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Anybody who...?(42 posts)

Anybody who...?Kristin
Jan 11, 2002 8:43 AM
Anybody who....has had to alter the way you approach your sport--or had to change that sport altogether because of a physical limitation or injury. Did you have to get on a structured program? Were you able to stick to that program in order to ride? Did that suck all of the joy right out of cycling? Was doing injury management worth it to keep riding? Or not? Were you depressed?

I just had "the talk" with my trainer. Its very possible that my ITBS will never fully heal and I will need to change the way I approach cycling forever. The best level I may get to is management. The irony is that I took up cycling because I love the outdoors, wanted to be fit and HATE the gym. Now, in order for me to ride, I must be in the gym regularly...following a structured training program. I'm unstructured and would just like to ride my bike. So, I'm at a crossroads. Invest more money, and risk hating cycling in the end, or just quit now...sell my bike and buy hiking gear.
First thing, get a second opinion!Softrider
Jan 11, 2002 9:02 AM
Maybe you should see someone else about the problem. You might find someone with a different perspective or approach that would serve you better in the end.
Some good advicenothatgullible
Jan 11, 2002 10:56 AM
When I got that injury in the 80's I quit cycling, sold everything, couldn't get over it. After a 9 year break I came back and it was all healed! Guess what, that was in '97 or so. I got re-injured in 2000 and haven't been able to ride since. I was my own fault. Trying to do too much too soon. In this sport if you are prone to injury and you start training without a good base of at least 3 months of easy aerobic training, you will get hurt. At least that has been my experience. I don't know where you live but there is this guy in Colorado named Mike Leahy that practices a form of therapy called Active Release Technique. It is supposed to do miracles for injuries like this one. I live in Orlando and went to a chiropractor that was supposed to be trained on it but like anything else it depends on how much experience you have with it. It didn't do squat for me and it wasn't cheap. But this Leahy guy works with world class athletes. He actually worked with Davis Phinney a long time ago when he went through his own bout of ITBS. If you read Phinney's book(and I have mentioned this before to you, as a matter of fact I seem to repeat myself a lot when I respond to your posts)Phinney ended up having surgery for this problem. He tried everything but nothing helped. Don't know what to tell you because I myself am going through this problem. If I was able to go to the Leahy guy I would but I live in Orlando and I don't have the finances to go to Colorado,etc.,etc. Do a search for Active Release Technique and check out this stuff. And this time actually take the advice, and do something with it. Don't just ask for it. I'm the same guy that has told you about 5 times to get the Greg Lemond book on cycling because it will answer a lot of your questions. Did you get that book yet? I'm not trying to be mean, it's just that I know a few people that no matter how much advice you give them, they say: "yea, you are right" but never do anything about it.
Okay, I'm not going to be mean either,Kristin
Jan 11, 2002 11:42 AM
but I am going to be direct. I have not asked for your advice about my injury. Today, I asked for peoples personal experiences regarding injuries and their affect on sports. I am not asking you for medical advice specifically because I have already obtained some very qualified medical help. It is also not time yet for a second opinion. NO ONE has said I need to quit cycling and I am not quitting today.

I needed some encouragement as I am discouraged about an injury and the fact that I may not be able to cycle the way I'd intended. I also wanted to know how others have coped with injuries, so I could learn from them. I will listen to the advice given and make a decision as to whether I will accept, reject or follow any of it. And you should note that I have accepted a huge amount of advice from this board. In the end though, the decision is mine to make. Honestly, its my life and I have the right to reject any peice of advice given to me...whether to my detriment or gain.

