Itb syndrome

Quoted post said:

Originally posted by smittycsi
I have been having itb problems for a few years .I have ben for PT
I have taken time off ,stretch 2 times a day ,nothing seems to help .i have had my bike fit ,video and laser alignment,custom footbeds.If i ride my roadbike at about 30 miles it starts hurting ,I have had to ride back on one foot because it hurt so much.What is strange is i can do a 3 hr mountain bike ride at high intensity and it does not hurt.Anybody got any ideas ? know any exercise physiologist or sports doctor in the new york area who can examine you on a bike to see if it is a physical problem or that specializes in cycling?

Hi smittycsi.

You've already answered the bulk of your own question. If you can do a hard effort on your mountain bike and this problem only exists on your road bike, you'll have to evaluate what you're doing different regarding the two different styles.

If you don't use a footbed on your mountain bike, you shouldn't need it on your road bike.

It could be your position on the bike.
It could be the nature of the road miles vs the trail miles (ie, if the 30 road miles is straight up hill).
It could be that you push huge gears on the road bike vs small ones on the mountain bike.
It could be your pedals should you have more or less float on the mountain bike vs the road bike.

Personally one of the things I find makes my ITB more sensitive is having the seat too high. Mine is usually a cm lower then my "calculated height". When you say “My bike is Professional fit”, that usually goes by norms. It's usually up to the individual to tweak those norms into what works for them. The first thing I'd do is look at the seat height vs the furthest reach of the pedal (ie, where the cranks are aligned with the seat tube) and match my road bike to my mountain bike. Then I'd ensure my fore/aft seat position was also the same using the pendulum over the knee to the pedal axle method.

I could probably list 2000 more of such points, but you'd probably be able to dismiss 1992 of them instantly.

There's a host of good information about working with ITB and other knee issues on this forum.

If what you're saying about your mountain bike is true, then you've already got the perfect benchmark. Now you'll have to figure out how to match that benchmark on your road bike.

Thanks for the reply
over the years I have messed with seat height forward back up down and tilt ,the road miles seem not to matter if i go hard or easy just seems to be around 30 miles even on a flat ride .I had some custom pedal spacers made to move out the pedals that did not work ,I have tried speedplay xpedals with alot of float and I am now on look with fixed cleat aligned by footfactors in newjersey when i di the bike fit and had the footbeds made.I have no doubt it is something with the bike or just the fact that on a mtn bike you move all over the place and on the road you dont .I am at the point wher i need to have either an exersize physiologist look at me on the bike or see if it is a muscle imbalance or something like that ,the sports doctor wanted me to take anti inflamatories that was their answer ,and no on in my area seems to know enough about cycling.what direction would you recommend to go in cycling coach ,sports medicine,exersize physiologist?

Quoted post said:

Originally posted by smittycsi
Thanks for the reply
over the years I have messed with seat height forward back up down and tilt ,the road miles seem not to matter if i go hard or easy just seems to be around 30 miles even on a flat ride .I had some custom pedal spacers made to move out the pedals that did not work ,I have tried speedplay xpedals with alot of float and I am now on look with fixed cleat aligned by footfactors in newjersey when i di the bike fit and had the footbeds made.I have no doubt it is something with the bike or just the fact that on a mtn bike you move all over the place and on the road you dont .I am at the point wher i need to have either an exersize physiologist look at me on the bike or see if it is a muscle imbalance or something like that ,the sports doctor wanted me to take anti inflamatories that was their answer ,and no on in my area seems to know enough about cycling.what direction would you recommend to go in cycling coach ,sports medicine,exersize physiologist?

Hi again.

I can sure understand your frustration given the amount of effort you've put into solving this problem. To me, the contrast that you've mentioned between mountain biking and road biking sounds too dramatic for it to simply be a "which specialist to see" issue. Rather, the problem sounds solvable from a different angle. The downfall is, you've tried so many things from the "other" angle that it makes sense you're searching for the magic potion.

You bring up one very interesting point. Many people have problems on road bikes that they don't have on mountain bikes because of exactly what you said, "the nature of mountain biking is that your position is continually changing while on the road bike you get into a zone and go". The problem on road bikes is usually any problem you have in your stroke (whether it be position related or biomachanics), you repeat over and over and over. The continued changing of position on the mountain bike keeps that repetition from happening to the same degree. In fact, many people find this problem even greater when using an indoor trainer.

If you could ride a road route with a lot of stops and sharp turns to ensure you continually change your position, you could experiment a bit and see if it changes your flare ups. If not, it would point more directly to the bike again.

One thing to check is a comparison of seat tube angles. You might be more suited to a seat tube angle that is closer to your mountain bike's frame and, hence, put you in a position that works better with your biomechanics.

Regarding the question you just asked; In Canada we have people that are called "Athletic Therapists". They have the skill set that is probably best suited to helping your with your situation. They have the medical knowledge to know what's happening inside and they can help put a program together that uses all the tools of physiotherapy including massage, stretching, and strengthening exercises (in case your ITB problem is caused by a lack of strength balance in the related areas). The main difference is that they focus on real training programs to help people that have problems in real training. Physio will often focus more on people that have lost significant function of something due to, say, a car accident or something.

Stretching alone is seldom a cure to a serious problem. But anti-inflamatories are never a solution. You take them for relief and to speed recovery but they will not fix what's causing the problem in the first place.

Good luck.

Maybe the distance between your feet on the MTB is greater than on your road bike...

Quoted post said:

Originally posted by turg77
Maybe the distance between your feet on the MTB is greater than on your road bike...

