IT Band Syndrome or other....

[Ozz]

I have a dr appt scheduled....but thought I would check with the brain trust here first...

So, about 2 weeks ago started feeling some pain on outside of left knee...not a sharp pain, but dull ache, swelling, reduced mobility. More bothersome than painful...but it is there

I figured it was a little tendonitis...took a few days off....felt better, rode again a couple days ago...it is back. Of course, I google "knee pain" to do some research. WebMD provides list of what increases chances of IT Band Syndrome:

• Bowed legs
• Knee arthritis
• One leg that’s longer than the other
• Rotating your foot or ankle inward when you walk or run
• Rotating your whole leg inward when you walk or run
• Weakness in your abs, glutes, or hip muscles

Yeah, I got 5 out of 6 (don't have knee arthritis AFAIK)

So my left leg is a mess from playing soccer for 35 years...ankle sprained so many times I have lost count (20+ easily), broken tibia & fibula so who knows if it is put back together correctly....

Anyway, anyone else gone thru this? What is best type of doctor to evaluate? I think there is a good chance this was caused by the instability in my left ankle....time to go to the "foot & ankle place" I guess!

I would think some PT is a good place to start, but probably Podiatrist, Physiatrist, or Ortho might be needed too....

This sux....weather is just getting good, and I finally have a decent fitness base.....ugh.

[fmradio516]

Crazy! 15 minutes ago I was talking to a colleague about how my knee has been hurting for the past month on and off. I get pain after twisting my left leg, or ride my road bike. Not so much when I ride my mountain bike. Really hoping its not a torn meniscus or something..

He went on to tell me that he had issues with his IT band. Never heard of it until 15 minutes ago...

[mastaliu]

So, with the caveat that each experience and history are different, I went through some serious knee issues for decades from previous soccer injuries (ACL, meniscus). I struggled with a return to cycling but got it all sorted out. I cannot run without issues but I can ride to a good level because cycling is forgiving as long as you develop some muscle balance and equal strength. Here are my insights:

Everyone will say foam roller and I will agree with that.
A good PT can be worth a lot more than an ortho.
Focus on butt/hip strength to build stability through the pedal stroke.
Get a routine of closed-chain exercises and band work and repeat daily.
Bike fit.

Best of luck, take your time and you will be back stronger and faster.

[citycyclist247]

I used to run and play soccer as well. Started having pain occasionally. My cousin who’s a physical trainer told me that it was likely my it band. I got a foam roller and after using it the effect was so much better!

I hope that a doc can help you figure out a solution to address the issue. I’m not sure what doctor would be ideal.

[Ozz]

Originally Posted by mastaliu

S...I went through some serious knee issues for decades from previous soccer injuries (ACL, meniscus)....

I always felt fortunate that I my knees are (were) in good shape....just about all my old teammates have gone thru knee surgeries....

Foam roller sounds like a good start....my son said the same thing (studying pre-health/pre-med, total workout/fitness nut)

[truth]

I've had outer knee pain that I alleviated by foam rolling (and rolling on a lacrosse ball) my glute med and piriformis.

If you've got a foam roller you can try rolling on the actual IT band. If it howls with pain you might have IT band syndrome or something else. If it's tolerable you probably have something other than ITBS.

[BobbyJones]

My experience:

1) Foam Roller or massage stick. Hurts so good! Make sure you start all the way at the hip and don’t neglect your Psoas and Tensor fasciae. (Look em up)

2) cross-over standing leg stretches... you’ll feel it when you’re doing it right.

3) consistency. A couple of times a day for each of the above.

When my flare ups happen, it can take months to totally eliminate the pain. I’ve been told by a PT that working through it isn’t destructive, within reason of course...and as long as there’s no “joint” pain.

Long term maintenance revolves around that consistency thing and some trail running and walking on uneven terrain.

Good luck with your recovery.

[FlashUNC]

Foam roller is about to become your "friend."

I use quotes because it's agony to start.

Start with a decent sports med doc if you can. They can diagnose IT band stuff pretty quickly.

And then follow the PT religiously. It'll likely become part of your regular routine to keep it from flaring up again. I foam roll at least a couple times a week these days.

[schwa86]

I’m a big fan of the roll recovery r8 that was flagged here originally. It has allowed me a bit more control/precision in working the IT stuff out. If you search you will find various threads. https://rollrecovery.com/

[joevers]

Take some time off the bike.