I do not know why you seem to take my responses (or lack there of) so personally, but it troubles me. Your posts seem to possess and air of superiority and, quite honestly, I feel scolded when reading them. I wonder if you don't intend for me to feel small. Here's the reality, you gave me advice that was not solicited. I will recieve it in that light and consider it. I may purchase the Lemond book at a later date, but right now I have other reading on my plate.
After reading this post, I went back to your original post tobill
Jan 11, 2002 12:20 PM
try to figure out what you are after. I'm still not sure, but it's starting to sound as if you really are looking for examples of inspiration or depressing reality rather than advice.
Tall order, either way.
I think that no one in the world can help you gauge what should be your reaction to these circumstances. Some people surmount incredible obstacles, physical, emotional, financial, whatever, to follow their dreams of physical endeavor. They put on the ace bandages (for all the good that they do), apply the balm, stretch, grimace, and let it hurt every time they move (for example, football players basically become cripples). For others, these sorts of pursuits don't enter their dreams. No one can say what's right.
You have approached this activity with enough passion that I think that you should just assume you find a way until someone says otherwise. There I go with the advice, but, hey, I'm trying.
It's scary isn't it.....Len J
Jan 11, 2002 12:35 PM
when you are faced with "Maybe" losing something you care about.

It sounds like a very human respone to be discouraged. I know I would be.

Being an ENFP means that you process out loud, in reading your posts on this problem it seems like that is what you are doing. Keep it up if it helps you.

Having some detachment, I was impressed with the outpouring you are receiving on this. While maybe providing advice, people generally seem to care, and recognize that this is really hurting you, both physically & emotionally. I hope you can see the responses as the gifts they are intended to be.

This is part of your journey, you will get what you need. It sure sounds like you are doing your part. Keep at it, your tenacity is impressive.

wishing you the best.

Len
ITBS never heal?Alex-in-Evanston
Jan 11, 2002 9:16 AM
ITBS is tendonitis. I always understood this to mean that it will heal with rest. Has anybody ever heard of permanent tendonitis?

I hope your at least doing your stretches every day before you think about quitting.

Alex
As its been explained to meKristin
Jan 11, 2002 10:10 AM
For some people ITBS occurs once, is treated and heals; never to return again. For others, then Syndrome portion of ITB(S) is a plague. My athletic trainer works for my sports doctor and has worked with a number of ITBS patients...mostly runners. And she said that some people never completely get past this. The tendonitis heals, but biomechanics or years of bad habits will cause it to retun with certain activities. She has NOT said that this is my reality, just that it might be. I may be one of the unlucky who has to train very specifically and who's goals will be limited. I'm not sure how I feel about this yet...and only time will tell. She has had several runners who needed to change their life-style in order to do their sport. Then again...isn't that the very nature of sports?
As its been explained to memorey
Jan 11, 2002 10:16 AM
Kristin,
I would definitely seek a second opinion. I was told I would never lift again after my auto accident while riding my bike. I set a record in the squat just 6 weeks later.
I believe that if you want it bad enough you will succeed.
I agree with MoreyAlexR
Jan 11, 2002 10:27 AM
I wouldn't let a trainer from the gym tell me what I could or couldn't do physically for the rest of my life.

Alex
WellKristin
Jan 11, 2002 11:04 AM
She's a certified Athletic Trainer who works for my cycling sports Dr. in the Pysical Therapy Rehabilitation department of a teaching hospital. Its a little different than someone at a club. Non-the-less, I am saying I don't believe it will ever heal or even that she has said this. But she suspects that it might be something I will always need to manage. Today, I'm just beginning to consider the "what-if's".
My prejudices are showingAlex-in-Evanston
Jan 11, 2002 11:54 AM
I don't like medical-types who lay down edicts.

Alex
I hear you. And one thing I will do--Kristin
Jan 11, 2002 11:58 AM
--just this moment decided actually. I'm going to go ahead for a second opinion. For one reason: my doctor and PT's have repeatedly told insisted that I not lay off riding, even if it hurts. They say to ride through the pain until it gets severe. This seems to contradict everything else I've heard and read. I'd really like to make sure that's sound advice. Do you know of any good Sports docs in Chicago who work with cyclists?
I hear you. And one thing I will do--morey
Jan 11, 2002 12:21 PM
Kristin,
Too bad you do not live in Tampa. I know several good Orthopods who cycle and lift weights. However, Mark is originally from Chicago and may know a good orthopod. I will let you know.
I faced a similar dilemma when faced with the end of my sports career. It can be a bummer!
I hope you have good insurance.Alex-in-Evanston
Jan 11, 2002 12:34 PM
You seem to be spending a lot of money on a tendonitis problem. I would skip the doc and just rest, stretch, and ice it after every ride when you do get back on the bike.

