Bike Fit to Fix IT Band

For those that have had IT Band issues related to a bike fit what did the fitter do to correct? I have been suffering from IT issues for 9 months and last week I had an epiphany that maybe the bike is causing my pain and not running.

Brief history, I took two months off back in September to rehab ankle tendinitis. Doctor said I could bike and or swim, but no running. I jumped on the bike 6-7 days per week for months straight. Once I started back running my IT band started to really hurt. I never noticed any pain (only minor discomfort on the bike now) for the last nine months. Pain was only there running so I figured running was the problem.

I am stopping the bike for now until I see a fitter, which isn’t until October 1st. First available appt that worked for my schedule (he only had 3 openings in Sept). The bike is a TT bike on a Kickr. I haven’t changed my fit on the TT bike since 2015/16. I have a road bike with a more recent fit that I use to ride outdoors and I never notice any discomfort while riding outdoors.

I am currently seeing a PT and doing strength exercises, but I feel like the bike is the source of the problem, I could be wrong though. Before all of this I would ride a few days a week, sometimes two, but was mainly running after stopping triathlons in 2019.

Really asking so when I do see the fitter what should I be looking for so I know he is not steering me wrong? I have paid for 3-4 fits in the past that were a complete waste of money. Supposedly this guy knows how to fit people with all sorts of fit related injuries.

i had ongoing IT band problems at the start of this year after running an ultra (or as my kids keep reminding me: only the first half of one).
I eventually worked it out as being nothing more than a trigger point in my Tensor Fascia Latae, So it might be the case that you need to look further up the legs than anywhere near the knee.

What exercises are you doing for this regimen?

1 Like

I got a IT band bad about 15 years ago, it was like a jagged edged knife. After seeing a physio I managed it with exercises but it only truly went away when a bike fit about 8 years ago identified a leg length discrepancy needing to be shimmed. Touch wood I have never had a problem since.

Andy Pruitt recommends lowering the bike seat 6 mm for ITB issues. Has helped me in the past.

I’ve had tons of ITB issues and have even gone as far as having surgery. I’ve tried pretty much everything and have found no miracle cure. Hope you find some relief.

I take it you are meaning to reply to the OP and not my post as youve done :+1: I did find managed relief through stretching just under 15 years ago and touch wood total relief after adding a shim (saddle was lowered at the same time). Thankfully I caught it before it actually needed operating or caused irreparable damage to the knee.

I’m a PT myself and have had issues with this. Every time it was due to bike fit and most importantly cleat positioning and the lack of varus wedges under my cleats.

I think stretching and strengthening your glutes will help but if your fit is causing too much knee varus or your Q angle on the bike is not optimal it can cause lateral knee pain regardless of fixing any impairments knee your body . Have them look at the cleat position in terms of lateral placement and in terms of the angle it’s placing your hip/knee during your pedal stroke. And have them look at this in relationship to your hip anatomy and how your specific angle of patella relative to your hips is interacting with your bike.

Good luck


TLDR: In addition to bike fit, examine your entire training setup, including flat floor.

I had a similar issue where, over time, I developed IT Band Syndrome on my left side as well as lower back pain on the right and slightly curved lower back (due to muscle fatigue, not skeletal).

My bike at the time was too big (effectively a 59), which was identified during a professional bike fit. We lowered the seat (already mentioned above), shortened the cranks from 175 mm to 170 mm, and narrowed the handle bars from 44 cm to 40 cm. This helped a lot but did not entirely alleviate the problem.

Like you, I was running at the time and attributed the IT Band Syndrome and low back pain to running, so I stopped. The pain was getting bad enough that I don’t think I could have run through it but I definitely lost a lot of strength in all of those small stabilizing muscles that you don’t use while cycling.

I first saw a chiropractor, but that didn’t help. I went to one physical therapist but his goals for my rehab weren’t aligned with mine. I got a referral to another who was totally onboard with getting me back to running as quickly as possible. She gave me a lot of exercises to strengthen and stretch my glutes (especially glute med) and did a lot of deep tissue massage and one session of dry needling.

I was able to get a new bike in the proper size (54) and, while setting it up on my trainer, I realized that the springs on the DIY rocker plate had fatigued on one side, effectively causing the bike to lean. My IT Band Syndrome and low back pain were due to my body trying to stay upright while the bike was constantly leaning to the left. This can also happen on a rigid trainer setup if the floor isn’t level. (I assume you’re cycling inside at least some / most of those 5-6 days per week.) The low back pain is due to the glute med and other muscles being fatigued by contracting every waking moment.

