You’ve been training well and feeling strong. But on the second of two long weekend rides you feel pain along the side of your leg at the knee. It hurts like someone is stabbing you with a dagger, and it’s continuing during shorter and easier rides.
According to cycling expert Andy Pruitt of the Boulder Center for Sports Medicine, this is an ilio-tibial band injury. The IT band is a wide sheath of fibrous connective tissue that extends from the hip to just below the knee along the outer side of the leg.
Pain occurs when the IT band rubs across the knee’s bony protuberance. It’s usually brought on by a saddle that’s too high. Contributing factors are bow legs and incorrect cleat placement.
What to Do If You Have IT Band Pain
Lower the saddle. This is certainly the first step if the injury occurred after an upward adjustment. You’ve already done damage, but in some cases the pain will vanish when the saddle is restored to its former height.
Adopt a wider stance. Some riders suffer from IT band pain on their road bikes because their feet are too close together. If they switch to a crankset with a longer bottom bracket axle, the resulting wider stance helps eliminate the pain.
Bowlegged riders or those with wide hips often experience this situation. Of course, you can’t install a new crankset in the middle of a weekend tour. But you can move your cleats fully to the inside edge of your shoes. This shifts your feet outward on the pedals, widening your stance. You can also put 1 or 2 washers between the pedals and crankarms.
Take your medicine. Use an anti-inflammatory pain reliever, such as ibuprofen, according to directions. Apply ice for 10-15 minutes several times a day.
Stop riding. If the pain continues, don’t force it. IT band damage can require a lengthy healing process. By continuing to ride despite the pain, you may develop a chronic injury.
Coach Fred Matheny is an RBR co-founder who has four decades of road cycling and coaching experience. He has written 14 eBooks and eArticles on cycling training, available in RBR’s eBookstore at Coach Fred Matheny, including the classic Complete Book of Road Bike Training, which includes 4 eBooks comprising 250 pages of timeless, detailed advice and training plans. The Complete Book is one of the many perks of an RBR Premium Membership. Click to read Fred’s full bio.