What's the best case scenario stemming from a doctor visist? A cure? They will probably just tell you what I've told you, but for $175.

Alex
HOLY COW!CT1
Jan 11, 2002 11:00 PM
WOW!!!! "They say to ride through the pain until it gets severe"

I'd get the Hell away from these AHOLES as quick as possible. This is the most asinine advice I've ever heard.

I'm a multiple sports injury patient and have spent many hours under the knife and in the PT office and I've NEVER HEARD SUCH A STUPID-STUPID SUGGESTION!!!

I wouldn't get a second opinion, I'd get a new doctor or better yet educate yourself and treat yourself. It's obvious that you've been getting BAD advice from these incompetents. Know thyself and heal thyself. :)

good luck!!!
JohnG
Don't give up on riding!guido
Jan 11, 2002 1:50 PM
Cycling is one of the lowest impact aerobic exercises available. Doctors recommend cycling to elderly patients as therapy after heart surgery. Others have testified here that cycling has also been a key strategy rehabilitating injuries from other sports.

I had chronic pain in my right knee the first couple of years of riding. It was caused first by doing squats with barbells, then by running, then aggravated by cycling on soft sole shoes. My legs felt so good from weight lifting, I could really mash down on the pedals. But the pressure on the knee during these activities was neither gentle nor evenly distributed.

I became obsessed with cleat adjustment, perceiving that very precise toe-in or toe-out of the foot on the pedal made a difference between feeling knee pain after a ride or feeling just fine. But I continued riding hard, in competitive group situations, and the pain returned again and again.

A few years ago I slacked off from over 5000 miles a year down to less than 1000. I didn't do any other stress inducing exercise on that knee. Riding, I practiced working the crank in circles, spinning. As long as I didn't push hard on the knee, the pain did not return. Now, about three years later, not only can I spin like a monkey, but that knee doesn't bother me anymore!

So there is hope. Don't let any doctor scare you away from riding your bike!
Can you ride at higher intensities now?Kristin
Jan 11, 2002 2:31 PM
What kind of distances are you acheiving today?

Thanks!
Yes.guido
Jan 12, 2002 12:32 AM
As long as I'm able to "stay on top of the gear," that is, maintain a cadence of 90-100 rpm, I can go up a hill without hurting my legs near the joints. My heartrate goes up through lactate threshold. The legs start to scream, "Slow down!" but I keep it up as long as possible. By the top, legs hurt all over, not just in the quads right above the knees.

At low cadences, say 60 rpm slogging up a steep hill, there's an instinct to just push down really hard and recover on the upstroke. So I have to make a conscious effort, raising one leg to take some of the load off the other leg pushing down. All the different muscles and tendons between tibia and femur are working, not just the ones attached to the knee, so the knee doesn't take all the load.

Here's how Genzling and Hinault described it in "Road Racing" (Velo News Press):

"To pedal well it helps to realize that the ideal would be to continuously change the direction of the force applied to the pedal so that the force would always be perpendicular to the crank arm as it rotates. This is the artistry of cycling and it requires a long apprenticeship. The many muscles of the lower limbs must acquire two contradictory skills--that of exerting the most force possible at maximum effort and of continuously changing its direction. The rider who achieves this just tickles the pedals instead of stamping on them and losing a certain amount of power with each stroke." p.92

And, speaking of high intensity: "If you want to go fast in a 53-12, which rolls out to 9.19 meters, it's not possible to use the economical style appropriate for moderate gears, doing most of the work at the power points, and following the pedal (recovering) for the rest of the revolution. That would put too much demand on the hip extensors and knee flexors. On the contrary, you must work at powering the pedal through the complete cycle, attempting to make the effort as continuous as possible by using your toeclips (lifting the pedals) as Jacques Anquetil did." p.97

Lance Armstrong came back from cancer by learning how to pedal fast in circles, the way described above. Carmichael said in Cycle Sport mag. it puts the stress on the heart and lungs, not the legs.

