# IT Band Syndrome and/or IT Band Friction Syndrome



## dana109 (Jul 15, 2008)

Anyone else suffer from this. I feel like i'm too young for this crap. I'm only 29. I actually really inflammed by IT Band on an epic backpacking trip which included two >5km downhill switchback sections. Then I did a 24 hour race (team not solo but still by the third lap my knee was done) and that made it worse. I've continued training pretty hard and thought I could work through it (dumb I know). At first I had to stop at 28km, and then i could only get 25km, then 20 monday night i have to stop after only 16km of riding. I couldn't go anymore. 

I just went to a physio therapist who said it's IT Band Friction Syndrome. I'm not allowed to ride my bike for at least a week and probably 2 weeks (which sucks because I'm a Mountain Bike addict). She gave me some stretches to do, which include standing and crossing my legs and then reaching down and twisting away from the back leg (so it's my left knee and I put my left leg behind my right and touch my toes and twist to the right). I have to do this 5 times for 30 second holds with a a minute rest between and do those sets 3 times a day (morning, noon, evening). They hurt like hell. I hope they work. 

I'm going to keep doing what my physio-therapist says but i'm wondering if anyone else has any experience. I'm really getting into shape and I really want to keep this up and have a successful race season next year. Anyone else know of good tips for helping this?


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## Solrider (Aug 6, 2009)

dana109 said:


> Anyone else suffer from this. I feel like i'm too young for this crap. I'm only 29. I actually really inflammed by IT Band on an epic backpacking trip which included two >5km downhill switchback sections. Then I did a 24 hour race (team not solo but still by the third lap my knee was done) and that made it worse. I've continued training pretty hard and thought I could work through it (dumb I know). At first I had to stop at 28km, and then i could only get 25km, then 20 monday night i have to stop after only 16km of riding. I couldn't go anymore.
> 
> I just went to a physio therapist who said it's IT Band Friction Syndrome. I'm not allowed to ride my bike for at least a week and probably 2 weeks (which sucks because I'm a Mountain Bike addict). She gave me some stretches to do, which include standing and crossing my legs and then reaching down and twisting away from the back leg (so it's my left knee and I put my left leg behind my right and touch my toes and twist to the right). I have to do this 5 times for 30 second holds with a a minute rest between and do those sets 3 times a day (morning, noon, evening). They hurt like hell. I hope they work.
> 
> I'm going to keep doing what my physio-therapist says but i'm wondering if anyone else has any experience. I'm really getting into shape and I really want to keep this up and have a successful race season next year. Anyone else know of good tips for helping this?


I'm a massage therapist and I can say first off that the stretches will help, so keep doing them! There are lots of people out there with tight IT bands, and the more athletic you are the more likely you are to have it at some point, so age doesn't matter much.

If you can, find an LMT in your area who has training in deep tissue/PNF/rehab-type massage. They should know how to work your IT and everything it attaches to, plus be able to stretch you as well. Unfortunately this training is few and far between it seems, with all the cheesy massage schools pumping out 'fluff' massage practitioners, but they are out there.

Also some ultrasound might help, do they do that at your PT's office?


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## dana109 (Jul 15, 2008)

My PT did ultrasound and interference (some machine that shocked me and actually felt pretty cool).


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## Solrider (Aug 6, 2009)

dana109 said:


> My PT did ultrasound and interference (some machine that shocked me and actually felt pretty cool).


Very good that should help you a lot, but remember you have to help yourself too. The most frustrating thing to me as a therapist is someone who just comes in and wants me to 'fix them' and isn't willing to do any of the homework. Then they wonder why they aren't getting better, faster.

If you aren't afraid of needles I also cannot say enough about Acupuncture. I have chronic neck and shoulder pain from a car accident years ago and nothing helped me feel better as quickly as acupuncture did.


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## Maadjurguer (Mar 22, 2008)

I've been working around this problem for the past 16 months, but not until the last few have I finally gotten it under control. I started out going to a PT who recommended the same stretches you describe in addition to using a roller (look it up) and using ultrasound, and electro-stim. In the end...this did not allow me to do major vertical which limited my riding miles per week. 

Then recently, I went to another PT who significantly increased my stretching routine to include core exercises...but no ultrasound and no electro-stim. All in all...it takes me roughly 40 minutes a day to complete which is a pain....but my miles started increasing to the point where I just completed my first endurance event...88miles, 10000 ft of climbing with no knee pain. Previously, I was only able to ride 30 or so miles at a time with only about 3000 ft of vertical before I had bad knee pain. 

In the end...you owe it to yourself to limit the activity on your knees for up to 2 weeks while you significantly increase your stretching of the IT band, use a roller and work on core exercises (particularly those that work your side such as plank exercises). Be very diligent with these EVERY DAY. Then get back on your bike and work up to the mileage where your knee hurts...then back off a bit. Stick with your exercises and cap your biking to that mileage or just below. After a few weeks if you've stuck with your exercises and stretching....bump your mileage a bit.

Be methodical about the stretching, riding and then a little bump in the mileage. It takes time, but you've got to build a foundation and gradually build from there. Without that foundation, you will get mixed results, inconsistent performance out of your knee and painful surprises from time to time. I wasted a year of riding trying to jump my mileage....


