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ITBS - How Long(19 posts)

ITBS - How LongKristin
Sep 19, 2001 11:35 AM
Appearantly, 2 days is not enough healing time. Even if your gonna spin easy. I'm glad my friends were patient with me last night. They said 7 days - no leg intensive cardio stuff. How long do you other ITBS suffers need to rest? Should I see my cyclist Dr. about this or can I self treat?

Pedaling one legged really exploits your stroke weaknesses. And that loud Campy freewheel doesn't help! I really need to work on smoothing out the top of my stroke. :-)
fyi, a web siteDog
Sep 19, 2001 11:53 AM
http://www.ridefast.com/ctscafe/articles/misc/successfultreament.htm
It's up to youmr_spin
Sep 19, 2001 11:54 AM
There was a post several days ago about patellar tendonitis which is similar in many ways to ITBS. At least for treatment.

Basically, it takes time to heal. And yes, 2 days is not enough. You didn't say how severe it was, but from my experience, it's more like 2 weeks. You can help by icing and stretching it, and wearing a knee brace, but whether you can ride on it or not depends on how much you can take the pain.

If you've never seen a doctor about it, you definitely should. And definitely make sure it's a sports medicine specialist, not just an orthopedist. They'll probably prescribe PT.
I'd say severeKristin
Sep 19, 2001 12:11 PM
The pain is towards the bottom outside of my left knee--where the IT Band meets the tibia. I'm a little worried about tearing, but I don't think this is the case because the pain began gradually on Saturday. Usually tearing is accompanied by a sharp onset of severe pain.

When I'm cycling, the pain is horrible at the top of the stroke (left knee at 90 deg.) and better at the bottom. When I tweak it, the pain is immense--I have to get off that leg. Then it feels better quickly. When riding, if I unclip and rest that leg on the chainstay, the pain subsides. Saturday afternoon the pain was so bad that I considered cruches. It really hurt--even just walking around. I stayed completly off of it on Sat. evening and Sunday and it felt fine.
Mine hurts just reading about itmr_spin
Sep 19, 2001 12:37 PM
Sounds nasty. If it hurts that much, you probably should see a doctor. Your insurance should cover at least a visit to a doctor. Check if it covers an MRI, too, since the doctor will probably want to do one. A lot of payors will only cover 80% of an MRI, and an MRI can cost $1000 or more. As for doctors, find out who the local sports teams go to and go there. It must be a sports medicine specialist!

When I first got it many years ago, it was actually from running. I went to a doctor, had x-rays and an MRI, and in the end, was prescribed physical therapy, which I thought was a waste of time and money after a couple of visits. But they taught me some stretches that have helped quite a bit to prevent reoccurrence.

Get a towel (I use a belt) and lie on your back. Put the towel around your foot and keeping your leg straight, pull it up until you feel the stretch. Hold for 30 seconds. Do the other leg. Returning to the first leg, turn your foot inward, pull your leg up as before, hold for 30 seconds. Do the other leg. Now turn your foot outward, pull up, 30 seconds, other leg. Turning your foot both ways stretches some of the things that are hard to get to. Finally, pull your leg across your body, and hold for 30 seconds. Do the other leg. I do this before and after every ride, and I haven't had any major IT problems since. Sometimes I get minor flareups that last a day or two, but I use my "Stick" and it goes away.

What's a "Stick?" Self-massage helps (from a partner is better!), so while you are at work or watching TV, massage it. I'd highly recommend going to http://www.thestick.net and ordering "The Stick." You want the yellow one. It's a great device for massaging all parts of your leg.
The StickTig
Sep 19, 2001 1:42 PM
I've seen them but didn't know if they worked very well. Thanks for the tip.

One question I have is do they grab hairs on your legs when rolling and massaging? Hey, using The Stick may be a real reason to shave legs! LOL
No shaving requiredmr_spin
Sep 19, 2001 1:52 PM
It doesn't grab hairs. Trust me--I don't shave my legs.
Ouch. ITBS hurts, but there's a good stretch that works.Alex-in-Evanston
Sep 19, 2001 12:11 PM
I'm sorry Kristin. I had a terrible bout of ITBS one spring that kept me off the bike for 6 weeks. I don't know how you feel walking around, but in my case, just walking up stairs was very painful - and frustrating.