Its harder to work at high cadence--burns more calories, but worth it, as Lance demonstrated pretty nicely. The off-season is a good time to learn how to pedal fast, whether on a fixed gear or spinning out in whatever gears your legs can handle easily, and just trying to maintain a high leg speed while you're putting in "base miles." By Spring, your leg muscles will be able to fire at higher rpms, and you'll be able to handle greater intensity without hurting your legs.
re: Anybody who...?DINOSAUR
Jan 11, 2002 9:25 AM
I had to stop running because of an injury. I have burstis in my right heel. I could have had surgery, which would have involved cutting out the bursa sack, cutting the achilles tendon and reattaching it to the heel bone. There was no guarantee that it would work. My injury could have stayed the same, improved, or become worse. I could have continued to run if I had kept my miles down but I started swimming and lifting weights which packed on a lot of weight and made running even more difficult. Of course this was 15 years ago and medical procedures might have changed.
I saw several orthopedic surgeons and podiatrists, several of which were runners and tried to work with me. Luckily I had cross trained with cycling and I came back to the sport, which is the opposite problem that you have. I stll experience problems with burstis and wear orthotics in my cycling shoes, without them I couldn't cycle. Part of my problem was waiting too late until I sought medical help.
I still cross train, now with a Concept2 Rowing Machine, I learned that it's good to have something to drop back to. All said an done, I wish I could still run as it takes less equipment and time. I really haven't done much to answer you question, but I'm thinking if there's a will there's a way. Don't give up the ship, I hope better advice follows..
I've read of other cyclists having bouts with ITBS and continuing, most required surgery though...now I wish I would have had surgery, looking back....
I had similar surgery in 1984 and had good results.dzrider
Jan 11, 2002 11:51 AM
The heel hasn't been pain-free, but I have been able to run enough to do marathons and a few ultras. At 53 I no longer expect running or cycling to be pain-free, it's just better than how I feel if I don't do it. The biggest adjustment has been learning to let go of the little bit of speed that I had.

Pain is often an obstacle but seldom a barrier. In time you can usually learn to get over it, get through it, or get around it. People who want to do something very badly almost always find a way to get it done.
I had similar surgery in 1984 and had good results.DINOSAUR
Jan 12, 2002 11:37 AM
My heel is just about pain free now, I could probably run if I padded it up and keep my miles down. Unfortunately at age 60, and hauling around 30 extra pounds from my running weight I have no desire to put myself through all the pain again. Looking back, if I had to do life over I would have never stopped running. However there are other ways to keep fit, when one door closes, another one opens... One big part of getting over an injury is REST, probably seals the coffin on this whole topic. No one wants to stop, but sometimes that is the only answer to allow your body time to heal.
re: Anybody who...?Len J
Jan 11, 2002 9:50 AM
Yea....in 1977 after several years of mega-miles of training & running high level marathons I developed a low grade hip & knee pain. Having a high pain threshold I ignored it & kept training. A year later the pain had increased to the point that it was affecting my sleep. I finally broke down & went to an Orthopod. After what seemed like a million tests he concluded that the cumulative affect of the years of pounding had worn away some cartilidge & was leading me to severe arthritis (SP?). I will never forget the moment I heard the words: "If you want to be walking when you are 40, you need to stiop running immediatly!" Running was my whole world, it was the one place in my life that was totally mine, my one escape. I was devestated. Depression is a mild description of what I went through.

After dealing with the grief of losing running, and getting distance from the event, I was able to realize that what I really missed was both the escape and the physical competition that went on within myself. Once I realized this, I looked for something that would provide the same thing without the pounding. That's how I got into cycling. I'm happy to report that I am now 46 and have been pain free for 24 years and yes I am still walking.

If I were you, I would probably do the following:
1) Learn as much as you can about your injury. What really caused it, what really aggrivates it, Is it riding or is it riding hard? Is it related to your bike fit or is it always going to occur when you ride? (It sounds like you are trying to understand this...good for you!)
2) Get a second oponion from a sports doctor who cycles....see #1 above.
3) Try to really understand what it is about cycling that feeds you. Is it the competition, the being outside, the physical challange, the mental challange, the exercise, the doing? If you can really focus on this, and understand this it will help you decide either what you are willing to put up with to do it, or it will help you select something else that will feed these needs at a lower risk/pain level.
4)Before you give up on cycling, you may want to try other kinds of bikes. My wife has a severe back problem and some knee damage, both of which are aggrevated riding an upright bike. However, she is able to ride pain free on a recumbent. The difference in how she sits & how she applies pressure to the pedals is enough to remove the pain. (Recumbents are much easier to ride if you learn how to spin as opposed to mash).

