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By Lennard Zinn
Dear Lennard Zinn,
I currently suffer from iliotibial band syndrome, which tends to affecthigher-mileage runners and cyclists. It causes a pain on the outside ofthe knee due to the repetitive motion of bending the knee. There is quitea bit of info on the problem with regard to runners but very little concerningcycling. I have gone to physical therapy and received a cortisone injectionfrom a knee specialist. Not much has helped. Have you heard of this affectingother riders? If so, do you know of any potential treatment options thatI have not tried? I can give up running but not cycling. –MattDear Matt,
Iliotibial band syndrome is a huge issue for many cyclists, and I usedto be one of those suffering from it. You certainly do not need to giveup cycling. I treated mine with ice, Ibuprofen, specific IT-band stretchesand with canting my shoes. Later, once the pain subsided, I got customfootbeds. In my case, these are “posted” to tip my feet very slightly inward(called “valgus posting”). I am led to believe my some in the businessof working on cyclists’ feet that it is rare to require this. But if myfeet are tipped too much to the outside, there is too much tension pullingon the band. Tipping my feet a bit to the inside, or at least eliminatingthe outward (“varus”) tip of the shoes I was using when the problem firstflared up, was an important part of the solution. Once the inflammationwas gone from the ice and anti-inflammatories and rest, the stretches andfoot correction kept it at bay. I continue to do the IT band stretches,now 14 years further down the road, and I only ride in shoes that are customizedfor my feet, either with the addition of my footbeds, or in the initialproduction.Incidentally, the surgical treatment, should other methods fail, iscalled a “lateral release,” in which a football-shaped hole is cut in theIT band along the side of the thigh where it is at its widest. This reducesthe tension in the band. I recommend avoiding it if you can, although Ihave several friends who have had this procedure and are happily ridingmany years later. –LennardI want to ride again
I have a problem with my pedals/cleats/shoes. I have Morton’s neuroma,flat feet and heavy pronation, and it never bothered me mountain biking.In fact, in mid-October, I hadn’t ridden in several weeks and went to Moabfor 4 days and hammered non-stop, chasing my 16-year-old son, with absolutelyno problems. I rode a Superlight w/ SPDs that was way out of fit for me,and I had no injuries or anything.Here’s the issue: On my rode bike, properly fit, I am riding with Lookpedals, red cleats (RAD fit) and Sidi Megas. I’ve developed a terribletibial stress syndrome on my left calf. At the top of the pedal stroke,my left knee moves way out away from the top tube and it kicks in as Imove through to the bottom of the stroke.
The result is one day in December I had a long hard ride and I developedshin splints, pulled Achilles tendon and strained soleus (belly of themuscle) all in one, very cold, very long ride. Lennard, this was a mess!After months of strengthening and icing the conditions subsided. I goton the bike last week and could see in the left calf a real torsional clockwisetwist with pronation.The right leg is perfect. Now I know about leg discrepancies, I measureok, I have orthotics, but I think the problem is in the cleats.
I borrowed a friend’s Look CX7 pedal and playing around with it; the+3 brought the knee in so that it travels straight up and down but stillkicks in some, more than the right knee.I’m afraid of another overuse injury!How do you measure the Q Factor or hip width and transfer it to thebike? Would SpeedPlay pedals (canted to keep the knee in line) be a betterchoice for my problem than Look? Finally, I would be more than willingto take pictures of my leg problems and try to work with someone or theSports Clinic ad hire someone who knows how to work through this problem.No one around here really knows what they’re doing.I need to resolve the pedal selection so that I can stretch and exerciseand rehabilitate myself before a year goes by.I want to ride again. –MichaelAnswer from Andy Pruitt, director of the Boulder Center for SportsMedicine
Wow, that is quite the story. Obviously there is no way that I cangive you good advice without actually seeing you in person, but here aresome things to think about. The fact that you wear the SiDi Megas tellsme that you have a large volume foot. The Morton’s Neuroma can be causedby compressing a wide forefoot into a narrow toe box made worse by pressingon the pedal 5,000 time an hour. As for your mal-tracking knee, that isa tough one. Valgus posting (lifting the outside of the foot on the pedal)is very, very rare and even more rare with a wide, pronated foot so I doubtthat that is the answer (you could always be that rare exception, however).If your skeleton matches your mega feet, you might need a wider stancebringing your foot out into alignment with the knee. Stance width is occasionally incorrectly referred to as Q-factor in the cycling literature. What you really need is a full cycling gait analysis and physical exam. This ishard to find; there are many shops with excellent bike fitters but onlythe best shop guy is going to put all of your pieces together in the rightplace.There is an increasing number of medical professionals interested inMedical Grade Bike Fitting and are offering this as a cash pay servicein their offices. If you have exhausted all of your bike shop talents,then explore your local physical therapists or sport medicine physicians.
