IT Band - affecting cyclists?

DanP

Hi folks,

Dont want to rehash what is likely a tired topic but the search function didn't return much...

Curious about the impact of IT Band injuries and effects on cycling, particularly on multisports / tri folks.

Specifically, my IT band flared about 6 weeks ago and after a couple of miles running I can barely walk.

Yet even while in pain after a run I can consistently get on my bike and ride my usual TT training like nothing is wrong, my knee doesn't mind the hard ride and its no worse after the fact (at least I hope so).

So my main questions are:

a) Would regular hard cycling (limited to fewer miles, say 15 to 20) still be detrimental to the knee even if it does not hurt (heard rumors of some "invisible injury" possibility unless I became a couch potato).

b) Is IT band simply not a common issue for you folks that are primarily cyclists?

Thanks for any tips!

Rocket69

Hey Dan... I too have been dealing with an IT band problem for a while now. I am a cyclist, not a Tri athlete. The best solution I have found is stretching... I think this is the ONLY solution... I MUST stretch at least 10 minutes before and 10 minutes after a workout to minimize any kind of pain.

Funny thing, I went Xcounty skiing two weeks ago and I didn't stretch after my workout and I had IT band pain for nearly three days!

Anyway, search yahoo for IT band syndrome and you will find a few good stretches you need to do before and after working out...

Good luck!
Rocket69

DanP

Thanks - there sure is a lot of info on IT Band injuries out there!

The one thing that I'm having trouble with, and seems to be a point of debate for some, is whether if one has confirmed IT symptoms while running one should continue biking if there is no pain.

Some of the info says to go ahead if no pain, others state not to because one could be furthering the damage.

It'll probably be a couple of more weeks before my insurance lets me go to PT, just don't want to be idle in the meantime.

dkrenik

I've been racing for 20 years and have found the need for for increasing attention to my IT bands. Going back and forth on a firm foam cylinder has helped the most.

Most importantly you should see a Physical Therapist for advice and treatment.

DanP

Well, managed to somewhat expedite the insurance/ Dr. thing, but my GP wants me to see a knee Dr. rather than a PT first, I'll be doing that on Monday.

Will keep the forum posted if anything related to cycling comes up.

Thanks again.

Jhikers

Dan!

I saw your message the other afternoon but was just checking my emails, and the forum - before heading out training.

And, as I was expecting - especially by the number of replies you've received in the last 72 hours - this is definitely not 'rehashing a tired topic'...



Firstly, to answer your questions:

"CURIOUS ABOUT THE IMPACT OF IT BAND INJURIES AND EFFECTS ON CYCLING, PARTICULARLY ON MULTISPORTS / TRI FOLKS."

Well, unbeknown to most athletes, whether they be Cyclists, Triathletes etc (though Track athletes are generally very good) the IT Band is one of the major muscles that stabilises the legs - holding everything 'in'. Just like an astronaut's suit in space, if we were to be without it, our legs would just 'explode' outward.

Therefore, whenever we are using our legs, and keeping them going up and down, the IT Band is very much in use - STABILISING all the time.

So the impact is large in these sports, but unfortunately people are unaware of this until, just like you - the IT 'flares'.



YET EVEN WHILE IN PAIN AFTER A RUN I CAN CONSISTENTLY GET ON MY BIKE AND RIDE MY USUAL TT TRAINING LIKE NOTHING IS WRONG, MY KNEE DOESN'T MIND THE HARD RIDE AND ITS NO WORSE AFTER THE FACT (AT LEAST I HOPE SO)

Sorry, but you are still very-much-so using your IT Band on the bike, and although it may not feel as bad - it's there. Always getting tighter. The reason it hurts so much when you are running is because you are stretching it out so much more.

You say "MY KNEE", so I would recommend that you think about looking at your quadriceps as well... they will affect the top, just below and to the inside-side of the knee, as well as the knee-cap. The IT Band would be causing pain on the outside-side of the knee.