Unless you're completely covered and have no out of pocket for the visit, skip the doc. Their advice will be to let pain be your guide, and take an Alleve every morning. After spending $340 for a visit (and getting the above advice) I poked around a bit on my own. Below is what alleviated my ITBS, and has kept it away for two years.

First of all, stretch every day. If you have a desk job, you can do a very effective ITB stretch in your chair. Cross your legs like a man (ankle resting atop the opposite knee) and lean forward with a straight back. You will feel it in a very localized point in the hip of the crossed leg (that's where the IT band starts). It will hurt in a good way. Hold the stretch for a minute or so, or until you feel it loosen. Switch legs and repeat. This stretch can also be done sitting on the floor or standing on one foot. Standing is my favorite.

This stretch has been very effective in curing my ITBS and keeping it away. So much so, that I think it was scandalous that my orthopedist said nothing about stretching. I don't think I'll ever go to another Ortho unless I need surgery. That's all they're good for. If I just had pain or a nagging something or other I'd see a trainer.

Anyway, hope all is well. Don't do any plyometrics until you're recovered.

Alex
For Your ITBSJon
Sep 19, 2001 12:27 PM
Kristin,

I was very prone to ITBS in my running days. As noted above, some weeks may be required to heal
the inflammation. To permanently fix the problem you have to locate and treat the cause, which
quite often has to do with your biomechanics and structural alignment. For me there were two
problems: the tibio-fibular joint itself, where the IT Band passes over, and my pelvic alignment or tilt.
A very knowledgeable chiropractor specializing in sports med. successfully treated me. I would
suggest you find and consult with a good chiro. if you can find one. The stretching advice is sound,
and should be followed. Good luck.
re: ITBS - How Longpeloton
Sep 19, 2001 7:53 PM
I would encourage you to see an orthopedic doctor who can diagnose you properly, and advice you on PT for recovery. That is really the best bet, and you know you are getting sound advice. That said, my experience with ITBS has shown me that rest is really the best medicine. Ice, and anit-inflammatories such as Advil work for me to keep swelling and pain to a minimum. Stretching is great once the flare-up of ITBS has gone past the stage of pain. If something is inflammed like your ITB probably is, stretching it is going to hurt like a sonofab@#$%, and it may irritate the bursea under the tendon. You are probably looking at a week or two before things get back to normal for your knee. It's better to take a little time now, then to push it so that it becomes a chronic problem. A surgical repair for ITBS is an unpleasant one as far as surgeries go even and the recovery time is extended. Not to scare you, it's a minor problem really that can be cured with rest. Unfortunately, that means you have to rest. You will feel better soon, but check in with a doctor to be on the safe side and to get his view on the subject.

ITBS is pretty common when training loads are suddenly increased in intensity or duration. It can also come from alignment issues like Jon Billheimer mentioned. Happens to a lot of us.
Alignment QuestionKristin
Sep 20, 2001 5:37 AM
Its funny that people keep using this word "alignment". I've puzzled over something for the past 2 months. I've noticed when riding, that my right knee tends to hit the top tube. I studied this for a bit and my right leg comes much closer to the frame than my left. Its weird. Almost as if the seat is not centered over the top tube. But it is! If my bike were a car, I'd check the allignment. But the bike "looks" fine. I've also noticed that all pain/injury occurs on my left side. I clip/unclip and weight to the left, always take off with the right foot. I'm right handed & left brained. :-)
Alignment QuestionLen J
Sep 20, 2001 5:59 AM
Is your right leg longer than you left?
Which leg did you do your seat set up with?
when you stand up and look at yourself in the mirror, is your right knee bowed in somewhat?

It may not be your bike that is "Out of alignment"!

BTW, Have you "self-diagnosed" your injury or has a doctor been involved?

Len
Alignment Questionpeloton
Sep 20, 2001 7:53 AM
Alignment is simply how your body stands and moves athleticaly in relation to balance. Ideally, your alignment allows you to be in balance and move with freedom. Often there are factors that hinder balance and therefore athletic movement. Factors that can affect your alignment might be a leg length descreptancy, or being 'bow-legged' or 'knock kneed'. Alignment is hard to generalize because it is very personal from individual to individual. There are quite a few things that can be done to correct biomechanical alignment issues to improve the balance of an individual.

