Frustrated (ITBS)-long

Hi ladies,
I am having a hard time and needed to get this off my chest. This winter I started going to PT for ITBS, but it wasn't cycling related (at the time). It was from me trying to run and do other gym activities (elliptical, etc). I finished by 8 sessions and continued on with the stretching and hip strengthening exercises + superfeet inserts. Things definitely got better.
I got a new road bike in Feb, had it fitted properly at the LBS. Everything was great til 2 weeks ago when the warmer weather hit and I started doing more riding. Also I got pedals with the platform on one side, SPD on the other. Towards the end of that beautiful week I was using the SPD's pretty consistently and feeling comfortable.
Then over that weekend my ITB flared up. I was stretching and doing my exercises. The weather turned bad so i rested last week for a few days. Wondered if the IT flare up was related to the SPD's, so I went back to the platform pedals. Well, after 2 rides this weekend with the platform my ITBS is worse than ever. So I have no idea if it's the pedal or not?
I tried lowering my seat, but that caused kneecap pain (too low). Is it just that I messed things up with the SPD and need to give it a chance to calm down, then switch to speedplays? I never expected the platforms would give me trouble too.
It's getting so nice out, I want this solved so I can ride...:(

I had an isolated incident of cycling-related ITBS.

History: Two running-related ITBS incidents- two or three years ago. First time ever- trail 50k on sand/hills/etc. Went away until, two months later, trail marathon on sand. Never heard from again, until:

400k cycling event a month ago. Rode very fast (fastest Century time ever) for 80 miles, then pretty fast for 100 miles, then agonizingly slowly until I was unable to continue.

Rested three weeks (only slow 30 mile rides on Saturday and Sunday only) then successful 600k ride with no ITBS.

While in pre-600k panicking mode, a physical therapist and ultracyclist advised me to do three things, if necessary, in order of severity. If the least correction fixed the pain, don't move on to the next.

1. Make sure your toes aren't pointed in, in your pedals.
2. Move cleat to inside of shoe (effectively moving foot away from bike)
3. Put a washer in between the crank and pedal to move foot even further away.

Luckily, I didn't stress my ITB, and was careful to watch my toe to make sure I wasn't pointint it in (which it wants to do naturally, on one side only.) I have Shimano 747 SPD's which are pretty float-y.

Good luck.

Nanci

Quote:

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Originally Posted by Nanci

1. Make sure your toes aren't pointed in, in your pedals.

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Earlier this year I started developing a bit of discomfort (I wouldn't call it pain, really - maybe sort of a "pre-pain" ?? ) on the outside of one knee along the IT band. I would generally notice it on rides longer than, say, 40 miles.

I changed the angle of the cleat on that shoe ever-so-slightly so that foot pointed outward a tiny bit more.

It was a very small change, but it seemed to do the trick.

Edited to add: Now, bear in mind this may have worked for me since I have a tendency to ride slightly pigeon-toed. What I'm saying it that what worked for me (for the way my feet and legs are naturally aligned) might not work for you. You may just have to experiment a little. If you do may changes, make them gradual.

You might want to have someone who knows of these things check your foot position relative to the pedals and your natural foot/leg position.

Quote:

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Originally Posted by Nanci

3. Put a washer in between the crank and pedal to move foot even further away.

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Give your PT a call and see if he/she noticed if one leg is longer than the other. Even a smidge is worth shimming the pedals.

It's also why I got Bebop pedals, they have more float than Speedplays.

I have super-grumpy ITB's (and hip flexors, and hamstrings, and weak external hip rotators, and sloppy ankles, and pronated feet, and, and, and... typical wide-hipped-woman issues). That's why I haven't even considered trying clipless. It's not worth trashing the uneasy truce I have with my hips and knees and feet.

Ask your PT to do some myofascial release and active release techniques with you. She should also be able to teach you how to do your own MFR with your iliotibial band. Don't forget the ITB continues all the way down to the sole of your foot (it "tacks down" at the tib and becomes one wall of the anterior tib compartment, then tacks down again and becomes part of the "stirrup" in the arch of your foot) so she should show you how to stretch and release it all the way down.

There is also a branch of the ITB that wanders over to the kneecap and yanks it to the outside of the groove it runs in. If the rest of the ITB gets cranky it can give your kneecap fits, too. So have her teach you how to handle that.