Good luck in your journey. Don't let it get you too down, there is a solution if you keep looking especially if you know exactly what you get out of riding.

Len
re: Anybody who...?DINOSAUR
Jan 11, 2002 10:37 AM
I had the same experience with running. My doctor said everytime I ran it was like hitting myself in the heel with a ten pound sledge hammer. It got so bad that I was almost retired from work, as we had to pass a fitness test which required running.

I found that I was an exercise junkie. I swam for years and trained on a Concept2 in a health club. It was a pain to drive to the club everyday and drag my two year old daughter and park her in the toddler room while I worked out. I was probably in the best shape of my life and had a good tan to boot. I know this is a cycling forum, but there are other ways to keep in shape, some (God forbid) are even better than cycling. Cycling has that call of the open road and the splendor of being outside...I don't know how else to describe it...
re: Anybody who...?vo2max
Jan 11, 2002 10:03 AM
You might want to check out the e-book entitled "Medical Guide for Cyclists" by Dr. Andrew Pruitt. You can buy it online only at www.roadbikerider.com (it's an Adobe Acrobat file that they will e-mail you and you can print out at home, and only costs $12.95 - no shipping, and you'll get it within 24 hrs!). There are three pages dedicated to Ilio-tibial Band Friction Syndrome, covering symptoms, causes, treatment, and what to do if the remedies don't work. I'm sure you know the symptoms, but the "Causes" section are as important to read as the "Treatment". You may find that your bike and/or cleat set-up is wrong and causing the problem. The book also has four great chapters on bike fit that may help you correct these problems (includes pedals and cleats). Pruitt offers many different remedies, and includes a last resort list to try if all else fails. If you go to the website you'll get to read an excerpt from the book (which just happens to cover part of the section on Patellar Tendonitis), and read the Table of Contents. Check it out. Pruitt probably knows more about cycling biomechanics than anyone else, and has worked with a lot of amateur and pro cyclists at his clinic in Boulder.
Good Luck, and let us know how it comes out!
re: Anybody who...?morey
Jan 11, 2002 10:18 AM
Krtistin,
I would also definitely recommend Pruitts Book.
I've had mysterious tendonitis come and go -- in my elbow, inbill
Jan 11, 2002 10:53 AM
my shoulder, once in a while in my knees. Just when I was about to conclude that it would never go away (I had tendonitis in my elbow for YEARS; related to what, I could not say), it always has. I had bursitis in my shoulder; went to one session of physical therapy, took some VIOXX, went away.
Tendonitis is inflammation. Even chronic inflammation can resolve with the proper drugs, guarding, and strengthening. I would not give up (and, I'm sorry, I wouldn't rely on a trainer to tell me to change my life; doctors don't know everything, but, you know, there's a reason why they go to school for all of those years).
not quite a direct answer butnaff geezer
Jan 11, 2002 11:25 AM
i feel sort of qualified as i have 37 sets of x-rays accumulated from all different sports and recreational activities. surgery on both knees, one ankle, shoulder and jaw.

was told by a doctor to give the game of rugby away at the age of 19 as the demands on my body were too much. respresented and was a club athelete in atheletics and swimming but needed more of a thrill so i took up surfing and especially enjoyed big waves but this love wasn't the best for my body either.

i am now 33 and still needed a physical outlet and got back into cycling after a long layoff and my body was screaming with one niggling pain after another. lower back, knees, groin shoulders, feet etc etc.

my body is a great candidate for arthritis and its onset has scared the life out of me and only through a friends advice have i taken a change and given yoga a serious try. 6 months on i feel ten years younger. more supple, balanced, stronger and i can feel my body a lot more. i cant help but say what a difference it has made for me.

if only i had been wise enough to take this on when younger. the body takes years to shape and strengthen and there are forms of development which are not right for some.