Tried that also had a set of custom pedal spacers mad up did not make much difference ,because there is about 3/8 inches difference from road to mt bike pedals distance from center

Did spacers make up the difference?

Quoted post said:

Originally posted by turg77
Did spacers make up the difference?

they did make up the difference but did not seem to help with the itb problem i tried them for 2 months .i think you can get them on internet called knee savers ,but a buddy of mine whipped them up for me in his machine shop

Quoted post said:

Originally posted by smittycsi
I have been having itb problems for a few years .I have ben for PT
I have taken time off ,stretch 2 times a day ,nothing seems to help .i have had my bike fit ,video and laser alignment,custom footbeds.If i ride my roadbike at about 30 miles it starts hurting ,I have had to ride back on one foot because it hurt so much.What is strange is i can do a 3 hr mountain bike ride at high intensity and it does not hurt.Anybody got any ideas ? know any exercise physiologist or sports doctor in the new york area who can examine you on a bike to see if it is a physical problem or that specializes in cycling?

I've been suffering with Itb problems for years and on occasion I still do. The following may be of some assistance.
Get yourself some good deep tissue massage from a good sports massuer in order to try and release the tension in your ITB's this may take a few treatments and will be bloody painful. Continue with the stretching (its essential). Self massage is also useful (I use a massage stick)

I see no problem with using over the counter anti-inflammatories in order to speed recovery but an ice pack applied to the outside of your knee immediatly after you've done your post exercise stretches provides excellent relief and quickly reduces the inflamed tissues as they are relatively close to the surface.

Whilst your body is recovering from the bruising the massuer inflicted with their steely thumbs find a level and a tape measure and make absolutely sure that your road bike is set up the same as your mountain bike, video aligment is fine but it sounds to me as though you already have a bench mark in your mountain bike.

ie. I have had to make significant adjustments to make sure the saddle bottom bracket relationship is the same on my road and mountain bike. I also changed the cranks on the road bike most roadies ride a 172.5 almost all mountain bikes come with 175's, which seem to work better for me.
In my particular circumstances muscle imbalance was also a factor cyclists are notorius for chronic muscle imbalance. huge quads puny hamstrings etc.

Hope that helps..

have you tried using a foam roller?

smittycsi said:

I have been having itb problems for a few years .I have ben for PT
I have taken time off ,stretch 2 times a day ,nothing seems to help .i have had my bike fit ,video and laser alignment,custom footbeds.If i ride my roadbike at about 30 miles it starts hurting ,I have had to ride back on one foot because it hurt so much.What is strange is i can do a 3 hr mountain bike ride at high intensity and it does not hurt.Anybody got any ideas ? know any exercise physiologist or sports doctor in the new york area who can examine you on a bike to see if it is a physical problem or that specializes in cycling?

Ditto on the foam ITB roller.

I had some serious pain due to ITBS, however it was caused by running 400s, and 1600s in track back in high school. The severity increased until I could no longer run or ride for much more than 10-20 minutes :eek:. So I saw the PT at our school and was prescribed a treatment regimen that included 4-8 minutes of heat pack before excercise, and "ice-cup" massages for 10-25 minutes immediately after. (An "ice-cup" is simply a paper dixie-cup filled with water and frozen, then torn around the top to reveal the icy massaging surface.) Each day, I was to stretch at least twice using ITB specific stretches, as well as hip, groin, glute, and hamstring stretches. This would be followed by self massage, and rolling on the foam ITB cylinder - Which yes, does cause considerable discomfort.🙁 However, after 2 months or so of closely following this treatment, the symptoms from ITBS decreased significantly.

The keys are reducing the repetitive excercise (such as spinning or road riding) that causes inflamation of the IT Band, and RICE (Rest, Ice, Compression, Elevation. Compression with ITBS consists more of massage than ACE bandaging or the like.)

As for OTC anti-inflamatory medications... Use them as needed for pain, obviously, but be aware that they do not fix the problem, they simply reduce the pain due to swelling/inflamation. Also, many of these drugs, namely ibuprofen, can put significant strain on the liver in high doses.

Good luck with your recovery, it will get better! 😉

spinner32 said:

Ditto on the foam ITB roller.

I had some serious pain due to ITBS, however it was caused by running 400s, and 1600s in track back in high school. The severity increased until I could no longer run or ride for much more than 10-20 minutes :eek:. So I saw the PT at our school and was prescribed a treatment regimen that included 4-8 minutes of heat pack before excercise, and "ice-cup" massages for 10-25 minutes immediately after. (An "ice-cup" is simply a paper dixie-cup filled with water and frozen, then torn around the top to reveal the icy massaging surface.) Each day, I was to stretch at least twice using ITB specific stretches, as well as hip, groin, glute, and hamstring stretches. This would be followed by self massage, and rolling on the foam ITB cylinder - Which yes, does cause considerable discomfort.🙁 However, after 2 months or so of closely following this treatment, the symptoms from ITBS decreased significantly.

The keys are reducing the repetitive excercise (such as spinning or road riding) that causes inflamation of the IT Band, and RICE (Rest, Ice, Compression, Elevation. Compression with ITBS consists more of massage than ACE bandaging or the like.)

As for OTC anti-inflamatory medications... Use them as needed for pain, obviously, but be aware that they do not fix the problem, they simply reduce the pain due to swelling/inflamation. Also, many of these drugs, namely ibuprofen, can put significant strain on the liver in high doses.

Good luck with your recovery, it will get better! 😉

hi guys,
does anyone have any input on cortisone injections for itb pain? is the injection put into tendon tissue or just under the skin?
thanks, dean

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