How is your IT band? + Leg Pain

This is a new, updated version of an old post responding a question about IT-Band Pain. I have adjusted the content to be more general to leg pain common to cyclists and endurance athletes generally. 

It is OK to get Help! 

Try some of these modifications and ideas but it is rarely a bad idea to go see a local, trusted practitioner who has helped you or similarly athletic friends – this could be a Physiotherapist, Chiropractor, Osteopath, Massage Therapist, Kinesiologist or another practitioner. These sessions can provide some ideas for reducing pain now and progressing back to your sport gradually. There is also a benefit to talking to someone about your concerns and likely in having therapeutic touch/massage.  

How Did It Start?

• Consider things you have done that are in excess of your usual or very different in terms of volume or intensity (ie. did you do a really long ride? or Lift really heavyweight?) 
• Read: Are you Training to Much on the SmartAthlete Blog
• Your Training Log can help (ie. Training Peaks? or something in one of those wearable watches?) 
• Position? Did you change the position on your bike (and then do something listed above?) Be cautious with changes to your position/movement by reducing the volume/intensity. A New position, bike-part, whole bike, cleat/pedal setup (or old parts) can be part of the issue! 

Listen to Greg Lehman talk about pain science on the Consummate Athlete Podcast and how psycho/social aspects can influence our pain sensation

Rest – Sometimes We Don’t Need to do anything! 

• While it is tempting to roll, stretch, ice, get a massage, get chiro, get supplements, get cremes, get braces … sometimes we just need rest and to leave that ‘hot’ area alone. 
• Can you (have you) take a few days to let your body recover? Often we can treat our pain and soreness with adequate rest. This can be completely off day or even just a day (or three) where you do a different type of activity or movement (ie. swimming or pilates instead of cycling).
• Move differently is a solution sometimes but complete rest (again) can be under-appreciated. Dr. Stuart McGill in his books (including ‘Back Mechanic’) discusses how surgery often ‘works’ because we are forced to take time off. If you have an ongoing/chronic issue consider a ‘fake surgery’ where you skip the scalpel and just take 2 weeks off before gradually easing back into your sport. 

Change Something

As a Registered Kinesiologist, I love the idea of foam rolling, stretching and movement but we need to be careful thinking we can spend enough time stretching each day to compensate for hunching over our desk, bike and dinner plate and also need to be careful thinking movement is the only thing that influences pain (ie. we may just need to rest and relax!). 

Sleep, Nutrition, Lifestyle factors (stress) can all influence our sensation of pain (read more about Greg Lehman’s ‘Cup’ Analogy)

Are you doing something in your daily life you could modify? This could be a nutrition, stress reduction techniques, or more movement/posture oriented changes like a pillow between the knees or under the low back, or cruise control while driving or a walk at lunch to change up our routine, enhance digestion and reduce stress. 

‘Easy’ Habits

I like things we can do once and they are set. The Shoes we wear, beds we sleep in, seats we sit in, and options for the movement we setup (ie. book into a class or lunch massage) are ways we might shift loads and stimuli we are exposed to each day without adding another thing we have to motivate ourselves to do each day. Many of my clients have pushed ‘walking meetings’ and phone calls to get outside and move more. Often the meetings seem to go better! 

Listen to Katy Bowman talk about how ‘movement matters’ On the Consummate Athlete Podcast. Those little movements each day can add up! 

Try to Add Variety into your day – while it is tempting to say ‘stop sitting’ this is very challenging for most of us (and frustrating!) Thinking of ways to sit differently and vary position is perhaps more workable. 

• Add Variation (crosslegged, side sit, sit on the floor, squat, lunge, stand)
• Swap the side of the bed you sleep on (crazy idea right!) 
• In general, minimize seated postures, use standing workstations.
• This MovNat Flow is a great way to explore sitting Postures

WHAT TO DO WITH PAIN NOW: 

• You can ice that ‘hot spot’ to reduce pain. This is not a long-term strategy but can reduce the pain initially. 
• You can roll above and below the area (or stretch/move those areas) … try to think above and below more than right on top of the sore/painful area (give that spot a break!) Mobility Wod on Above/Below concept
• Ensure your bike-fit is suitable. Generally, front of knee pain comes from a saddle that is low or too far forward. Back of knee pain from a seat that is too high or too far back. Mark your current position then make a small change and see if its better!
• Try to avoid painful ranges/sports/movements for a few days and see if you can focus on moving in different ways. This might mean using a different bike (clueing you to a bike fit issue?) or a different sport like going for a walk, swimming, upper body strength etc.
• Your Knee alignment in the movements you do *may* be a way to influence your pain. Hip and foot exercises can help enhance your athletism, which may then also influence the knee position. mobility wod video discussing this knees out in stair climbing

If you do not have a local therapist, or you are visiting Collingwood, Ontario we can work together in person or consider a phone/skype consult. Booking is here.