slow and steady wins the race. i hope that you dont have to part with your bike and i hope you seek the advice of a doctor that has specialty with atheletes. i know its hard to hold back but when dealing with accumulated injuries it takes great patiance and restraint.

good luck
re: Anybody who...?harlett
Jan 11, 2002 11:33 AM
kristin.i've seen it take 6 months for runner friends to come back from a severe itbs injury-- 4 to 6 weeks for more minor injuries-- one of the worse things you can do is try and come back without being rehabilitated fully, doing that you risk itbs becoming a chronic condition--
there are lots of treatment procedures being used now.electro-stimulation, ultra-sound, cortisone steroidal, physical therapy.have you had a good conversation with your doctor about the treatments and about how your feeling now? use the minds of your physical therapist and doctor to help you through periods of doubt like this--
even with a serious injury there is life on the bicycle again, it may take some time but it will happen-- there are ways to bicycle with even an itbs recurring problem--
the friends i know that are dealing with it on a recurring basis are mostly using walt reynolds' program of stretches and exercises on a daily basis and immediately going into a rice (rest ice compression elevation) routine whenever there is the first hint of itbs pain- in all their cases they are enjoying bicycling and or running and using preventive measures that work--

depression and stress comes with injuries, it's a natural thing to be feeling-- some of the ways i deal with it are consciously trying to create a positive environment around me, making a special effort to take good care of my self with enough sleep and nutritious food and doing rhythmic exercises that help produce a calming state like meditation (yoga is a part of my daily routine)-- exercise is a release-
talk to your doctor about your concerns and that may help relieve some of these present worries--

lauren
Don't give up Kristin!Dean
Jan 11, 2002 11:37 AM
While reading Lance's book, "It's Not About The Bike" I read that is doctors gave him something like a 2%-5% (That may not be exact, but it is close) chance to live and look at where he is now. There has to be a way to let it heal then train specifically to strengthen yourself enough to ride. If you want to ride bad enough, you will!
Give up???...Look at Lance...Geof
Jan 11, 2002 12:20 PM
Keep riding... You may have to back off and let your body heal, but with proper management, wieght training, and stretching you should be able to get through this. You should also, by now, have a good idea what it is that flares your ITBS. I have a relatively mild case and ride, race, climb etc. Sometimes it sucks but others I just watch it. Get a second opinion. One of the problems is, your "trainer" may be overtraining you. If that's the case, you'll never recover. Something to think about. The best way to find out is to get more educated on training specificity and see if what you learn jives with what your doing. It sound like your just running the injury into the ground...
re: Anybody who...?gtx
Jan 11, 2002 12:20 PM
I think at a certain point you need to make a distinction between an injury and chronic pain. An injury if treated properly will usually heal in a matter of weeks. Consider, for example, that if you break your femur (biggest bone in your body) it takes 6 weeks to heal. So I would consider anything that last MONTHS to be chronic pain. Lately, it seems that anyone who complains of knee pain gets the ITBS diagnosis. As another poster mentioned, this is generally a fancy name for tendonitus, which goes away if treated properly. But if you have a nagging PAIN problem, it could be something else. (I had a horrible crunching problem in one knee earlier this year, which eventually got painful, but I made it go away with a stretching program). But for the pain issue--pain that doesn't respond to any kind of reasonable treatment--you might consider looking at this book--this guy saved me after two years of horrible back pain--after plenty of docs told me I'd never ride again (my bikes got dusty, but I didn't sell them!). His ideas are controversial, but they work for a lot of people. Good luck!

http://www.amazon.com/exec/obidos/ASIN/0446675156
re: Anybody who...?mackgoo
Jan 11, 2002 1:14 PM
Kristen, with a sports doctor and trainer it sounds like you compete. Forgive me for not knowing enough about you to know if that is the case. If that is the case in fact may be it is time to hang it up, the competition that is. Continue with cycling for the recreation and pleasure. In the end down the road you may find your condition has changed.
re: Anybody who...?BryanJL
Jan 11, 2002 1:49 PM
Hi Kristin,

I've had a few sports related injuries (several of the garden variety scrapes, cuts, bruises, etc., one broken collarbone, and three bouts of ITBS) and learned the most from the ITBS.