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## MTBigSky (May 26, 2008)

dana109 said:


> Anyone else suffer from this. I feel like i'm too young for this crap. I'm only 29. I actually really inflammed by IT Band on an epic backpacking trip which included two >5km downhill switchback sections. Then I did a 24 hour race (team not solo but still by the third lap my knee was done) and that made it worse. I've continued training pretty hard and thought I could work through it (dumb I know). At first I had to stop at 28km, and then i could only get 25km, then 20 monday night i have to stop after only 16km of riding. I couldn't go anymore.


Don't worry about being too old for it because it's not something I associate with being old. I consider it a problem with those who are physically active. It's probably due to your tight IT band so keep stretching it. ITB syndrome is common in runners because of where that tendon inserts below your knee joint. The constant rubbing of that tight tendon is irritated each time you bend your knee.


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## lukey (Mar 7, 2008)

dana109 said:


> Anyone else suffer from this. I feel like i'm too young for this crap. I'm only 29. I actually really inflammed by IT Band on an epic backpacking trip which included two >5km downhill switchback sections.


Sounds familiar. My first bout with IT Band issues happened after a long downhill run. The band pulls tight with your knee at just the right angle and the heel strike is a little harder and your hip drops a little more and all the causes of friction kind of line up. With a heavy backpack and a bent knee trying to decelerate your movement downhill, same kind of thing, the force was obviously at a peak just as the band was beside the bump on your knee bones.

Basically, in practical terms I've figured out that I'm "allergic" to running. If I stick to the bike, I'm basically ok and nothing happens. For me, the bike itself won't cause a flare-up. I sometimes get a touch of soreness if I do a lot of walking, but running is one sure-fire way to have a huge problem that will be sore even after rest.

Practically all the bikers that I know that log serious distances have / can suffer from IT Band flareups, but usually it happens from cross-over activities like running or other sports. I know one cyclist who ultimately had surgery and had to drop out of cycling as a result, but she was running marathon distances and endurance biking as well.

The tricky issue for me is that I have basic fitness from riding (where I could head on out for a long run and deal with it cardio-vascularly) but zero sport-specific conditioning for running or other activities. I have had to figure out that I would need to approach other sports in a very progressive way where I very slowly build up to distances and amounts that feel like real exercise to me. Like, I can't just go off on a 10 mile run (although I can deal with the distance in terms of endurance), I need to start with one mile...the next time do more...and slowly build up (because the joints and smaller muscles are relatively untrained).


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## dana109 (Jul 15, 2008)

Thanks for all the tips. I ended up taking about a week off the bike and stretching 3 times a day and using the foam roller once a day, and 3 PT appointments. Then my PT had me test the waters with biking. So I did 10, minutes and started increasing the time i ride by 10 minutes every time i go out. I'm up to 60 minutes with no problems. I'm still doing my stretches but not as much. Just 3 stretches in a row and I'm on the foam rollers every other day. 

I guess I caught it pretty early and was able to fix it with just a week of rest and some stretches. I guess it's good to know this is a problem so i now know how to properly stretch and roll it in order to prevent it happening in the future.


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## MTBigSky (May 26, 2008)

That foam roller can be killer the first few times one uses it. I'm assuming you are on your side on the foam roll and rolling up and down


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## dana109 (Jul 15, 2008)

Yup. That hurt like hell the first few times. I've been doing it for almost 2 weeks and it's starting to not hurt as much. It still isn't the most comfortable thing i've ever done.


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## nojoke (Apr 15, 2008)

I had a similar pain when I had my broken femur at the knee. Pain 1st started during PT/rehab. I broke the big ball off the femur at the knee on the innner side. I had hardware inserted at my knee threw the joint, 5 screws to be exact. I had one on the sharp side of screws that was rubbing on my IT Band where it had poked thru the bone.....any side loading of the knee would set it off seriously. This was when I was in PT. 

At 1st the therapist didnt manual therapy, alot of deep tissue stuff, that helped. From there out I started on the foam roll for 5 minutes per session, also at home, and that helped out alot. It never totally went away till I got the screws out. The foam roll seemed to help tremendously.....I do it even after 8 months post injury just to ward off any future occurences.


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## MTBigSky (May 26, 2008)

I've used that foam roll. It hurts if your IT is tight but with time, stretching and PT it will get better. My IT band is so tight you can see it when I extend my knee. So far, no pain.


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## danahs (Nov 22, 2007)

i am having the exact same issue right now with my left knee. time to start stretching, foaming and take rest days i guess


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## dana109 (Jul 15, 2008)

get on it early. 

I forgot about this thread. After making this thread I did some stretches and felt better. I road all of last summer and fall. This year I did 2 early races in April and early may. But my IT band tightness came back bad. I haven't been able to ride my bike apart from short easy 20-30 minute rides since may. I've spent 4 months of summer not riding, and thousands of dollars on physio, chiropractor, acupuncture, massage, Active Release, and IMS. Nothing has worked and I haven't improved at all since May, and show no sign of improving. I'm not even joking when I say that recovery has been like a part time job. I often spend 2-4 hours a day either at physio, or acupuncture, or doing stretches and/or exercises. 

