what causes IT band pain?

[vqdriver]

right around the 50 mile mark, my right knee starts to act up and by mile 60 i'm hardly able to apply downward pressure. a night of icing seems to fix it right up but obviously this isn't a recipe for ongoing success. orthopedist isn't a cyclist so he wasn't terribly helpful, just some generic advice. i've been fitted and have been otherwise quite happy with my position for the past couple years. anyone else experience this? what's worked for you?

i get that everyone's body is different, just looking for ideas....

[cat6]

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[echelon_john]

tight IT band rubbing over the bony protrusion at the outside of the knee. stretch hamstrings, quads, and calves, and use a foam roller on the ITB specifically. ice, anti-inflammatories, and rest until the pain is 100% gone, then keep on with the foam roller/stretching before loading up miles again.

sometimes canting your foot, raising the outside by a mm or two can help, but it can also create other issues, so proceed with caution on that front.

[jeremiah]

It might be an imbalance of strength in your leg.

I'm a triathlete, so do a lot of cycling and running. But always in a straight line!

If you're also a straight liner, try incorporating some hip abductor exercises into your routine. Also, be sure to use a roller frequently on that IT band.

And keep your cadence high!

[FlashUNC]

Foam roller is your friend.

[gary_a_gooner]

Where is the pain? How do you know it is the IT band.

My friend had knee issues from cycling. Turned out his saddle was too low. Hasn't had a problem since.

[Mikej]

I had good results with gluteus medius strengthening. Stretching and rolling never worked for me. Usually it's manifested in the knee or side of buttocks.

[roydyates]

Leg extensions work for me. I used to go to a gym, but a paint can hanging from my foot works about as well.

Of course, until you know what works for you, systematically working through the other suggested alternatives is makes sense.

[MattTuck]

If you do get another fit, ride 50 miles and then go to the fitting. See if adjustments help to resolve the issue.

In my experience, a fit is good, but nothing can replicate a few hours of saddle time to bring about the pains that happen during real rides.

[slidey]

+1

stretch hamstrings, quads, and calves, and use a foam roller on the ITB specifically. ice, anti-inflammatories, and rest until the pain is 100% gone, then keep on with the foam roller/stretching before loading up miles again.

Prevention of IT band pain is through regular post-ride foam rolling of IT band, and other areas as well.

Cure for IT band pain is:
1. resting with absolutely no riding till pain vanishes - at least that's the advice our trainer gave me
2. Foam rolling over the IT band
3. Icing the area vigorously

Good luck!

[Liv2RideHard]

My IT bands used to be chronically tight. Been to PT in the past to loosen them up. Strenghten your quads, glutes, abductors etc. Strong core also helps. Work on your core. Get a foam roller. Roll the IT band...alot. Stay loose and stretch everyday. Since I have been doing these things my IT bands havent been giving me issue. I also used to do stem and ultrasound on my IT bands with good success.

[kramnnim]

Last year I was riding 300-400+ miles/week, took a week off and had terrible knee pain on my first day back. Still not sure if it was IT band related, but I started using the foam roller almost daily, that particular pain hasn't come back.

Still have occasional twinges of pain that go from behind the hip bone down the side of my thigh...

The cheap foam rollers wear out pretty quick, I've been very happy with the Trigger Point roller I got thanks to the forum....

[Grant McLean]

right around the 50 mile mark, my right knee starts to act up and by mile 60 i'm hardly able to apply downward pressure. a night of icing seems to fix it right up but obviously this isn't a recipe for ongoing success. orthopedist isn't a cyclist so he wasn't terribly helpful, just some generic advice. i've been fitted and have been otherwise quite happy with my position for the past couple years. anyone else experience this? what's worked for you?


Oh yeah.

Anyone who's had that sharp stabbing pain on the outside of the knee
doesn't forget the feeling of hot knife in your leg.