I've had it twice on my right knee, once on my left.
The first time, it was very frustrating--I had to back off training, especially running, but also cycling a bit too. And I was on a roll--but I had to back off, otherwise I wouldn't be able to go forward.

Mentally, the biggest challenge was dealing with not working out. I had to look at it as a mental workout and an exercise in discipline--if I started running or cycling, the ITBS would flare up.

I stretched frequently, especially hamstrings and gluteus muscles. I iced every night for 20-30 minutes.

It wasn't long before I could cycle (easily) again (about 2 weeks). I gradually got back into it. It was likely brought on by overdoing it in the first place-too much too soon.

When it happened the second time, recovery was faster because I knew what to do--stop activity immediately, stretch and ice a lot.

The third time, I slowed down a bit, but had a 50 mile race on the horizon. I iced, stretched, and eventually rode through it. I am not sure if I became numb to the pain (which was never very bad anyway, but definitely present) or if I overcame the condition--but I completed the race with no problems, and the ITBS calmed down.

Nowadays, I am more in tune with what will cause a flare-up for me (which is likely what caused it in the first place):

Sudden increase in resistance (i.e. doing tons of hard gears up hills, or ILTs, etc) without stretching after, and taking it easy for a day or two afterwords;

Running more than 6 miles (this tightens my hamstrings/glutes, which tightens the band) without a proper build-up.

I can almost feel it if it's getting close to getting too tight--and I make sure to back off or stretch, or both. For me, it has been a lesson in the importance of stretching (which I always did, but not enough), and in building strength slowly but surely.

I was told by a few sources (doctors, books, trainers) that weak quadriceps (and adductors) can exacerbate the ITBS problem, so I have made sure to strengthen my quads as part of my routine.

Whenever I am unable to workout, I always think of my workout as focusing on resting to get better--I have to rest as hard (if not harder) than I work. My mantra for the past few months has been "Work hard on the hard days, easy on the easy days, and make sure to know the difference." I was inspired by trainers who said that a common training mistake is that we don't go hard enough on hard days and we don't go easy enough on easy days. So, I'm working on that.

Good luck working through this. The mental pain is worse than the physical in my experience. But I think it has made me stronger.

Bryan
re: Get second, third, fourth opinionTurtleherder
Jan 11, 2002 2:14 PM
Three years ago I had a problem with my right knee. On the inside, at the joint, I developed a large bruise that came from internal bleeding from the inside of the knee out to the skin. I went to an orthopedic who specialized in sports injuries. He told me I had a tear in the cartilage and needed surgery. I had waited long enough that there was no more pain in the joint and decided to try a more conservative approach. I took anti-inflammatories, took it easy and then picked up a book on cycling medicine. The book advised a different set up that seemed counter intuitive, less float and set the cleats so your toes point slightly inward. Guess what? Problem solved! No surgery and my knees feel great. I have my doubts about the original diagnosis and believe it was more of a muscle tear than a cartilage problem. Get a second opinion to be sure of the real cause of your injury.
heh, it's always amusing to see the # of resposes...dustin73
Jan 11, 2002 2:40 PM
to Kristin's posts. not that there's anything wrong with that.
Your real problem is that you didn'tDCP
Jan 11, 2002 3:24 PM
spend enough time and do enough research to enable you to buy the right bike!

