Knee pain on outside of right knee

Hello Dr. Asplund,
 
I was reading information about IT band injuries on roadcycling.com and was hoping you could share your expertise on how to prevent/treat a knee with pain in the IT band.  What stretching exercises do you recommend?  Should I apply a cold pack after cycling?  The pain is triggered by doing uphill climbs, which I enjoy doing, so any advise would be much appreciated.
 
Thanks,
Carey

Doctor Asplund Answers..

Carey,
 
IT band tightness can be caused by a couple of things - the main reason people get ITB tightness and pain is weak hip abductor muscles (muscles that move leg out to side)...working on abductor and external rotator exercises will help that.
 
Since yours is only one sided, perhaps there is a leg length discrepancy or flaw in your pedal stroke - have you had your bike fit analyzed and your pedal stroke evaluated?
 
For now, I would start with a low dose of an antiinflammatory medicine, ice, and activity modification as well as some stretching of the ITB and strengthening of the hip abductor muscles.
 
I hope this helps,
 
Chad Asplund

Cold-weather knee injuries

Good Morning,

This is a stab in the dark in hopes you might help.
 
Cycling coaches in the too-often cold and wet Pacific Northwest where I live advise any road cyclists to wear tights or other knee protection in cold weather. Without protection, the rider risks knee injury, the coaches say.
 
However, some local orthopedic surgeons insist that cold weather has no bearing on knee injury for cyclists.
 
I have ridden roughly 130,000 miles since I took up serious cycling in the 1970s and, except for a brief period at the start, I heeded the coaches' advice and, at 75 and coming up fast on 76, I have very healthy knees.
 
I have tried without success to locate Dr. Chad Asplund or any other sports-medicine authorities who have done or know of any studies supporting the need for protecting knees while winter cycling.
 
If you can steer me in the right direction, I will be very grateful.
 
All the best,
 
B.C.

Doctor Asplund Answers..

B.C.,
 
I am glad to hear that at 75 you still have good knees.
 
You are correct about your assumption.  There is no scientific basis for wearing knee warmers, tights or leg warmers to avoid knee injuries.
 
A recent systematic review of the medical literature by Pienimäki and his group out of Finland found that while musculoskeletal symptoms my be more prevalent early on in the exercise process, there was no increased risk for injury.
 
That  being said, if your knees feel better riding with warmers or tights, they certainly aren't going to contribute to knee pain and may actually may help with symptoms early on in a ride.  Also, a good warm-up will ensure that the muscles and joints are ready for exercise.
 
Hope this helps,
 
Good luck and good riding,
 
Chad Asplund

Chad Asplund is an MD and Sports medicine physician at the Ohio State University. Send your questions for Dr. Asplund to info@roadcycling.com. Selected questions and answers will be published on Roadcycling.com.