Treating My Illiotibial Band (IT Band)

Where My Pain is Located

As many of you may already know, I have been down with a bit of an injury that had been dogging me for over two weeks.

After writing a little bit about this problem, which has been aggravated by a new bike sitting in my house, I have received several messages regarding riders who have experienced knee and IT band pain.

What is the IT Band?

The iliotibial (IT) band is a tough group of fibers that run along the outside of the thigh. The gluteal muscles and the tensor fascia lata muscle attach to the top, and the lower part attaches to the tibia, just below the knee. It functions primarily as a stabilizer during running and can become irritated from overuse. Runners will usually describe pain on the outside part of the knee or lower thigh, often worsened by going up or down stairs, or getting out of a car.

For me this is the second time I have dealt with this issue, and I have found some treatments to be more effective than others. In extreme cases a doctor may use steroid treatments or procedures to deaden the nerves to make full motion more bearable.

The first stage of treatment is R.I.C.E. (Rest. Ice. Compression. Elevation). This helps reduce acute pain and allows for the second stage of treatment to become bearable.

From my experience, the most effective way of reducing this type of pain is from stretching. There are numerous stretches that can be done to reduce friction and pull on the IT band.

For some people, the location of the pain may be a symptom of an imbalance elsewhere. Knee pain may be due to an imbalance in the hip or an IT band that has tightened further up the leg.

In my recent case, the problem was a calf muscle that had tightened and started pulling on the lower part of the IT band. For this I have been doing calf stretches as well. These stretches have had immediate results.

Aside from stretching, I have also been using forms of massage to help the muscles relax. I find if I spend a little time in the shower using my knuckles to really work the leg muscles, the soreness subsides. This is probably just a good habit anyway if you are a regular athlete.

The last part of how I have been dealing with my knee issue is looking back at what happened leading up to the injury.

As athletes, we tend to over do it. We push ourselves to be stronger, faster and better. This can push us over the edge to injury. We often bite off more than we can chew.

For a few of my riding partners, I have seen them move too fast into long rides. It takes a plan and preparation to build the strength necessary to do all the rides you want to do. It takes patience as well.

For my own injury it may be a combination of factors.

First, I have not been as active after my bike broke. My fitness may have waned and then like a junkie going back to the regular dose after a stint at rehab, I suffered. I am not sure this is the case.

On the day my knee flared up, I felt a light cramp in my calf after a brisk morning ride to our scheduled meeting place. I wanted to hammer out there to get there early and have breakfast. The cramp never fully materialized and I rode 70km before the pain started in. It seems a small cramp had actually materialized in my calf and I later discovered a small ball of tight tissue that felt tender under pressure. Bingo!

I had also been riding a different bike with a different geometry that what I was used to. This may have changed how I ride and which parts of the muscles I was working.

I noticed my pedal form had changed with the borrowed bike and I needed to shift my cleats. I have always hated finding the right cleat position. I used to get all kinds of cramps as I dialed in my former position. It never felt right.

I recently learned a new guideline to find a good position for the cleat.

One Suggested Fit Method

Find the bumps before the big and little toe. Then find the center point between them. This is a good indication of where your cleat should be centered. This has helped me tremendously.

At this point my knee feels great.

I hope some of you other riders out there who are experiencing similar issues can benefit from my experience.

Unhappy Endings for the Post Ride Massage

Like a lot of people I enjoy a good massage after a long ride or when my muscles feel beat all to hell. Unfortunately, a good massage is hard to find as nobody seems to put enough elbow grease into it and it just ends up tickling. Anyways... like most people I assumed the massage was a great way to recover. It unknots muscles and flushes the toxins and lactic acids that accumulate in the muscles during exercise.

The only problem is that... it doesn't flush out anything. Or at least that is the conclusion reached by Michael Tschakovsky, an associate professor in the School of Kinesiology and Health Studies at Queen’s University in Kingston, Ontario.

"The results, published in the latest issue of the journal Medicine & Science in Sports & Exercise, are a blow, at least to those of us who justify our massages as medicinal. It turned out that massage did not increase blood flow to the tired muscle; it reduced it. Every stroke, whether long and slow or deep and kneading, cut off blood flow to the forearm muscle. Although the flow returned to normal between strokes, the net effect was to lessen the amount of blood that reached the muscle, particularly compared with the amount that flowed to the forearm muscle during 10 minutes of passive recovery. Meanwhile, active recovery reduced blood flow as well, since muscular contractions, however slight, compress blood vessels in the muscle briefly. But the overall reduction of blood flow was significantly less during active recovery than during the massage session."

Although the conclusions of the study do not dispel all claims that massage after exercise is beneficial, but it does cast some doubt on the pseudo-scientific claims associated with massage therapy. Regardless if the feelings of recovery are a placebo or related to other aspects of therapeutic massage, if it works and is enjoyable... then I don't see any reason to stop.