Illiotibial Band Syndrome – Mountain Biking Knee Injury

Anyone who’s done a lot of cycling throughout their life will almost certainly have come across some kind of recurrent or niggling injury which gets in the way of training, racing, or just getting out and having fun.

Well, I’ve had trouble over the past year with a condition called Illiotibial Band Syndrome, something which a lot of doctors don’t seem to know a lot about and so I thought it was worth talking about incase it helps anyone else in the same boat.

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The problem reared it’s head during a duathlon I took part in early last summer – a 13 mile hill run followed by a 20 mile cycle. About half way through the run the outside of my right knee started to twinge – quite a sharp little pain, like something scraping inside on each step. It seemed to hurt only on the straightening part of my stride and would come and go over time. By the end of the run it was really hurting though and I was glad to get on my bike, thinking that the lower impact movement would help.

At first it did, but after about 5 miles of cycling it was back, same again on the straightening part of the pedal stroke. Stupidly I kept going, thinking all would be fine, but a mere 2 miles from the end I felt a really sharp pain and the whole knee just locked up. I couldn’t bend or straighten it at all now and after 10 minutes lying on the side of the road I realised it wasn’t gonna get better any time soon.

After the race it took around 2 or 3 weeks to get back to normal, but on and off since then I’ve had periods when it can get pretty bad, the pain coming on after only 20 minutes of walking – similarly just a sharp pain on the outside of my right knee.

I went to the doctor initially but he didn’t have too many ideas, and only after pushing it did he refer me to a sports physio who eventually saw me and immediately diagnosed illiotibial band syndrome.

Illiotibial band synrome is something that develops when the thin fascia on the outside of your thigh tightens up, either through lack of stretching or bad foot positioning on the bike, and starts to pull your knee cap offline. The kneecap grates on the wrong parts of the surrounding tissue and starts to create the pain and stiffness that I often get.

Treatment for Illiotibial Band Syndrome is basically a long regime of really particular stretches, some of which you can find here: Illiotibial Band Stretch, and assessing how your feet are positioned on the pedals.

Some thing that can help are putting your pedals further out from the frame, ie. taking them off and putting spacers inbetween the crank and pedal to place them further out. Cleat positioning can also help by ensuring that your feet aren’t too ‘toe-in’. The heels should be as close to the crank arms as possible. And lastly, Illiotibial Band Syndrome is one of the only knee complaints that advise lowering your seat rather than raising it in order to reduce its appearance.

Anyway, I’m seeing the physio regularly over the summer so hopefully I’ll be able to add more advice as and when I get it. If you have any yourself then please leave a comment below, I’d love to hear it.

[tags]mountain bike, injury, knee, illiotibial band syndrome[/tags]


Colin started mountain biking in the early 2000s and has haphazardly, and with barely increasing skill, dragged his bike around the majority of Scotland's trail centres since then. Colin has oodles of hard earned experience in how NOT to do things - listen, be warned and don't repeat his mistakes...   More about Colin... Google+ Colin

3 Responses

  1. Matt says:

    Hello Colin! Any updates to your knee situation? I did a 15 mile muddy rooty ride yesterday and noticed a sharp pain on the outside of my left knee. It wasn’t bad during the ride, but an hour later, I almost lost my footing when my knee tried to lock up. This happened several other times yesterday and then again today. It comes and goes and I have no idea what to expect.

  2. Colin says:

    Hey Matt!

    I’ve managed to get my illiotibial band knee problems under control these days with a few particular stretches and roller moves. It still comes back every now and again, but just on and off – I think it’ll always be around.

    From what I’ve learned over the years, locking up is one indicator of cartilage or meniscus damage, but it has happened to me once when I pushed the knee too far, way beyond when it began to hurt. Usual advice I think Matt – get to the Docs and he’ll send you to a NHS physio to get it checked out.

    My illiotibial band syndrome was pretty obvious actually, once the physio pointed it out. There’s a band down the side of your thigh, but in a normal person it’s not the most obvious thing to find. In me, though, when I extended my leg, it popped out like a cable down my leg. If you see similar in yourself, it might be a good indicator!

    Good luck with it,

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