Iliotibial Band Syndrome or ITBS - help

[RobMobius]

Hi there,

 

I have picked up ITBS in my right leg at the level of my knee. I think it was initially caused by running as I do (used to) a lot of trail running.

 

So I stopped running but kept riding (MTB) and the knee seemed fine. Then on the Karoo2Coast it gave me hell for the last 30km and now I just can't shake it.

 

I have rested and rehabed ( I am a biokineticist so I like to think the rehab was correct). I can now cycle and run but as soon as I up the length or the intensity even by 5 % it hits me again.

 

I am new to the cycling world. This is my first year doing the sport. From a cycling perspective is there anything I should be aware off or doing differently?

 

Thanks

 

 

[RABUBI]

Speak to Nochain, he is the ITB expert

[Brakkies Sport Fotos]

I also heard that the best is to have it "knip". ??

 

 

 

The cut is on the outside. small mark.popeye2007-11-09 01:18:19

[Thug]

I used to be a serious road runner and suffered greatly with ITB in races over 60k (ie Comrades). The cure I would recommend would be rest and specific ITB stretches. Although the operation to cut the band does work, its only recommended in extreme serious cases.

 

I have yet to have any indication of ITB pain since taking up MTB and for that matter Road riding, so I would recommend that you have your bike, shoes and cleats set-up professionally done.

 

 

[Man with no name]

Speak to Nochain' date=' he is the ITB expert

[/quote']

 

Rob, nochain is probably the one who's been chastised the most with this condition.

 

I know his knees has been a lot better since he moved to Specialised shoes using their variable insert system, which is specially designed to help in cases like this.

 

I know cyclelab stocks this, you should be able to get some from CL in CT.

 

nochain, kom praat bietjie

[THE BODY CENTRE]

RobM -- there is a new school of thinking around ITBS which suggests this discomfort is not caused by friction of the ITB over the lateral aspect of the knee, but that is rather a compression syndrome where the compressed structure is the fat pad underneath the iliotibial tract. Thus the origin of the pain, is because of lateromedial compression of that pad.

To alleviate that you can check the mobility of the whole spiral line, including tensor fascia lata, tibialis anterior, peroneus longus and especially over  the body stations at the ischial tuberosity and fibular head.

 

I would think that anything that changes this lat-med compression should change the symptoms, so presuming your cleat setup is sorted, why don't you try shift your saddle a leeeettle bit forward .. and see what happens when you up the intensity?

[4feet]

RobM - I experienced this condition during the Panorama this year and my experience is that absolute rest for no less than 6 weeks, but preferrably more, combined with specific stretching exercises have put me back on the bike with no re-occurrences. The cause though is something you need to resolve - mine was definitely set-up...I had messed with my saddle just prior to the tour and paid for it.

[Ratty]

I started running training in June as I want to do triathlons and although it didn't hurt while running, I had problems on my mtb bike.  At one point I had to walk down Jonkershoek because it was so painful.

I went to the physio and she did wonders.  Basically just stretched my ITB.  It was right up by my backside that was the worst, but yet it was the knee that had the pain.  She gave me some really good strechtes which I found really help! 

Take the others advice though and make sure your bike setup is correct.  having my saddle slightly too far back on my road bike definately aggrevated it. 

 

 

[RobMobius]

Ronelle, interesting and novel advice. I have been doing a lot of mobilisation of the TFL, glut med and lateral structures as well as eccentric training of the TFL to try and control the deceleration of the rotation of the lower limb when running. It seems to have helped for running but not riding.

 

Interestingly, since my first serious ride I have had pain and stiffness post ride of the peroneus longus especially on the fibular head and I have been sure that this is involved somehow. This seems to tie in with what you are saying.

 

I spend some time yesterday on spin bike experimenting with different positions and I had some relief moving the saddle back not fwds as you recommend. Can you explain your thinking regarding the seat position and the orientation of the spinal line?

 

[Spinnekop]

Nochain se server is week loop soek vanmore. 

[Spinnekop]

My right knee was sorted out with rest and a lot of specific streaches given by the phisio.

[Brakkies Sport Fotos]

http://www.health24.com/fitness/Stretching/16-1372.asp

 

 

 

nice reading.

[RobMobius]

Thanks for the all the advice everyone. Very lekker. I am always blown away by the sense of community on the Hub compared to other forums I am active on.

 

Ronelle I would be keen to hear more about the fat pad theory, perhaps on PM as it might be too boring for the forum?

 

[Spinnekop]

Ronelle I would be keen to hear more about the fat pad theory' date=' perhaps on PM as it might be too boring for the forum?
[/quote']

 

Not boring.......I just battle to understand Micra.......

[shade]

sorry to hear.. prepare for 3months + !  I had it, from cycling, 2005 post Double Century haunting, an overuse injury.. Spent +R2k on Physio bills,3 different physio's ! Went to see a Knee Surgeon too, they found nothing abnormal, gave a corticosteroid injection, it helped for a little while as it usually does,  used NSAIDS /Inflammatories etc.. Checked cleat setup, bike setup..  All This..

 

I could cycle, but only for 45min. easy.  Had to sit out all races.

 

Strapping sometimes help, if you really need to continue riding, but ultimately , you need to rest along with massages and stretching of the IT Band .

 

 

 

[THE BODY CENTRE]

Can you explain your thinking regarding the seat position and the orientation of the spinal line?

 

RobM - i referred to the Spiral Line, of which TFL and ITB form part. You can Google that. (Try Spiral Line Anatomy Trains as keywords) or look at this

http://www.massagetherapy.com/articles/index.php/article_id/738 for starters.

 

So any adjustment on the bike which will influence the spiral line, will influence your pain. You are welcome to mail me rust AT iafrica DOT com to talk this through. Personally i'm not so pro resting if the initial cause is not addressed. AND one can stretch all you like, without actually stretching the tight structure! So in effect just wasting your time. The fascia itself is likely to be tight here, and 'normal stretching' is not going to adequate loosen the specific tightness.

 

Ronelle2008-03-23 08:48:17