by Jo McRae
Iliotibial band (ITB) foam roller mobilization
The iliotibial band, or ITB as it is often abbreviated, is so called because it runs from the ilium (the crest of the pelvis) to the tibia bone, the larger bone in the lower leg. It is fascia, not a muscle but a fibrous band that wraps around the muscles from the outer hip and along the outer thigh, assisting in extension of the hip (as your leg moves backwards, such as on the downstroke of the pedal) as well as abduction and external rotation (moving your leg out to the side and turning your foot out). Some of the gluteal muscles actually attach to the iliotibial band too.
As a cyclist you may be familiar with the ITB because you have suffered from ‘ITB syndrome’, which presents as pain in the lateral thigh, more usually towards the knee, or as pain in the knee itself.
The syndrome is an ‘overuse injury’ in which tightness, stiffness and shortness result in inflammation where the band crosses the knee to attach on the lower leg. Repetitively bending the knee from 30–40 degrees (such as that typical with cycling) is most provocative, together with greater impact or loading (such as when climbing or sprinting hard on the bike). When you go on an intensive training camp where the volume and intensity of riding are both suddenly increased, knee problems can develop as a result.
The ITB is implicated in another syndrome common in cyclists called ‘chondromalacia patella’ or ‘patella femoral pain syndrome’. In this condition the cartilage or underside of the kneecap becomes inflamed, or there is excessive friction as the patella moves up and down the thigh bone.
The long bone of the thigh (the femur) has a groove in it where the kneecap (patella) should smoothly slide up and down as the knee bends. If the tension along the lateral thigh and ITB is too great for the strength of the muscles on the inner thigh the kneecap can be pulled off to one side, causing friction and pain.
Similar issues can aggravate both conditions, and there is considerable overlap between the two. In short, maintaining a flexible and mobile ITB is essential if you want to avoid knee pain of one sort or another as a result of your cycling exploits.
Preparation
Start with your weight resting on the 6-inch diameter foam roller just below your hip on the leg you are going to stretch and mobilize. This bottom leg needs to be straight but relaxed. Use your arms and supporting (bent) leg to take some of the load off the roller so that it is not too uncomfortable.
Movement
Moving slowly and managing the intensity of the discomfort with your arms and the supporting leg, start to slowly inch your way over the roller, pushing with your bent leg and using your arms for support. Move slowly from hip to knee in this way, lingering and ‘letting go’ over any particularly tight spots as you roll over them. Stop just above your knee and then retrace in the opposite direction from knee to hip.
You can repeat this same ‘strip’ of tissue two or three times, or roll your hips forwards or backwards so that you are slightly on the front or back of the thigh rather than on the side. Focus on the areas where you feel the tightest until they begin to loosen off.
If you struggle to achieve the necessary pressure to be effective, you can work with both legs outstretched and stacked one on top of the other as shown to the left. It is important that the underneath leg remains relaxed in this instance, as it is all too easy to tense up and ‘lock out’ the muscles.
When and how much?
Pre-exercise: Working along the three ‘strips’ directly on the side, slightly behind and then slightly in the front, can be a good way to decrease the ‘tonicity’ in the area pre-ride or prior to other strengthening work. Aim to take approximately 20 seconds from top to bottom and then bottom to top in each of these three areas so that the overall mobilization takes 2 or 3 minutes on each side. If you are tighter on one side than the other spend a little longer on that side. If you have knee problems I highly recommend you use this exercise on a regular basis as it will help you to correct the muscle imbalances at the root of the problem.
Post-exercise: A lot of cyclists are very tight in the ITB, but using this mobilization post-exercise or before bed can have a lasting impact on this persistently tight area. Repeated exposure of ‘little and often’ works well, as working too deeply too soon can make you sore in the same way that overly zealous deep tissue massage can. This is not a reason to avoid the area, but rather to modify your approach. Try the method suggested for pre-exercise stretching daily, before gradually prolonging the time spent to have a greater impact, provided you do not suffer debilitating soreness as a result.
Swiss ball quad and hip flexor stretch
Most cyclists will be aware of their quadriceps muscles at the front of the thigh. These are the muscles that we feel the most as they fatigue over long rides or hard efforts. The quads are responsible for knee extension (leg straightening) as we push down on the pedals. They need stretching because they work hard as prime movers on the downstroke, but not every quad stretch is created equal, and targeting the most relevant areas of the quads is really important if you are going to prevent imbalances from developing in this important muscle group.
Connected with the quads are the hip flexors, which originate at the spine and pelvis, and cross the hip joint to attach on the long bone at the upper thigh. These muscles flex the hip and are active on the cycling upstroke as we bring our leg up towards the chest.
The ‘origin’ of a muscle describes where it attaches or ‘starts’, while the ‘insertion’ describes where it goes to or ‘finishes’. Origins and insertions of muscles are usually on bones but can also be along fascia. The origin is the end of the muscle that usually stays anchored during the contraction while the insertion end moves.