Use a foam roller and do yoga (https://www.youtube.com/watch?v=YWzR...&pbjreload=101 is my absolute favorite)

See a bike fitter.

For me, my fit was apparently terrible and I did a 400mi brevet 2 years ago that just put it over the edge. I didn't think my fit was bad, I was working in shops, riding with people, and just never noticed apparently. I guess I'm just not good at recognizing what's wrong with my fit. I couldn't ride a bike for a month my IT band was so bad. Near the end of the ride with 20 miles to go I had to lay down on the ground for nearly an hour because I couldn't do one more pedal stroke.

Saddle too high, cleats too forward, knees bowed in towards the top tube, and never stretched were the issues that lead to it, and I had to correct all of those. I started stretching, lowered my saddle nearly 30mm, moved my cleats back and shimmed them out so my knees tracked straight with my legs.

The stretch that helped relieve pain the most was standing up, turning one foot out 90* and slightly forward(so if you looked down at my feet they formed a T shape), and reaching for my toes (specifically, reaching for the toes that formed the bottom point in the T shape).

[Ozz]

Originally Posted by joevers

Take some time off the bike.

Use a foam roller and do yoga (https://www.youtube.com/watch?v=YWzR...&pbjreload=101 is my absolute favorite)

See a bike fitter.

For me, my fit was apparently terrible and I did a 400mi brevet 2 years ago that just put it over the edge. I didn't think my fit was bad, I was working in shops, riding with people, and just never noticed apparently. I guess I'm just not good at recognizing what's wrong with my fit. I couldn't ride a bike for a month my IT band was so bad. Near the end of the ride with 20 miles to go I had to lay down on the ground for nearly an hour because I couldn't do one more pedal stroke.

Saddle too high, cleats too forward, knees bowed in towards the top tube, and never stretched were the issues that lead to it, and I had to correct all of those. I started stretching, lowered my saddle nearly 30mm, moved my cleats back and shimmed them out so my knees tracked straight with my legs.

The stretch that helped relieve pain the most was standing up, turning one foot out 90* and slightly forward(so if you looked down at my feet they formed a T shape), and reaching for my toes (specifically, reaching for the toes that formed the bottom point in the T shape).

Yeah, bike fitter might be a good idea. I've been messing with new saddles, an raised my saddle a bit, and not paying attention to putting the pieces where they are supposed to be.

It was all much easier when my body just adapted....

[Ozz]

OK - took some time off the bike (2 weeks or so) and did the foam roller a couple times per day.....seemed to be working and was optimistic. Did a few rides last week......ugh.....it's back.

I have an appt with Erik Moen scheduled for July 1 (should be confirmed today) for evaluation and fit assessment...

Good news....the fit should be covered by my insurance!

I hope I don't have be buying a bunch of new stems, bars, seatposts or saddles!

Getting old sucks....all those old injuries come back to remind you about how invincible you were back it the day (not).

[truth]

Erik Moen is fantastic!

I wonder if he'll recommend a wider stance width for you?

[ojingoh]

yeah third recco for Moen.

I get IT band stuff when I come back from a few months off (nov-dec-jan round here.) I attribute my IT band soreness to bad form, specifically bad hip+glute activation, e.g. pedaling squares.

I found my fix in core stabilization exercises, basically planks, woodchoppers and side bends.

[jimcav]

I DON'T advise pushing through it--1st time I got it was 2 weeks b4 my 1st ironman and I felt I had too much interested in the event so did it--hurt horribly and I was in a leg brace for 6 weeks after and could not run for 6 months.

Subsequent flares I took the time to ice at 1st sign, rest it, stretch, roll it etc.

Is it really ITB? For me it's quite easy to diagnose- I can just put pressure with my thumb or fingers on outside of knee right at the bony end of the femur (for me that is just a bit below a line from the center of my kneecap with leg straight) and cycle my knee through 30-45 degrees of flexion: it hurts right there.

The ITB goes from hip to tibia (shin), so you need to let the inflammation at the knee calm down, then make sure you loosen the adhesions (foam rolling), address muscle imbalances as others have mentioned, and stretch it so when you start up it doesn't again "catch" and over-rub as it glides over that bony aspect of the knee: see this pic/article:

https://www.physio-pedia.com/Iliotibial_Band_Syndrome