The Iliotibial Band (IT) is a thick and fibrous band of connective tissue that runs on the outside of your leg, from the upper calf, past the knee, up to the hip. This tissue (or sometimes called fascia) surrounds muscles and tendons and allows muscles to glide over each other more easily.

For cyclists, the IT band is a constant element in our pedaling mechanics, and because it’s always engaged, it’s something that is susceptible to injury. If you’ve ever experienced sharp, nagging pain on the outside of your knee, you may have something called IT Band Syndrome (ITBS). In terms of physiology, ITBS is triggered by a complex combination of rotating leg bones, tightness of the IT band, and the flexion of the knee. The condition is very common amongst cyclists, but luckily, it’s not career ending. It usually happens for two reasons and in both cases it can be relieved and/or corrected.

Overuse is one culprit of ITBS. It usually occurs when a cyclist increases their riding mileage abruptly and significantly. Similar to tendonitis, the recommended solution is to rest. A few days to a few weeks off the bike gets most people on the road to recovery. After returning to the bike, a gradual, rather than a sudden increase in miles should keep further flare-ups at bay.

Improper bike fit is another common cause of IT Band Syndrome. Specifically, cyclists should pay particular attention to their seat and pedals when evaluating their position on the bicycle. First, check the height of the saddle. One that is too high can cause the knee to stretch beyond the optimal range of motion while pedaling. As a result, the IT band has a good chance to become irritated. Next, review the saddle position in relation to the seatpost. A seat that is too far back can cause excessive reach toward the pedal. This will also cause inflammation to the connective tissue. Finally, check the cleat position. Make sure that the foot is not twisted to one side or the other where the cleat engages the pedal.

Cyclists may also want to be aware of their skeletal abnormalities. It’s not uncommon for people to have a difference in the length of their legs. Cyclists that have this issue can build up (shim) the cleat of the shorter leg.

Most bicycle shops are equipped to do proper bicycle fit. Using plumb lines and measuring angles, they can determine optimal riding positions that prevent ITBS and other injuries related to pedaling mechanics. It can be expensive, but may be well worth avoiding chronic overuse injuries.

Bike fit or rest is occasionally only part of the solution to dealing with IT Band Syndrome. Taking care of your body is also important. A regime of stretching and rolling is a great way for cyclists to stay in top form.

In addition to the common hip flexor and gluteus stretches, the modified hamstring stretch is one of the best for relieving IT band tightness/pain. Start in a standing position and cross the left leg behind the right leg. Then, bend over and reach for the left foot while leaning away slightly. The stretch should be felt in the left hip and leg. Repeat the stretch on the opposite side.

To compliment stretching, cyclists have found foam rollers to be an effective way to keep their IT bands loose and in shape for pedaling. Made of high density foam, rollers are usually 6-inches in diameter and come in various lengths. Using the roller is simple and straight forward. Lie on the roller while on your side; it should be perpendicular to your leg. Be sure to target the soft tissue between your knee and hip while avoiding the joints directly. Supporting yourself with your arms, let your weight focus on the roller while pushing yourself back and forth. Repeat the process by turning over onto your other leg. When just starting out, you may experience some discomfort. Start with a small amount of reps (5-10) and work your way up to a bigger number over time. Before you know it, you’ll be back pedaling pain free.