The rectus femoris is one of the four muscles that make up the quads and bridges both the knee and hip, both extending the knee (on the downstroke) and flexing the hip (on the upstroke). Due to this dual action, the rectus femoris muscle can become particularly tight in cyclists as cycling forces the hip end of this muscle to work in a shortened range. For this reason, a quad stretch that also stretches the hip flexors is an essential for cyclists.
In addition to targeting the hip flexors, it’s particularly important for cyclists to focus their attention on the lateral part of the quadriceps group, as this tends to become tighter than the medial part. Since the leg remains slightly bent throughout the pedalling action, and the medial or ‘inner’ portion of the thigh muscles is responsible for the last 15 degrees of knee extension, a discrepancy between ‘outer’ and ‘inner’ strength can develop. The vastus medialis, the ‘inner’ of the four quad muscles, is important in stabilizing the knee joint and weakness here is implicated in knee problems and pain.
For cyclists it’s also particularly important to include exercises that stretch the outer quadriceps and strengthen the inner quadriceps. In practice, stretching the outer thighs can be achieved in conjunction with stretching and mobilizing the ITB along the outside of the thigh and hip.
For this reason, the stretch described below is most effective when performed immediately after the ITB foam roller mobilization on the previous pages. It targets the quadriceps group as a whole, but also effectively stretches the rectus femoris at the hip.
Preparation
Kneel on all fours in front of the ball, raising one leg up onto it behind you so that the heel of your foot is directly behind your buttock. This exercise is quite difficult to do ‘free standing’ and it can be helpful to wedge the ball in a corner or up against a sofa so that it doesn’t move around too much while you are trying to get into position. In fact, if you are quite tight, this exercise can be performed rather well with your foot up on the seat of a sofa rather than a ball. In this sequence I will show you what it looks like when you are quite tight (as in the case of Paul) and more flexible (as in the case of Nichola), so that you can gauge where you are on the spectrum.
Movement
In order to move towards the upright position, slowly move your other leg forwards to
place it alongside your hand, or as far forward as you can take it, as shown left. Then, placing both hands on your front knee, slowly push yourself up into the stretch position, drawing your navel in and tucking your tailbone down. The stiffer you are, the harder it will be to bring your body upright, and you may have to have your back knee slightly further away from the ball at the start.
Once you feel the stretch sensation in the quad and hip flexor, hold the position for 1–2 seconds, before kicking your lower leg back into the ball, as if moving from the knee joint. This is an ‘isometric’ contraction – you are contracting the muscle against an object of resistance but there is no actual movement. By contracting the quads in this way it will momentarily release the stretch sensation.
Hold this isometric contraction for 1–2 seconds before releasing the ‘kick’ and immediately easing further into the stretch, either by gently pushing your body a little more upright as in our stiff example of Paul or by easing slightly forwards as in our more flexible example of Nichola below. Repeat this contract-relax process four to five times or until you are not making any further gains in the movement, before relaxing and changing sides. If you know that you are tighter on one side than the other, come back to the tighter side a second time.
If you are more flexible, you will be able to tuck the knee tighter into the ball at the start and come into a fully upright position much more easily, with the supporting leg brought further forward as seen here. You will also be able to shift forward more easily into the stretch as you work through the contract-relax sequence. Nichola demonstrates the difference with a more flexible quad and hip flexor.
How much and how often?
Pre-exercise: If you are particularly tight in the quads, use the ‘contract-relax’ method described here for 4–6 repetitions on each side before riding, as well as before any other strength work. This should take you 2 minutes, once you are used to getting into position. This may help prevent the onset of cramp in the quads, or back pain where tightness in the hip flexors is implicated.
Post-exercise: The contract-relax technique can be effectively used post-exercise too, but you can hold the relaxation phase for much longer to allow your thighs to relax for 20–30 seconds before introducing another ‘contraction’, and then taking the stretch further again. Repeat this method two or three times on each side or until you feel your quads are relinquishing no further. Post-exercise, you can also experiment with positioning the heel of your rear leg more to the centre of your hips or outside of your buttocks to seek out the tightest ‘lines’ within the quad/hip flexors that you are stretching. This stretch can also be used to prevent soreness from longer, harder rides to aid recovery.
The hamstring stretches
Most cyclists know where their hamstrings are and feel they should stretch them, but many don’t know how to do it right, or feel nervous about causing an injury by doing it wrong. Of all the muscle groups that a cyclist ought to learn how to stretch properly, for me the hamstrings come top of the list. Running along the back of the thigh from your pelvis (sitting bones) and down behind the knee, they are a muscle group that can become chronically short and tight in response to sitting for longer than is natural. And that can be sitting in a chair, or in the saddle.
As they originate at the pelvis, when the hamstrings become short and tight they can transfer tension to the lower back in particular (as well as further up the spine) and can be a common causative factor in lower back pain. In cycling-specific terms, shortened hamstrings can also affect your ability to get into an optimal position, especially limiting saddle height and ‘drop’ from seat to the bars, thereby limiting power production and bike handling. The hamstrings are a muscle group that will always need maintenance stretching as a minimum since the majority of your time pedalling is spent seated, which can encourage tightening.
