Cycling and the
outside of the knee
Pain on the outside of the knee tends to start late in a long ride, not at the beginning. The IT band itself barely stretches. The muscles pulling on it are what Jonathan can work on.
Pain on the outside of the knee tends to start late in a long ride, not at the beginning. The IT band itself barely stretches. The muscles pulling on it are what Jonathan can work on.
Lots of clinics offer to release your IT band, and most riders have spent a winter on a foam roller trying to do it themselves. It helps to know what happened when someone actually measured it.
Researchers took six IT bands from donors, with the hip muscle at the top still attached, and stretched them on a machine as far as a therapist's stretch would go. The band did stretch, but not evenly: about 4.5 per cent near the hip, and only about 1.7 per cent down the outside of the thigh, which is exactly where the foam roller goes. The researchers could not say whether even that change lasts.
For years, the explanation was that the band flicks back and forth over a bump of bone at the knee and rubs on a small sac of fluid. When anatomists looked, they found the band is fixed to the thigh bone by strong fibres, so it does not slide over it, and the sac was not there. Not in donated bodies, not in healthy volunteers, and not in people being scanned for this exact problem.
That is actually more useful to know. The band is not a strap that can be loosened. Its tension comes from two muscles that pull on it: one at the front of the hip, called the tensor fasciae latae, and your glute behind it. Muscle is something Jonathan can work on, so that is where the session goes.
Figures from Wilhelm et al., International Journal of Sports Physical Therapy, 2017; Falvey et al., Scandinavian Journal of Medicine & Science in Sports, 2010; Fairclough et al., Journal of Anatomy, 2006.
And the boundary is the same here as everywhere else on this site: if it turns out to need a diagnosis, a scan or a prescription, Jonathan will say so and point you to the person who can, rather than work around it.
Put in two numbers you already know, and see how many pedal strokes your week adds up to. This just describes your riding. It does not predict anything about your knee.
Every one of those pedal strokes moves your hip through the same small range. Your hip never fully straightens or fully bends while you pedal, in or out of the saddle, so the muscles at the front of the hip stay half-shortened the whole time. Running straightens the hip fully. Sitting does not move it at all. Cycling is the same small movement, over and over, in a position you are locked into.
There is more on each area on the body map.
Nobody is asking you to ride less. Regular sessions deal with the strain as it builds, instead of waiting for the ride where it finally hurts.
Most people who ride a lot come every three or four weeks, and more often when building up to a sportive or a big weekend. The Rhythm: cyclingSee how regular sessions work
At 5 hours a week and 85 turns of the pedals a minute, that is about 25,500 turns of the pedals, in a normal week, roughly 663,000 across a season, between April and September.
Every one of those pedal strokes moves your hip through the same small range. Your hip never fully straightens or fully bends while you pedal, in or out of the saddle, so the muscles at the front of the hip stay half-shortened the whole time. Running straightens the hip fully. Sitting does not move it at all. Cycling is the same small movement, over and over, in a position you are locked into.
Nobody is asking you to ride less. Regular sessions deal with the strain as it builds, instead of waiting for the ride where it finally hurts.
Most people who ride a lot come every three or four weeks, and more often when building up to a sportive or a big weekend. The Rhythm: cyclingSee how regular sessions work
Not necessarily. Plenty of people find it takes the edge off, and it costs nothing. Just know that you are not lengthening the band, whatever it feels like. If months of rolling have not fixed it, that tells you something useful. It does not mean you were doing it wrong.
It might be. Saddle height and cleat position come up in every serious look at this, and a saddle that is too low bends your hip further on every pedal stroke. Jonathan does not do bike fits. If it is your position, see a fitter. What Jonathan works on is the muscle your position has been straining.
Some of it. The movement is the same, but you do far fewer pedal strokes. Commuters report knee pain much less often than people who race, though that is an average, not a prediction about you. Put your own hours into the calculator above and see what your week adds up to.
Because the knee is often where you feel it, not where it starts. The pain and injury page explains that in more detail. On a bike, you are in a fixed position, moving through a small range, and the tension in the band comes from muscles further up the leg.
Possibly, and Jonathan is the one who will say so. He is not a physiotherapist, and this is soft tissue work, one-to-one. If what you have turns out to need a diagnosis, a scan or a prescription, he will tell you and point you at the right person rather than keep you on the table.
Yes. That is why the calculator asks about a normal week, not a whole year. Stopping and starting again puts different strain on you than riding steadily, and people usually notice problems at the end of a training block.
It is either your hip or your bike position. You can change the position this week with an Allen key. If that does not help, the hip is the next place to look.
Book a sessionOr start from where you are: something already hurts, or nothing hurts yet.