A) WOULD REGULAR HARD CYCLING (LIMITED TO FEWER MILES, SAY 15 TO 20) STILL BE DETRIMENTAL TO THE KNEE EVEN IF IT DOES NOT HURT (HEARD RUMORS OF SOME "INVISIBLE INJURY" POSSIBILITY UNLESS I BECAME A COUCH POTATO)

Yes! Regular hard cycling will definitely be detrimental to the knee, EVEN if it does not hurt, no matter what the distance.

However, the good news is that you needn't become a couch potato...
(solutions to come)



B) IS IT BAND SIMPLY NOT A COMMON ISSUE FOR YOU FOLKS THAT ARE PRIMARILY CYCLISTS?

The IT Band, I have to say, is DEFINITELY an issue for 'primarily cyclists', although I do not say 'common' because most people don't even realise what is happening.

The best analogy is this: You've got a credit card - you withdraw, and withdraw, and withdraw - but at some stage you're going to have to deposit some back - especially when you get towards or even go OVER the limit. Your muscles are exactly the same.

Just like you need to service your bike, because the gear/brake cables stretch, you need to oil the chain etc, - so too must you MAINTAIN yourself!



SO... WHAT DO YOU NEED TO DO?

Well, amazingly last week - one of my mates came to my physio for the first time because his IT Band flared up as well. He is a triathlete and looking to do an Ironman in about 6 weeks.
Unfortunately, he is going to have to work really hard to firstly have his IT Band well enough to return to full training to be ready for the event, but he's willing to give it his all - and so will be doing exactly this:

Firstly, you need to cut down on running HARD until your IT Bands are loose enough for you to run on without them flaring up.

You need to 'release' these guys, the poor things are probably as hard as a rock - but can be 'softened'.
No doubt, most of the action is at the knee-end, but the hip-end would also be copping it. The 'belly' of the IT needs work too - but not as much as the ends (the tendons).


THE EXERCISES:
These are going to have pain associated with them, but trust me - it is the only way. ROCKET, was right about stretching - it helps, but is only PART of the solution.

- Lie on your side on the ground
- Have your bottom leg at right angles with your torso
- Then a Right Angle at your knee so the bottom half of your leg runs perpendicular with your body.
- The top leg can just be straight - or for a better result - use it as a weight by placing it on top of the bottom leg.
- Then you need to get a broomstick, or a rounded stick of similar width, and place this under your leg - making a cross or X, with the IT Band... (e.g. one part of the X is your leg, the other the stick)
This is going to hurt, but you must let the weight of your leg sink into the stick, and soon you will learn to switch the muscle 'off', relaxing it - letting the stick make it softer.
- You can start the placement of 'the stick' in three main areas - The first, just under the hip bone, and second: RIGHT above the knee. In these two positions, the stick should run pretty much parallel to the torso.
- The third position is either straight/or diagonally across the 'belly'/middle of the IT Band - however by 'sticking' the two ends, this will relieve the belly a fair bit in itself.
Lay in each position for a few minutes each, and then do them again.

The above exercise should be undertaken whenever you think of it during the day - and can do it. Cut the stick down to about 1m in length - and lie on it in bed, overnight as you sleep.

Instead of STRETCHing out the problem, DENT it out.

Once you've got used to resting on the stick - build on DKRENIK's 'foam cyclinder' idea - and start going back and forth on the stick.

After this, to also help the knee, use the same idea - this time KNEELING on the broomstick. With hands on the ground, ankles straight, place the groove right under your knee-caps on the stick (both at once), and work towards taking your hands off the ground - kneeling up straight - putting your weight into the stick - relaxing the muscle under the knee-cap - letting it sink in, just like the IT Band. This is the quadriceps, and will help the knee pain!

The final stretch I would recommend for whenever anyone finishes a ride (or run), is to immediately take their shoes off and kneel - knees together, feet together, bum on feet - this stretches the muscles around the knee, putting length back into them immediately - while the muscle is still warm, and at its prime to be lengthened... maintaining your muscles!

The other thing you might really like to look into is getting some DEEP TISSUE MASSAGE done on them - this is basically what the stick is achieving - but once a week the massage would be most beneficial.

Some ‘just in’ good news is - my physio told me today that AFTER JUST ONE WEEK my friend (triathlete mentioned before) is already back into a full week of running... after receiving one treatment and doing the exact same exercises as above for 7 days.