Most cyclists will have shortened and tight hamstrings at the lower end where the muscles cross the back of the knee. This tension will affect the chain of muscles all the way up the back of the body, but in order to improve muscle balance and your overall flexibility, it’s helpful to isolate the stretch to this area to have the biggest impact. This means learning to specifically target your stretch to that lower portion of the muscle.
The hamstrings aren’t actually separated into upper and lower, but in terms of how they function the upper portion tends to work with the gluteals to extend the hip, while the lower portion tends to work to bend the knee. For cyclists where the lower portion at the knee often needs stretching, the upper portion at the hip often needs strengthening.
Combining the stretches here, which target the lower hamstrings together with the essential core exercises in Chapter 4, which target the glutes and upper hamstrings will give you the best chance of bringing the muscle group into balance.
I have included several options here to ensure that you will find at least one stretch that you can do effectively and easily. Follow the instructions for each and try them all before deciding on which will be most useful for you.
Supine knee extension
This supine knee extension stretch is the simplest of the dynamic ‘pre-exercise’ hamstring stretches and doesn’t require a strap or belt.
Preparation
Lie flat on your back, raise one leg and grasp it at the back of your thigh as shown. Your knee should be held directly above your hip with your lower leg relaxed so that your heel drops down. Slide your other hand under your lower back so that you can feel whether your back is rounding and pressing down into the floor as you go into the exercise. In this preparatory position, focus on gently arching your lower back to make room for your hand, and at the same time press down the straight leg at the back of the knee.
Your goal is to maintain a slight curve in your lower back (as assessed with your hand) in order that you target the stretch most effectively to the lower hamstrings behind the knee. Don’t allow your back to flatten or your hips to lift as you go into the stretch or the effective position will be lost.
Movement
Slowly extend your leg directly upwards, keeping your foot relaxed and focusing on maintaining a curve in the small of your back. As you move into the stretch feel for the point where if you go any higher you will be unable to maintain this curve, at which point hold the stretch position for 1–2 seconds. Then release the lower leg back down relaxing the hamstrings but maintaining the knee-over-hip position.
If you are performing the stretch well you will feel the focal point at the back of the knee. It can take some time to learn to maintain the curve of your back while at the same time extending your leg, but if you persist your control in this exercise will improve, as will its effectiveness. If you have practised but still struggle to feel the stretch in the target area you might want to try the next strap-assisted hamstring option to help you achieve the necessary pressure in order to feel the benefit.
Focus on the ‘feel’ of the stretch rather than trying to reach your leg high. Paul’s leg (previous page) is not fully extended but that is where he can feel the stretch. Here, Nichola shows a greater flexibility in her hamstrings performing the same stretch. She is more able to maintain a neutral curve in her lower back as she extends the leg, and nearly fully extend the knee. This is an example of optimal range in the hamstrings at the knee. Cyclists should aim for extending their range of hamstring flexibility to be confident that their hamstring length does not have a negative impact on bike fit or cycling biomechanics.
When and how often?
Pre-exercise: If you have any lower back problems that are provoked by riding, I highly recommend you include this or any of the other dynamic hamstring stretches before you get on the bike, as well as before any strength or core-focused work. Perform 8–10 repetitions on each side, or more if you feel you need a little longer to start to loosen up in the stretch. You should find that your range increases slightly as the muscles warm up but then will plateau, at which point you will probably not get any further benefit from the
stretch.
If you are tighter on one side (which will be evident if one leg does not extend as easily as the other), perform further repetitions on the tighter side until you feel more even. One of the key benefits of this stretch is that you don’t need any equipment at all so you can include it anywhere at any time, even if that is before you leave work for your commute home from the office.
Post-exercise: This stretch can be used in this same way post-exercise, but for more repetitions – for example 16–20 on each leg. Post-exercise, one of the strap-assisted options or the longer hold doorframe stretch will probably be more effective if you are particularly tight in this area.
Supine knee extension – strap assisted
This next exercise is very similar to the last, except with the addition of a strap to help intensify the stretch, making it more effective, particularly if your hamstrings are very tight and don’t respond to stretching easily. (I adapted this technique from the version I learned from AIS practitioner Hughie J Morris.)
Preparation
Hook a strap around the instep of your foot. The strap needs to be solid (not elastic) and long enough to work with comfortably. In these pictures Paul is using a martial arts belt.
Lie flat on your back and raise one leg directly above your hip, holding the belt at the knee with both hands (shown). Your lower leg should be relaxed. Relax the straight leg down at the back of the knee.
Your goal is to maintain a slight curve in your lower back in order that you target the stretch most effectively to the lower hamstrings behind the knee. Don’t allow your back to flatten completely or your hips to lift as you go into the stretch or the effective position will be lost.