–Andrew Pruitt, Ed.D.
Feedback on knee pain from June 10 Q&A:
Like Ian with the square Paramount, I have suffered from chondromalacia.I would recommend that he find a good shoe store or doctor to determineif he pronates while either walking or riding. Shoe marks on cranks area telltale sign of pronation. Pronation can cause chondromalacia and iscurable with shoe inserts or orthopedic shoes. I use Peterson Powerbedsin all my shoes except for NAOTs, which have orthopedic soles. I happenedupon the Powerbeds after two knee operations, rest, ice and anti-inflammatoriesdidn’t cure a debilitating knee problem. Even with the shoe inserts I haveto be careful that my saddle is high enough or the swelling returns.Pronation is not the only cause of chondromalacia but is probably theone with the easiest remedy. –JonWhose bar is that?
I noticed that Lance used a clip-on aero bar on his Trek 5900 in theDauphiné Libéré. Do you know which model of aero barthat is? –JeanAnswer from Trek:
The bar Lance attached to his Madone is made by Deda. It didnot duplicate his Trek TT bike position but gave him the option of ridingin a more aero position during the 5km prologue at the DauphinéLibéré race.
Response from 3T to the June 17th question regarding attachingclip-ons to a 3T More carbon bar
I don’t think that Mr. Lawson’s idea to attach clip-ons tothe MORE bar is a good one.There is one very important thing: the shape of the MORE handlebar exceptin the area where you clamp the stem is not round. It has a very particularshape specifically designed to improve the comfort of the rider. This specialshape is not suitable to be clamped with the standard fixing systems generallyused by the extensions.Furthermore, carbon-fiber bars can be very easily damaged by clampingforces applied in areas that are not designed to accept such items. Thecentral area of the MORE handlebar has an internal reinforcement whereit is supposed to be clamped into the stem.
R&D Engineer, 3T
More on XTR brake squeal:
I have the new XTR Disc brakes, lever shifters and wheels. A best ofthe best setup one would think (especially given the price). I have readall the letters in your column regarding the brakes rubbing and the calipersnot retracting. I have gone through the motions and re-lubed my calipersas Shimano suggests. Unless I line up the axle with the frame in the sameplace as I originally adjusted them every time the calipers rub.My question is, does Shimano have a real fix? These patches are justnot acceptable to me. This is supposed to be the best with a price to matchand the stuff is problem prone. Incidentally my rotors are new and straightand when I use another wheel set with Hayes rotors…NO PROBLEM! Come onShimano, stand behind your expensive stuff! –JustinResponse from Shimano regarding the XTR brakes:
We have seen instances where pad retraction performance haseroded on some samples. The first instances we witnessed of this were ona couple of the brakes that pros were using. This issue has not been shownto be consistent and seems also to have some relation to different framesand wheels being used. In response, we are looking at ways to improve theperformance consistency of the caliper to reduce the likelihood of oneof the pads dragging on the rotor regardless of the combinations of framesand wheels.In the meantime, brakes that exhibit this problem should first havethe installation double checked. The brake should have some time on itso that it is “broken-in” and should also be re-shimmed if necessary afterthat break-in period. The caliper should be cleaned of debris, as largeaccumulations of mud, etc. can impair piston retraction. Finally, the rotorshould be checked for true-ness and that it is properly tightened. If allof the above items are properly adjusted / corrected, and the caliper stillexhibits poor or uneven retraction, then the brake can be submitted forwarranty consideration through the retailer that the part was purchasedfrom or directly through Shimano.
Shimano Product Manager
Feedback on shimmy question from June 10 Q&A:
I wanted to share my experience that similar to a letter you publishedon 6/10.I also had a recurring violent and dangerous high speed wobble on my1999 LeMond Zurich. 45 mph was the threshold. The local bike shop thatsold me the bike could not diagnose the cause.I took the bike to another LBS and they put the fork on a fork jig.They said one blade was 3/8 of an inch off. LeMond replace the fork underwarranty. (Maybe there was a bad batch of Icon forks.) No longer had anywobble even at the highest speed I’ve reached — 56mph.By the way … I’m 6 foot 3 with a short arms and legs and a long torso.I ride a 59cm frame. –Laris
Technical writer Lennard Zinn is a frame builder, a former U.S. national team rider and author of several books on bikes and bike maintenance including the pair of successful maintenance guides “ Zinn & the Art of Mountain Bike Maintenance” and “Zinn & the Art of Road Bike Maintenance.”Zinn’s regular column is devoted to addressing readers’ technical questions about bikes, their care and feeding and how we as riders can use them as comfortably and efficiently as possible. Readers can send brief technical questions directly to Zinn. Zinn’s column appears here each Tuesday.