Anyone else had this experience? Everyone I've talked to that has had IT band problems tells me to take a week off, stretch and foam roll or get a massage or accupuncture if it gets really bad and then you'll be good. This has not been my experience at all. This has been a struggle for over a year now, and nothing works to make it better. in fact now it hurts just to do the 15 minute walk from my place to work.


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## brad72 (Jun 12, 2009)

I had IT band pain for quite a few months last year that nearly kept me off the bike. Like other have said, stretches and massage, and bit of pain really help but I also found that a correct specialized BG footbed shim under the insole helped heaps. I think I have a +1.5 in my right shoe only. My local bike fitter played with my setup and was able to fit the right size shim and the pain went almost immediately and power returned to my right leg. 10 months later and no pain.


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## mattsmc43 (Feb 6, 2004)

Would love to know some more opinions on the knee pain that has come out of no where last 2 rides? I'm no physical therapist and know nothing of anatomy really, but I've been doing some research here and elsewhere over the past week to try and see what might be causing this.

It's not a throbbing or unbearable pain, it's more of a soreness and unstable feeling - and it's just the medial side of my right knee. I would compare it to swelling, or possibly fluid build-up - and it really bugs me when I stand up and start walking after my ride. I would compare it to the feeling of when I've hyper-extended my knee in the past - you get this unstable feeling, like your knee might give out on you (make sense)?

Anyway - this just started last Saturday morning after a 2 hour ride. It wasn't really noticeable until after I got off the bike. At this time, I had not changed anything on the set up of my bike or cleats. 

Today, I went for another ride, this one about 1.5 hours - but during the ride, about 1/2 hour into it, I could feel the slight akward pain in the same spot. Prior to this morning's ride, and after doing some research on possible causes of this issue, I adjusted my cleats so that my right foot would be moved closer to the crank/bb. Also, my saddle is adjusted so that my knee is just slightly forward of the KOPS position.

I just started having this thought as I was riding and trying to pay attention to my foot position, my leg/knee, and the overall pedal stroke. Doesn't it seem that if I move my foot closer to the bb/crank arm, that this is forcing my knee to move to the outside while at the top of my pedal stroke - and in turn isn't this placing more stress on the medial side of my right knee when I come down/through the pedal stroke because my leg is not aligned throughout the entire movement; and if my foot were more to the outside, widening my stance on the pedals, wouldn't my knee stop going to the outside, and my pedal stroke be more aligned from top to bottom (I really hope this is making sense and someone can clarify this for me)? I'm not enjoying the feeling in my knee right know - not so much overly painful, but definitely awkward and annoying.

Any thoughts?


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## dana109 (Jul 15, 2008)

forgot about this thread. after over 2 1/2 years of pain and every single treatment known to man (traditional physio, IMS, acupuncture, many massages, cortisone injections), even experimental treatments (payed a lot for PRP injections), and more tests than i can remember (ultrasound, bone scan, MRI, etc...), i finally met with an orthopedic surgeon. I am currently recovering from surgery that removed the inflamed bursa on the outside of knee, and released my IT band. Extremely painful procedure but i'm about 2 weeks post-op and I can kind of walk. Surgeon is confident I will be riding my bike in late march or early april. 

After 2 1/2 years and how painful this surgery was I hope he's right.


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## kfox527 (Apr 15, 2009)

*Knee update*

Hey Dana
What's the latest prognosis? I'm on about a year of this pain in 1 knee and the other has started up about a week ago. What are the surgery results?


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## trhoppe (Sep 3, 2008)

Maadjurguer said:


> I've been working around this problem for the past 16 months, but not until the last few have I finally gotten it under control. I started out going to a PT who recommended the same stretches you describe in addition to using a roller (look it up) and using ultrasound, and electro-stim. In the end...this did not allow me to do major vertical which limited my riding miles per week.
> 
> Then recently, I went to another PT who significantly increased my stretching routine to include core exercises...but no ultrasound and no electro-stim. All in all...it takes me roughly 40 minutes a day to complete which is a pain....but my miles started increasing to the point where I just completed my first endurance event...88miles, 10000 ft of climbing with no knee pain. Previously, I was only able to ride 30 or so miles at a time with only about 3000 ft of vertical before I had bad knee pain.
> 
> ...


Old thread, but I clicked on it, as I had some serious knee pain last August.

First off is bike fit, but once that is nailed (and it was in my case and I still got overuse/IT band issues) look at the above advice. It's right on.

I started with 6 full weeks off the bike, and then started gradually building back up and doing loads of base, Zone 2 HR work with NO climbing. Took me 3 months before I was back and doing climbs. I'm now back, but if I don't stretch enough and go hard on the bike and do some hard climbs, I feel my left knee a bit, which reminds me "stretch and roll dummy".

Now stretching and rolling is part of my regular routine. I also go to a PT once every 2 weeks and get Graston and ART work done on both my quads and both IT bands. That has really helped, and best of all, is covered by my insurance at 90%, so each visit is only $10.


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