Mine goes away with even a modest amount of stretching.
The attack of inflammation goes away quickly,
No roller, no changes to my bikes.
Google ITB stretches

-g

http://saveyourself.ca/resources/images/itb-syndrome-l.jpg

[etu]

my season thus far has been wrecked by IT band irritation. i started rehab by myself and then with a PT for the past 2 months. yesterday i was finally able to ride 30 miles at a decent effort without pain. it's been a long two months but i am beginning to see the light.
sounds like people of variety of experiences, but my problem was clearly due to hip imbalance and weakness. i had weak gluteus medius that resulted in internal rotation of the thigh with over-stretching of the IT band. i found this blog that explains it very well - http://runningwritings.blogspot.com/2012/02/injury-series-biomechanical-solutions.html.
so i started doing a couple of exercises, stretches, and foam rollers. when progress came slow, i sought the help of a PT. she gave me additional exercises and stretches and added more every couple of weeks. now i spend 45 minutes three times a week doing hip exercises and stretches. most recent additions have been single legged squats and romanian deadlifts.
i feel much stronger and although it was only one ride, i feel confident that i am going to have this IT business best. even better, i am really excited to have gained a greater appreciation for strength and balance training as well a core training.
good luck with your re/pre-hab. fortunately it sounds like your problem is not as severe as mine.

[scrubadub]

I've had good luck with treatment by PTs, massage therapists, and chiropractors. Find ones that work specifically with athletes as I find they are more aggressive (e.g. deeper and more painful massage).

Where are you located? I'm sure somebody could give you a recommendation for someone near you.

[Mikej]

you really cant stretch the IT band, you need to work the TFL and medius.

[Ray]

When I was relatively new to riding a lot, I used to get it sometimes in early season when I'd get too enthusiastic and up the mileage and intensity too quickly. And it happened once on a late season century full of climbing - I didn't last 60 miles that day. I'd already decreased my mileage and intensity a fair amount for a month or two and then suddenly attempted this crazy ride.

I never found any therapy or training that worked for it. I just had to ease back into heavy miles each year and once I learned that I never had any trouble with it again. I don't ride a lot these days, so I'm probably susceptible to it now, if I were to really start ramping up quickly again next month. When it happened, I just had to back off for a couple of days and come back a little easier and build up more slowly. It was usually a March affliction - by April I was always past it.

-Ray

[bigreen505]

Start with cleat cant and alignment. If you pedal very toes-down, maybe experiment with a more neutral ankle.

[timto]

I had terrible IT band pain too - went to physio who wasn't cycling specific and she noted muscle imbalance - namely weak Glutes and tightness.

Well because I'm lazy I still don't stretch but have no pain at all and worked on the glute strengthening and I think mostly the benefits come from enlisting them more while pedalling.

Using glutes in conjunction with quads and opposingly the hip flexors with hamstrings. Physio pointed out these relationships and I more consciously use more of my legs/hips as a result. No more pain. Plus i'm more stable on the bike and have more power. win win!

FWIW

[IJWS]

I also had some early season IT band pain a couple of years ago. I was heartbroken--sure that I had finally reached old age. I wanted to fix my fit, change my pedals, you know just scrap everything I thought I knew because all of the sudden I was one of the guys complaining about pain after riding.

Turns out I just needed to rest. A Dr, or fit specialist might be able to help you with some very specific issues that might be related to long-term IT band pain, but their best advice would be to wait it out first. 2 weeks off the bike, and I was back to normal. 2 weeks later I was back to the higher mileage that initially caused the pain.

In summary, beware of the internet. Anyone that told you to take a break, maybe buy a foam roller (as-in massage and stretching) has some pretty sound advice. The other solutions might just be confusions hurling towards you at 50 mbps!

[zott28]

I foam roller every night during TV watching time. You'd be amazed at how quickly it helps everything.

[scrubadub]

In summary, beware of the internet. Anyone that told you to take a break, maybe buy a foam roller (as-in massage and stretching) has some pretty sound advice. The other solutions might just be confusions hurling towards you at 50 mbps!

Maybe I'm misunderstanding your post, but I wouldn't be so dismissive of these "other solutions". Rest is not always enough (or even an option for some of us Type A folks) and I think early treatment is a good idea.

If this is your first IT band episode and rest alone with a little foam roller action did the trick, I'm happy for you. I hope it never gets any worse, because I suspect you'll find yourself pursuing these "other solutions".