Just a joke - hope it made you laugh
Just take it easy.Leisure
Jan 11, 2002 5:32 PM
Not just physically but mentally.
Physically first: While muscle growth is stimulated by high loading in short duration, tendon and ligament growth are stimulated by light, smooth repetitive loading over long periods of time. The lesson is that as an athlete you can follow specialty workouts that grow incredible muscles really fast, but that you're tendons and ligaments will not necessarily develop in complementary amounts, and will end up being overloaded and injury prone. In college I had tons of fellow weightlifters that would get assorted injuries lifting the same sorts of weights I did who wondered how I never got hurt. Blind luck that I was so lazy perhaps, but everytime I began feeling joints getting irritated I would back off the loading a bit and focus on light weights and slow, super smooth repetitions. Tended to work, even though I often plateaued and my buddies accused me of not working very hard. My witchdoctor rationale was that I needed to keep things moving but not overloaded, and make my reps really smooth to avoid more tendon/ligament damage. I ended up being stronger than any of them. It was pretty cool to later learn in biomechanics and physiology classes that I happened to be doing the right thing all along.
Your situation is a bit different, because you're already injured whereas I was trying to avoid it, but the tissue dynamics will be the same. By doing light, low-impact workouts consistently over a long period of time, you should be able to rehabilitate. If you want to be unstructured and just ride, you can probably do exactly that, just go a significantly lower intensity. I suggest consulting with a dedicated and *recently graduated* physical therapist, or one in academia that's up to snuff on the latest research, to get the best advise for your specific situation. A lot of what I'm saying here was actually preached against as recently as 10 years ago; there's a lot of obsolete medical rhetoric that gets thrown around because "someone else said it 50 years ago" and ethically noone wants to attempt researching what happens when you go against "medical" dogma. That's why you shouldn't expect your trainer to be the final authority in the matter, even though s/he undoubtedly means well. Or even the doctors that are advising you to keep pushing until it really hurts. That sounds like it's going too far the other way.
Now mentally: don't feel any particular rush to get fully rehabilitated next week, or get this sense of panic that it's all over if you don't. Give it plenty of time, especially since tendon and ligament repair takes more time than it does for muscles anyway. Think about it: chances are, the best rehabilitation is to take casual rides. You can sit back and enjoy the scenery and be comfy knowing that you're doing the best thing to heal. Can that possibly be a bad thing?
I did not want to respond, butO
Jan 11, 2002 8:24 PM
I do not like people to know that I have a carbon fiber Aorta valve, because I am usually treated differently after someone learning about my disorder. I am supposed to be on beta-blockers, which if I did take them would exhaust me. Since my surgery I have gotten stronger and stronger. I have never raced before, but would now consider myself in cat. 3 shape. I am going to (probabaly) try racing this spring. I stopped taking the blockers because not only was I exhausted much of the time, but their overall positive effects are hypothetical. My opinion on the subject is that I would rather lead a (possibly) shortened yet fuller life, than a longer life of grogginess. Plus, no person knows what is going to happen in the future. Be well.
re: Anybody who...?4bykn
Jan 12, 2002 8:47 AM
Kristin, I don't have much advice to offer, but I do offer a bit of support. My physical condition is almost the opposite of yours. My ortho surgeon has told me I need to ride, and now it sometimes feels like a chore to get on the bike. If you do continue to ride, and your goals are just to ride for fun and health, feel free to head on down for a nice recreational-type bike ride. No competitive stuff here.
Maybe a more casual approach.non-sprinter
Jan 13, 2002 7:16 AM
You may be going about cycling too serously. I'm a competitive rider, but I don't think go about it with as much worry as you do. but it is good to talk. For some that is how, they get through their plateau. About your problem, don't make drastic decisions yet. Don't invest more money, than you have to, also don't sell everything either. Just ride the best, that you can. If you're doing that, then it is fine. Don't get on yourself about your limitations, whether they were inherited or inflicted, injuries are just that limitations. We would all love to have the flash, flair and sprint of a Cippolini, the cardio of an Indurain, and mental drive of an Armstrong all in one, but we are not allowed to choose our genes nor our futures. All these men have problems. Lance has a bad back. Mario can't climb, because of his musclature, and Indurain had problems with his big size. We just make do with our limitations and exploit our strenghts. Cippo, Indurain and Armstrong did!
re: Anybody who...?RayBan
Jan 14, 2002 6:38 AM
Kristen, I've had ITBS if you mean Illitibioal band syndrome, I've had arthroscopic surgery which resulted in a loss of muscle strength requiring a shim on a cleat for a season to offset the muscle balance, I've had hip pain that required physical therapy. The point is it was all temporary, and DID improve/heal. A strong dedication to improving, getting stronger etc will get you thru it.
As far as ITBS goes, its usually caused by overuse (too much too soon) and since it is January in the midwest, I really think this is the best time to be working thru an injury. This is base mileage easy riding time for a lot of us. Don't be discouraged, everything happens for a reason and nothing is permanent. Have a positive attitude and you will be riding pain free when it counts!