It sounds like you may have some sort of leg length descreptancy, a large portion of the population does. ITBS can be aggravated by a saddle position that is too high. Perhaps your right leg is longer than your left. The left side suffers due to the saddle position being higher for it relatively than it is for the right. Your right leg may also be adapting some unusal mechanics (rotary movement of the knee maybe here?) to compensate. Perhaps a shim under your left cleat would help. It's very hard to say though without seeing you in person, and these are just guesses which could have no relation to what is going on with your knee. Orthotics can also help to take care of leg length issues by making one thicker than the other. I can't say enought good things about orthotics, especially if they are designed by someone who knows your sport. If I were you I would see a podiatrist and then a pedorthist to get your alignement assessed and dealt with. It's worth the cost to be properly aligned. Alignment is balance, and without your balance you will always be handicapped in terms of performance and injury risk.
Bingo!Jon
Sep 20, 2001 8:17 AM
"It's not about the bike." I'd now expand my advice to see a chiropractor to also include a physician
or other health care professional who is a true expert in biomechanics and movement. In addition
to an assessment which might include orthotics, etc. your spinal and pelvic alignment and balance
also need to be looked at. But regardless of the source of the problem, from your description there
is definitely some physical asymmetry that is contributing to the problem....Plus, get OFF the steroids
and stop gear mashing!! Okay?
LOL - I'm doomed!Kristin
Sep 20, 2001 8:18 AM
Okay, you're all gonna imagine me as a gimp now! I think I have a lot working against me here. I am both knock-kneed and bow legged w/a legnth discrepancy. No lie! I was born in 1970 with "congential bowing of the legs." Full leg casts (done by the Navy) from 2-6 months of age. After that, ortho shoes with bars. Didn't learn to walk till I was 2. The result. A slight bowing in my calves, knock-knees and pigeon toes. Yeah, I'm a real beauty! My left leg is .75" shorter than my right--if I recall correctly.

Hmmmm. I wonder if this would limit how much I can ever push myself on a bike. May be I can only do this recreationally.
No Limits!!Jon
Sep 20, 2001 8:54 AM
You just need some expert help in making the necessary mechanical adjustments to get you
balanced on the bike, e.g. orthotics, appropriate shimming under your cleats, etc. Where there's
a will there's a way! For many of us the bike is about pushing through limitations...though it feels
good too!
Repititive Motion..........Len J
Sep 20, 2001 8:56 AM
exagerrates any slight discrepincy.

LOL Gimp.

I don't think it will limit you if you take it into account properly when you set up your equipment (including your shoes. Some people just are harder to fit. When you get it dialed in, you will notice the difference immediatly.

Len
LOL - I'm doomed!peloton
Sep 20, 2001 9:25 AM
Makes sense. I can see the shorter left leg in relation to saddle height irritating your iliotibial band. The 'pigeon toes' can also bother an ITB when on a bike. I wouldn't worry about this limiting you too much on the bike. It's just a biomechanical issue that needs to be dealt with. I would find someone in the field of sports med in your area who knows the biomechanics of cycling, and they should be able to provide you with the resourses to solve the alignement issues that you have. It's really not such a big deal, and pretty common is sports today. A doctor in orthopedic medicine can diagnose what is going on with you. A pedorthist will create the orthotics with the input gained from the orthopedic. I don't know about a chiropractor. My personal feeling (open to debate) is that unless you take care of the muscular issues that are causing the spine to be out of alignement, then any aligining that is done will revert back to where it was due to not dealing with what pulled it out in the first place. Some people swear by them though. When you do find someone to help correct your alignment, don't be afraid to ask questions. Your own understanding will make the process faster and more effective. Over the years, I have had some people in this field who refused to do things the way I knew worked best for myself, or didn't answer questions in a way that instilled a lot of confidence in me so I pursued other options. Make sure you are getting what you want to deal with your alignment.
Run Forrest Run!! ;-) n/t53x12
Sep 20, 2001 11:53 AM