The bridging march exercise.
Photo courtesy Michael Choate
While it is more commonly known as "runner's knee," IT band friction syndrome does not spare cyclists. Symptoms include pain on the outside of the knee, tenderness and sometimes swelling.
If you've been riding for a while, chances are you've experienced it. Here, we take a look at what exactly IT band friction syndrome is, and more importantly, how to remedy the problem.
IT pain is typically associated with prolonged, repetitive activity. But more advanced cases may cause pain when simply walking or going up and down stairs. You may feel stiff or tight after periods of inactivity and especially after prolonged sitting.
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What the IT Band Is
The iliotibial band (ITB) is a tendonous and fascial band that originates on the iliac crest (hipbone). It also attaches to the gluteal muscles (your rump) and the tensor fascia latae (TFL). The TFL is the muscle on the outside of your hip that moves your leg outward.
As the ITB travels toward the knee, it narrows and attaches to the outside of the tibial plateau (the top of your lower leg bone) with fibers also extending over to the patella. The band often feels palpably tight and can almost be strummed with your fingers on the outside of the knee.
The syndrome occurs as the band slides across the lateral femoral epicondyle, a bony bump on the outside of the femur. As your knee flexes and extends repeatedly, the band can become inflamed. During a pedal stroke, the band crosses the epicondyle once on the down stroke and again as the knee flexes back to the top of the stroke.
If you consider a cyclist pedaling at a moderate cadence of 90 rpm, that would equate to 180 slides per minute. On a two-hour ride, the ITB will cross the knee 21,600 times!
Many factors can contribute to the problem. One is muscle imbalance, where some muscle groups are tight and others are weak or fatigued. The basic cycling position can feed these imbalances.
Tightness, or a loss in flexibility, can occur in the hip flexors, hip abductors and internal rotators. Correspondingly, it often helps to strengthen the hip extensors, abductors and external rotators.
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