# ITBS out of nowhere, Advice?



## dutchgenius (May 29, 2012)

So I am a daily bike commuter and ride everyday barring an emergency, although my commute is only 2.3 miles each way. That being said, I have been building up my training on the weekends for some bigger summer rides and usually get in 1-2 30+ mile rides a week. The last 6 weeks, I have had 2 over 30, 1 over 40, and 1 56 mile ride... all with no leg pain. The first ride gave me some back pain (which was expected with a new bike with no fit) but I went to a PT bike fitter and got it all worked out.

Fast forward to this last weekend, where I had the 7 Hills of Kirkland metric century on Monday (metric century version, 11 hills, 4600 ft. of climbing). So I went out for a ride on Saturday of ~56 miles at brisk pace on flats (16-18) with about 2800 ft. of climbing. After about the 35 mile mark, I start to feel a bit of irritation in the outsides of my knees. This is the FIRST time I have ever felt this while riding a bike. It is kind of annoying but manageable and I finish the ride fine. In the past, I have felt a similar pain when getting back into full court basketball (2-3 hours or so) after a long season off which I play once a week in the sunny season.

So I rested on Saturday afternoon and evening, stretched with Ibuprofen and just did nothing. Monday comes and I felt good to go. The ride was going well when I started to feel the pain again around the 33 mile mark in my right leg, and then progressively worse in my left leg later on. The last 6 miles of the ride were pretty agonizing, but were luckily all downhill from there. I took Monday off from riding altogether and am not back to daily commuting with minimal pain (but I can still feel something was wrong... and maybe still is). Based on my internet diagnoses, it seems like ITBS, which is fairly common.

I have a century planned for June 8th, what course of action should I take at this point? I have read it could be a clear positioning issue, but this has never happened before this last weekend, even on longer rides... and my cleats were adjusted at my fit by my PT. I just want to be sure I can get things set in time to ride pain free - the 100 miles is nothing in terms of fitness and endurance for me, but if I get this pain again mid-ride I am done for.

How long should I wait to seriously ride again? Treatment options? Do I have enough time to get right before a century? (basically 9 days)


----------



## kjdhawkhill (Jan 29, 2011)

Foam roller. Hip and glute stretches. 

9 days is probably not enough time to recover and learn management techniques before a century ride. I'm no physical therapist or MD. 

If you have bailout options, i'd say try the ride and quit when the pain becomes too much.


----------



## dutchgenius (May 29, 2012)

there are shorter distances in the ride, so there are options.

Was wondering this - on these two rides I started using a new electrolyte out of the blue in one of my bike bottles. Ended up having to pee a lot more than usual on the ride and consistently found myself with bladder discomfort as I was holding until the next stop. Any chance this could have tweaked my posture ever so slightly or raised sodium (or other mineral) levels in my muscles to cause this irritation? I am looking at any possible cause for this.


----------



## kjdhawkhill (Jan 29, 2011)

I think you are getting old and paranoid. 

If it doesn't go away in about two or three weeks with the foam roller and stretching, go see a sports MD.


----------



## Cbookman (Jul 2, 2009)

New bike and new fit? I'd lower my saddle a tad and see if that helps. It may be that you are stretching a bit too much at the bottom of your stroke.


----------



## robmac (Dec 7, 2009)

I have had IT band issues in the past, it usually comes on from a sharp increase in training. I would strongly recommend using a foam roller as one poster suggested. I would also look into your position on the bike, specifically do your knees crash inward towards the top tube? You should look into getting a bike fit and some insoles might be something to look in to. Good luck.


----------



## genux (Jun 18, 2012)

How did this turn out for you, dutchgenius? Did you find treatment and do the century ride?

I had a similar situation as you. I rode quite a bit from January - May, ramping up miles (both flats and climbs). I managed to do 3 centuries and walked away with only fatigue. However, during the AIDS/LifeCycle event (Days 2 & 3), I got a dull sensation on the outside of my left knee which gradually became a sharp stabbing pain. Classic case of ITBS, I was told. It came to a point where I could barely walk without limping.

I followed the usual advise of foam rolling + stretching, but apparently I was doing it wrong. It helped that the on-site physical therapists and sports medicine doctors showed the proper way of doing it. I was literally rolling my legs over the foam roller without stopping and waiting to allow the muscles to release the pain.

After the event (I managed to finish despite issues), I was ordered off the saddle for 3 weeks for proper recovery (mostly rest). My quads & hamstrings are excessively tight right for the past 3 weeks, but daily stretching, foam rolling, and strengthening exercises have helped.

Last weekend, I put in 40 miles on Saturday and 60 miles of flat riding on Sunday without issues. Today, I revisited my training hill and finished the ride without any discomfort. I've lost cardio fitness, though, but that's something I can work on again.

I agree the pain is extremely annoying and can get agonizing. So now, I follow a proper cool-down, post-ride regimen of stretching. Hopefully that'll help ward off ITBS for good.


----------



## tturner (Mar 18, 2012)

How did things work out for you?? 

Whenever my 44 year old body starts acting up I, stretch, apply trigger point therapy with my tools and take time off (usually I get some very small rides in with my little girl). I do this until my symptoms are gone then I give it 2 days for good measure.. that works for me anyway. I have yet to develop over use issues that have kept me off the bike for more than 10 days. 

I wanted to share a video that an advocate of MassageBlocks.com recently created specifically targeting IT Bands with Trigger Point Therapy. These tools do work in our opinion better than rollers as they stay put (see genux comment) and really dig into the IT Band without having to balance in awkward positions that can limit the time you stay applying therapy. 

MassageBlocks.com - IT Band Trigger Point Therapy


----------



## vagabondcyclist (Apr 2, 2011)

Some good stretches and foam roller, etc. exercises for your legs, hips, and knees--parts 2-7 can be found here. 

There's text-based instructions and videos demonstrating the techniques.


----------



## dutchgenius (May 29, 2012)

update - sorry for the late reply.

So I went with the following regimen:

rolling pin everyday
yoga (when I had time)
stretching everyday
got my pelvis adjusted
got my muscles stripped 3 days before the ride

During the ride I went with a healthy dose of Ibuprofen (500-750 mg every 4 hours)and wore IT compression straps on both legs. I completed the entire ride in around 11:30 actual ride time, averaged 17.7 mph for the entire 204 miles. Legs felt good all the way through the end and I was pulling the entire group for the last 30 miles, mostly 21+ mph.

Hands ended up hurting worse and I had no hand strength for about a week. overall though, it was worth it and I am taking a different approach to my legs now. Advil during rides with plenty of rolling, stretching, yoga, and seeing the chiro often.


----------

