ITB pain advice - looking for some help/advice

Hi guys

I’ve been having some knee pain issues recently and just looking for any advice to help remedy the problem

Nothing has changed in setup on bike , shoes or cleats. I’ve had the same setup for the last 8ish years without any issues. No matter what distance or intensity.
But recently my left knee has been hurting on the outside after 10-15km riding.
It feels ok once I’ve stopped riding. But sometimes hurts when I lay on my side with my legs together.
I’m 38 years old and have been racing/riding for Nearly 10 years without an injuries or issues.

Done lots of googling , but hard to to filter through all the info.
Does anyone have any recommendations towards what stretching etc I could do to help relieve the problem. I’ve spoken to my GP and he has a referred me to a physio. In the mean time any help or advice would be really appreciated.

Had issues with my right side and improving flexibility made a huge difference. Picture below was essentially my PT’s assignment for me. The biggest influencer was the hamstring stretch against a wall.

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Some existing comments and discussion:



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I was in the same boat last year, started having IT and knee issues out of the blue with no apparent changes to bike setup over the last ten years. Then I had to change doctors due to an insurance change. The new doctor actually measured my height for the first time that I can remember, turns out I lost about 1.25 inches, I had been setting saddle height to the same number forever, turns out it was about 3/4" too high. So check your setup. Also stretch the IT band and ice it after each ride.

Had/have similar issues with itb, mostly when running especially directly after riding.

I went to a good physio and learned a lot, but body weight exercises didn’t quite cut it. I substituted them for heavy weights 2/3 times in the gym and within 3 weeks the problem was on it’s way out


How old are your cleats? It’s possible over time (esp if it’s your dominant clip out foot) that the cleat can loosen and move. If you can find a Retul fitter in your area, they have an excellent method of lining up the cleat properly, as well as evaluating your forefoot position to determine if you need arch support and/or a shim. We initially put a Specialized foot bed in my shoe (which felt great) and on a follow up visit (TT bike fit), added a forefoot shim. If that doesn’t work, make sure you are strengthening your glute med and glute min. Lastly, although stretching around the ITB may help, you can’t really make a change in length of the ITB tissue itself. It’s way too thick. They’ve done cadaver studies where they hung a 50lb weight on a wet dissection of an ITB for a week and there was no change in length. What can happen, though, is the tissue gets irritated/inflammed and stuck to the lateral quad muscle and this is often a root cause of pain. Aggressive soft tissue work (myofascial release, ART etc) can help w/ that. Good luck!

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A year ago I had terrible ITB pain on my left side that started after about 45 minutes of cycling. I found these two videos very helpful and by applying their advice was able to completely resolve the issue. Obviously your results may differ, however, these are just simple techniques and no harm in trying them out. Good luck.

I started the year with pretty terrible ITB pain which seemed to mainly stem from increased training load - like you, no change in set up or actual technique. Multiple expensive physio trips later and lots of trial and error and I found that it was just extremely tight and needed to be rolled and stretched… This stretch in particular done multiple times a day - held for 30 sec at a time x 3-5 reps on each side, and lot’s of foam rolling from hip to top of knee. Plenty of people think rolling the ITB is pointless but I had great success with it (mainly to breakdown the connective tissue at knee and hip, not so much the actual ITB in my opinion).