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 Post subject: IT band - recovery time?
PostPosted: Tue Nov 25, 2014 1:54 pm 

Joined: Sun Jun 29, 2014 1:27 pm
Posts: 59
I just got back from a knee surgeon, and he said the pain I was experiencing (only when cycling) was from the IT band. He suggested a few training things I could do for about 3-4 weeks to recover. There was no medication prescribed, I'm not in any pain. I'm curious as to whether this is going to become a permanent thing. It would suck as I really enjoy long rides, and rides with lots of climbs.

PostPosted: Tue Nov 25, 2014 3:05 pm 

Joined: Sun Oct 12, 2014 12:39 am
Posts: 15
IT bands vary a lot person-to-person.

Some people will get better with some rest, ice, and then a more gradual progression back into distance being ridden. Suggest working with a physiotherapist for that part. Bike fit can also play a huge part - has anyone fit you?

Others will require surgery.

Posted: Tue Nov 25, 2014 3:05 pm 

PostPosted: Tue Nov 25, 2014 6:08 pm 

Joined: Tue May 23, 2006 4:33 am
Posts: 742
IT band therapy is changing these days. The standard used to be to have you do a lot of foam roller work, but data have shown that this simply increases adhesions to the ITB. Physical manipulation helps, both leg manipulation and localized massage, but it has to be done right and most physical therapists aren't up to date. If you want to address it yourself, a few thoughts:

1. It's hard to stretch the ITB effectively. One can do better with someone manipulating your leg, but even so, stretching tendons isn't the real idea here. It's an unusual piece of tissue because when you stretch your achilles tendon, you are actually stretching the gastroc that's attached to it. Tendons just aren't intended to stretch that much. ITB pain is more about pressure on the muscles underneath (or pressure as the muscles hypertrophy with use) and about both irritation and adhesions that develop. However, your ITB can also get dislocated by uneven muscular hypertrophy caused by heavy exercise, and then it starts colliding with parts of the knee or hip joint in ways it wasn't intended to. That's where you get sharp snapping pain or just a popping feeling near the joints. Rehabilitative strength training to even out your leg musculature is what helps best here.

2. In cycling, wedging the cleat or the foot directly is often the easiest most immediate solution so you can keep riding, but you shouldn't depend on it entirely or the pain is likely to return. I haven't found many fitters who really can address this problem, so you might work on it yourself unless you're lucky enough to be around someone really qualified.

3. Try changing saddle height slightly. It isn't a long-term solution, but it can change the line of your ITB slightly as you apply pressure to pedals and can sometimes avoid the snapping and the pain. It gives you time to fix the problem and then adjust your saddle back to what was presumably your ideal saddle height.

4. Lots of general stretching and time in a sauna or hot tub help a lot.

5. If you are wearing tights or knickers at this point, and they have high compression, they can actually move your patella slightly so it interferes more with your ITB. Just keep an eye on it. And if you are riding in cold or wet weather, it changes your pedaling stroke somewhat, which is why you see so many extra ITB cases in the late fall.

PostPosted: Wed Nov 26, 2014 3:14 am 

Joined: Sun Jan 11, 2009 2:27 am
Posts: 11
Its a good suggestion above to check your bike fit. My pain was actually caused by having bars too level to the saddle on my cross bike which caused me to lean back when climbing having my pedal stroke 'strained' as it were. On my road bike, with low bars and weight much more forward the pain was never there.
Also spin over grinding if you like to climb - this is taking my years to get used too as I used to style my riding after Merckx when I was a kid. Take a look at old videos of him in the tour.

PostPosted: Wed Nov 26, 2014 3:45 am 

Joined: Sun Oct 05, 2014 11:51 pm
Posts: 35
1) google MobilityWOD

2) invest time in your functionality (see 1)

PostPosted: Wed Nov 26, 2014 6:47 am 

Joined: Tue Jan 14, 2014 1:00 am
Posts: 60
Recovery time can depend on how badly you hurt it. It also may never go away without certain lasting changes in riding position or riding style if it's chronic damage. With my IT band injury the main things that help me in descending order of usefulness:

Push less on the affected leg
Do not ride through the pain (when you feel that stabbing pain it's best to stop asap)
Lower the saddle height (pain usually occurs when knee passes through at 30° angle - lowering the saddle prevents your knee going through that angle so much)
Spinning not grinding (puts less strain on the IT Band - I bought myself a 12-30t cassette to go with my compact)
Rolling the IT Band (I found it helps, but only after changing from a foam roller to PVC water piping - a foam roller was just too soft to do much)
Keeping the peddling stroke straight (moving the leg around while peddling can cause the IT Band to rub, and movement occurs more readily when pushing hard)
Ride in the saddle (including at traffic lights and when climbing - riding out the saddle moves your legs around and can cause your IT Band to rub when it's most stressed)
Push through the ball of the foot (try some one-legged squats and feel which leg muscles you use - push through the ball of your foot only to try and get used to not using the IT Band to help support your leg through the peddling stroke)
Adjust leg length (not surgically of course, but check if your leg with the IT Band pain is physically longer than the other leg - if so try putting some cleat shims or an extra insole in the other side to balance them out and so the other leg does a bit more of the work)
Massage the area of pain (this helps for me and my pain, might help for you - be vigorous)
Ice + Ibuprofen after exercise (may help, probably won't hurt)

I'm planning to try plasma rich platelet (PRP) therapy to see if that helps my chronic injury. It's not really a medically proven thing but it's very, very low risk.

6.92 kg CAAD 9

Posted: Wed Nov 26, 2014 6:47 am 

PostPosted: Thu Nov 27, 2014 8:59 pm 

Joined: Fri Mar 18, 2005 4:12 pm
Posts: 2323
Location: eh?
Try all the conservative therapies but it it keeps coming back have the surgery.

The surgery is very effective and easy to recover from. I had epic bilateral IT band syndrome. I have had both knees done. The results are perfect. The surgeons I have spoken with have yet to see an unsuccessful case using current surgical techniques - triangular resection of the IT band near the femoral epicondile and excision of the bursa like tissue beneath. A surgeon in Belgium did a sample of 32 athletes with the excision only with 100% success. This suggests that removing the inflamed tissue underneath the band is the key. One idea is that the removal of this tissue simply removes the source of the pain.

My sports med is a surgery as a last option kind of guy but with ITB syndrome he is losing faith in conservative therapy and going to surgery more quickly with his athletes. My only regret was wasting time and money on a lot of physio etc.

swinter wrote:
Mr.Gib got it right

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