(Part 3 of 3)
by Dr. Jen Moehring-Schmidt, PT, DPT, OCS
IT Band Syndrome
Pain in the Iliotibial band (ITB) is a very common, and oftentimes, recurrent complaint of runners, cyclists, and triathletes. The afflicted athlete will experience pain, sometimes sharp, anywhere along the ITB, which originates on the lateral aspect of the hip, traverses the length of the femur and inserts just below the knee on the outside. Various muscles along the thigh blend into this thick connective tissue, adding to the complexity of this structure.
Weakness in the lateral muscles of the hip (the muscles that pull the leg out to the side away from the body) is usually the culprit; this causes the knee to rotate inwards and compresses the ITB against the bone, adding inflammation and pain. Scar tissue and muscle adhesions along the various muscles of the ITB can also contribute. When muscles are used extensively – as happens when cycling - the muscle fibers tear slightly and rebuild during recovery periods. Sometimes, these muscles do not recover properly and actually can become "sticky" or scarred over, inhibiting the muscle from firing properly. Releasing these muscles with deep tissue massage, active muscle release, foam rolling, and trigger point dry needling can alleviate the symptoms, as well as strengthening the muscles of the lateral hip.
With respect to bike fit, a saddle that is too low can add undue forces and compression to the distal ITB at the knee. Sometimes, a cleat-pedal system with inadequate float or with an improper angle of the foot/ankle can increase the compressive forces at the knee and/or hip.
While these injuries may be the most common, there are plenty of other reasons that keep cyclists from the perfect ride, including neck pain, hip impingement, nerve impingement in the hand/wrist, achilles tendonitis and even vascular issues in the perineal area, to name a few.
Your Keys to Cycling Success
Cycling is a sport that can easily cause muscle imbalances and postural deviations for riders of all abilities, which can eventually lead to pain and decreased health of the structures involved. A proper bike fit is very important, for some more than others, and well worth the money. Adhering to a thoughtful training plan with adequate recovery to work ratios is also imperative, especially to the serious cyclist. Regular strength and mobility training to achieve a more balanced musculoskeletal system can also help to prevent these common injuries. If you are experiencing any symptoms that are consistently keeping you from enjoying your ride, it may be time to involve a medical professional followed by a bike fit specialist. Do not allow these injuries to persist - more time dealing with these issues can oftentimes increase your recovery time and delay your return to the sport you love.
Are there other injuries you would like us to address? Leave a comment below!