflammatory that goes through the skin right on the bursa via a little pad that sticks onto the side of your knee. The ionto is only a band-aid and will help you get to back to running but you have to fix what caused the problem in the first place.
Here’s the full meal deal:
Shoes—I would guess that you pronate. If so, make sure your shoes have no more than 450 miles on them and are stabiltiy or motion control shoes with a good medial post. If you pronate badly get orthotics from your PT, some insurances will cover this too.
Have someone check your leg length, if one leg is shorter or longer that could be the cause as it may mean that your pelvis is twisted a little which makes the IT band tighter. If that’s the case you will also need to go to a sports chiropracter and get adjusted.
You need to stretch the living shit out of your IT band and the insertion points. Obsessively. Many times a day. Google stretches and IT band syndrome---- it’s too hard to explain it here.
You need to strengthen your gluteal medius. Put a theraband around legs below knees and move one leg apart at a time. 15-30 reps x 2-3 sets for each leg.
As you are getting back think frequency and short runs. Don’t do anything long for at least a month.
ICE the bursa on the side of your knee after every run and then several times a day. Watch out for frostbite.
i used to think i was really flexible. from martial arts i could do splits forwards/back and sideways. when i got ITBS i focused on stretching the outer butt, so pulling my right knee toward my left shoulder. but the stretch that really got me over the ITBS was one that stretched my right hip.
if im sitting and crossing my left ankle over my right knee, my shin is parrallel to the ground. but when i crossed my right ankle over my left knee, my right knee would be pointing more upwards, really tight right hip. so i would cross my right ankle over my left knee and place the right knee under the desk adjusting the height of my chair so that the desk would be applying pressure down on my right knee. after i started doing this my ITBS started feeling alot better.
Last year I had a serious ITBS problem. It would flare up 15 minutes into a run. Problem nagged on for about 6 weeks. Tried massage, chiropractic, rest, ice, advil, etc. Lowered my seat post 5mm and problem solved almost instantly. In my case, the damage was done on the bike but it only hurt on the run.
Wish I were FASTSPLITS Karl.
The long story. 10 days before IMA I noticed my iliotibial band at the end of a 7 mile run. Nurtured it (never feeling any pain on the bike) until race day. It got progressively worse on the bike and I could not run. Walked 8 miles and DNFed.
With a few days off, ice and Celebrex, I was riding fine within a week and running within 2, but never running more than 5 (my next big race was Aquabike) As I am a teacher, I foolishly up my miles on the bike when school got out.
I am trying everything you guys can suggest. However, I can not raise my seat and lower my seat and many have suggested. My seat height was at the higher end of what is “ideal”. Guess I should lower it???
Yes, my flexability sucks. NOW, I will work on it