This whole message is the solution - it is now up to you...

DanP

Jhikers,

WOW, thanks for the incredibly detailed and helpful message! Much much appreciated and I get the feeling others will benefit from it too.

DanP

Another related question:

So is the issue that, once this triggers, this muscle gets tight and stays that way for days & days, therefore the massage therapy, etc. to get it to a more loose state...

Or that once one is hit with "IT syndrome" then the problem is the the muscle tightens quickly every time one begins an offensive activity like running?

Is it possible for a muscle to stay tight for such extended periods?

larry barr

I am going to try this at once. My question though is when the IT flares are we doing damage to the knee and what kind of damage if we are. I have had two knee surgeries and have given up on running due to the arthritis that is already developing.

__________________
Remember, pain is just fear leaving your body.

Jhikers

Apologies for my delay in replying, just been busy times...

The issue is more-so the first one that you put forth, like you were saying:

You exercise (train/race) - thus shortening and tightening your muscles. The muscles tighten because you have strained them... that is, used them beyond their strength and trained ability - they stay this way, tightening every session, eventually cramping or tearing.

What is a cramp?
A cramp is a warning, it is the muscle's way of saying - "Hey, that's it... I'm struggling, don't use me!"

So how do you make them not tighten?
At first you might think to do strengthening exercises so they will become stronger and not strain so much - but this will not work.
If training hard or racing, you will always go to your max or beyond. Like you said, "the muscle will get tight and stay that way". Infact, even when not training hard - just spinning, I still come home and work on my muscles - finding and feeling that they have tightened up even if just a little.
The best way to make a muscle soft again is to imagine it as a hard piece of play-doe/clay. Then roll it, mould it, round it, squish it and lean on it - until you've softened it right up, all mushy - releasing it and encouraging blood flow, at the same time putting length back in.
E.g. the exercises with The Stick mentioned last time.
THEN, you can do strengthening exercises - strain it, tightening and shortening - but then soften it back up and put the length back in with massage and stretching.

When your muscles tighten, they begin to fuse - to each other, and to the bone.

Ever had numb feet on the bike? In summer, whenever?
That's because the muscles around your shin and calf tighten so much that they compress the veins and vessels - restricting the blood flow to your feet. If these muscles were massaged and softened, they would release, resulting in much greater blood flow both to the feet, and to the muscles themselves.

( See post on: http://www.cyclingforums.com/t81697-15-2.html )



Remember:
EXERCISING is using your Credit Card
STRETCHING and MASSAGE is paying it off



YES, it is possible for a muscle to stay tight for such extended periods!

Your IT-Band would have been tight for many, many months before it finally flared. Infact, if you've hardly ever had any physio/massage etc at all in your life - then most of your muscles would have been tight most of the time - for most of your sporting career.



I would be really interested in hearing how you guys' IT-Bands are going and how you've found the exercises.

Hope to have been of some help, and will keep an eye out for any further discussion.

Jhikers

Larry, I cannot say for certain whether the ITB is doing any further damage to your knee when it flares (e.g. to cartilage/bones etc) but will look into it for you.

However, I can say that the feeling you are getting is the muscle.
The 'flare' is because it is too short and too tight.
Put length back in and unjam the muscle with the stick.
The contractile belly is shortened - pulling on the tendons, which in turn pull on the bone around your knee - causing the pain.

You will notice that most muscular pains are around joints - where the tendon pulls on the bone...

larry barr

Good advice. I have been doing the recommended stretches and it is feeling much better already. I really haven't stretched for the better part of 42 years. I guess it is never to late to start.

__________________
Remember, pain is just fear leaving your body.

turg77

I'm not sure I get this part:

- Have your bottom leg at right angles with your torso
- Then a Right Angle at your knee so the bottom half of your leg runs perpendicular with your body.

After the two right angles, wouldn't my bottom leg be parallel with my body? I just want to make sure I'm doing it right...

Thanks.

larry barr

Yes, parallel would be the more accurate word to describe the relatioship. With the right angle at the knee your lower leg would be running perpendicular to your upper leg.

__________________
Remember, pain is just fear leaving your body.