Other things that can cause IT band syndrome are alignment and bike fit. Even with good saddle height and position, problems can arise from misalignment of your feet and ankles. People who tend to be bowlegged are often more at risk. However, a more common issue is the person who tends to be a pronator, or flat footed.
Cycling isn't considered a closed kinetic chain activity. (Closed chain activities are weight-bearing exercises or activities where the foot is in contact with the ground.) However, in cycling there is a nearly constant downward force on the pedals. Although there isn't the impact associated with running, there is still a tremendous amount of room for joint movement in the ankle, hind foot and mid foot.
As downward force is exerted on the pedal, the foot pronates, resulting in associated internal rotation and abduction of the hip and knee. This creates increased tension on the ITB and a higher degree of friction.
If foot and/or ankle misalignment is an issue, the problem can often be addressed with a good set of shoe inserts. In severe cases, custom orthotics may be necessary. It is also important to ensure proper cleat placement so the knee tracks properly over the foot and pedal.
How to Fix It
Treatment of IT band syndrome includes stretching, massage and frequent icing. Although flexibility of the ITB complex isn't typically an issue, stretching can be beneficial (especially during the healing process). Massage promotes blood flow to the affected area and can minimize scar tissue formation. This can be done by a professional or by self-massage using a foam roll or massage stick.
The good news is that, often, you don't have to stop riding completely. Exercise can promote blood flow and be beneficial to the healing process. However, you probably should curb the intensity and duration until the inflammation abates. If the stress on the affected tissues can be reduced and the pain subsides, begin to increase your riding time and intensity.
If your symptoms don't improve, seek further evaluation. Lateral meniscus tears, articular cartilage lesions or arthritic changes can mimic ITB problems or may be concomitant issues. However, it is always best to catch and address the problem early. Better yet, get on a program to reduce your risk and address any factors you know may contribute to the problem.
For example, if you know you are a pronator, get inserts in your shoes now—not when the pain starts. The best prevention is by ensuring proper alignment and fit as well as being consistent with a stretching and core-strengthening program.