It’s been 18 months since I last ran in earnest and have only started again this week. The IT Band Syndrome is effectively gone ( :crossed_fingers:) but I still get pain in the lower back nearly daily due to the muscles still working too hard. I can “release” it by rolling it out with a lacrosse ball (or tennis ball) against a wall. Takes about 15-30 seconds and I’m good to go. I now have lacrosse balls all over the house and in my gym bag.

Anyway, this is a lot of info. If it is in anyway related to your situation I’m happy to discuss in much more detail, including the specific strengthening exercises and stretches, as well as what I’m doing to ensure I rotate the springs on the DIY trainer regularly.

That’s a needle in a haystack right there. And so challenging for clinicians because no chance the PT could have known that!

Good on you for noticing the environment contributing and causing the condition!

Thanks. You’d think that I should have noticed it while biking and leaning to the side but I didn’t. :man_shrugging: Maybe too much suffering and cursing at the workouts. :joy:

I increased the q factor by moving my cleats to move my feet further away from the bottom bracket and installing a longer pedal axle.

Our bodies are so good adapting to external stress. To a point. Then we start to have pain kr dysfunction.

1 Like

Not sure what a bike fit is going to do for pain related to the IT band. You want to find the root cause and eliminate it. For me, I gave the IT band slack by loosening my TFL. I now include that exercise in my morning mobility exercises, and never have knee problems (due to the IT band). See this brief Kelly Starrett mwod video (I know enough to decipher it, but not sure if others will get much out of it): IT Band Hell | Feat. Kelly Starrett | Ep. 61 | MobilityWOD - YouTube

Everyone is a sprcial snowflake. Pain labeled as a syndrome can have multiple causes in different ppl. One YouTube video, or what worked for you won’t work for everyone else. Half my patients with back pain go on YouTube and come in worse because they followed some “3 EXERCISES TO CURE BACK PAIN!” That actually make them worse.

Trust me. I deal with this everyday. Yes, tightness of the TFL can play a role, but what if they have hamstring tightness or patellofemoral tightness as well? The IT band inserts on those structures distally at the knee as well. So if you fail to address those causes you could stretch or roll your ITBand all day and have limited results. Same with bike fit. You could have a loose TFL but kf your clear and shoe position places you in too much valgus it can cause it.

Yeah, that’s what Kelly Starrett says in the video. But since he published enough other info via his Supple Leopard book and videos, you can resolve the pain yourself. I literally eliminated all back pain by assembling all of his advice and following it. To date, Kelly Starrett’s advice has helped me resolve 100% of my issues (Achilles, carpal tunnel, tennis elbow, knees, neck, headaches, etc). His goal, at least for smart people, is that you can prevent the pain from even happening despite high athletic loads, which is where I’m mostly at now with my daily mobility exercises.

I like that. “For smart people”

If you’re dumb, you’re screwed.

Your response reads more like an advertisement than anything else but I don’t honestly care. If he helped you I’m glad.

I’m out.

For a lot of people, the bike fit IS the root cause. It may not have been the case for you, but that doesn’t mean it isn’t the case for other people.

Personally, my IT issues were due to weak glutes…once I got serious about strengthening them, my issues went away relatively quickly…but my IT issues were related to running, not riding. The one time (many, many years ago) that I had IT issues on the bike, a few mm of saddle drop instantly resolved it.

It totally is an advertisement (but I’m not paid for it). Kelly Starrett’s Supple Leopard book is a treasure. I wouldn’t be biking without it.

I know lots of people recommend bike fits, and lots of people say it helps, so go for it. And either you have full range of motion in your joint movement, or you don’t. Changing the bike fit won’t give you full range of motion, as by definition, you don’t have range of motion in the particular setup of the bike that causes pain (which is why I can’t consider bike fit as the root cause). I’d rather hunt for and resolve whatever is causing the pain in that particular setup of the bike so that I have full range of motion. This way my body can handle more scenarios and I don’t have to worry about my seat’s precise positioning (dropper post).

Range of motion won’t help a saddle that is too high, a reach that is too long (or short) or any number of different bike fit related issues.

Can it help some? Absolutely. But, again, “whatever is causing the pain in [a] particular setup” may just be that particular setup.