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Knee pain / IT band syndrome from riding?

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  • Knee pain / IT band syndrome from riding?

    I recently sold my horse and started riding more frequently on lesson horses (1x/week to 3-4x/week). A few weeks ago, I started experiencing pain/stiffness on the outside of my knees when I first got on the horse. At first it went away a few minutes into the ride, so I only noticed it when I first got on. Each ride, it's a bit worse, and now I have some amount of discomfort even off the horse.

    The pain goes away completely if I stand in my stirrups or move my feet forward (motorcycle style) and is worst when I bend my knees to put my feet behind the ear-hip line (to the point that I physically can't put it very far behind that line, at least when I first get on).

    It sounds like IT band syndrome ("runner's knee") to me, but I haven't seen anything saying it's common with horseback riding.

    Besides the increase in riding frequency, I've made the following changes: I now ride in Petries instead of half chaps, I'm riding different (wider) horses, I've improved my leg position (my toes have always pointed out at least a little--lately I've focused on weighting the outside of the stirrup to get a better leg position with toes forward), and my legs are more open and relaxed (I used to grip more with my thighs).

    Has anyone else experienced this issue? Any suggestions?

  • #2
    The first thing that comes to my mind is make sure you're not putting your toes in by rotating at the knee. Its very common for instructors to simply say 'put your toes in' and not explain how to do this properly. Your toes need to be in because your femur is in the right position, this happens at the hip joint. If you keep your femur in an incorrect position and rotate at the knees you will do damage to your knees given enough time. It is difficult to get this rotation of the femur if you're body isn't used to doing this. Cold weather and non-warmed muscles & ligaments make it even harder to do. Try warming up on your horse with no stirrups until your legs feel heavy and stretched before you put your feet in the stirrups. Also have a chat with your instructor about how to properly get your toes in the right position without achieving this by rotating at the knee.


    • #3
      I have had issues with my IT band and knee pain while riding. It took me awhile to figure it out, but last summer while taking a running clinic we focused on IT band stretches following a run. Within a week of regularly stretching the IT band, my knee pain disappeared. I now try to be very careful to do targeted stretches regularly and I rarely have a issues.


      • #4
        If you can get an appointment with a sports medicine PT, he/she can show you some exercises and stretches to help with that.

        Also, icing afterwards and using the NSAID of your choice prior to riding may help as you work through this.

        I too have IT band issues...but the stretching and icing does help. You may also notice that the size of the barrel of the horse plays a role.
        A good horseman doesn't have to tell anyone...the horse already knows.

        Might be a reason, never an excuse...


        • Original Poster

          Thank you all for your help! The stretches sound like a great place to start. I have a physical coming up so will try to get a referral for PT.


          • #6
            After the Finish Line

            I hurt my IT band skiing in Vail. I felt the band stretch as I took a fall on the slopes. I couldn't straighten my knee for over a month. Since it was impossible to put weight on my leg I jumped in the pool. Growing up I swam 10 years competitively. I used the kickboard to help strenghten my leg and lenghten the muscles in that area. That was the best therapy for me.

            Dawn Mellen, President
            After the Finish Line®
            10153 Riverside Drive, Suite 397
            Toluca Lake, CA 91602


            • #7
              i ride horses everyday. i compete on my high school equestrian team and i've been riding since i was about 4. I have ITB syndrome and bursitis in my hip. its not just from runners. i've been in physical therapy for about 2 years and it hasn't really helped at all. they told me the only other way was to work through the pain wich is what i have been doing, or surgery, which they told me recovery time for that surgery was 1 to 2 years. (the reason i'm not getting it done lol). anyways, i just wanted to help ya out


              • #8
                Runner's knee is slightly different than IT band knee pain and causes pain on the inside or center of the kneecap, but runner's World has a good article on dealing with IT band issues. What helps me most with my IT band is stretching, massage, and using a foam roller to roll the entire IT band out -- rolling helps a lot because it's an awkward, difficult part of the body to stretch adequately. Here's a link to a foam roller exercise for IT bands, and I warn you, it HURTS before it starts to feel good: http://runningtimes.com/Article.aspx?ArticleID=9911

                When my IT band is hurting, the entire outside of my thigh burns -- it starts with the knee pain and gradually gets worse over time. I've never had a problem with it from riding, probably because my leg position isn't great and I don't rotate the thigh in enough, but I have issues with it from running. Which, come to think of it, may be why I don't rotate the thigh in enough...time to break out the foam roller again!!


                • #9
                  I was recently diagnosed with IT band tightness resulting in knee pain. I have underlying arthritis under the knee cap (welcome to middle age say my friends...) and the tight IT band caused the patella to "track" incorrectly and exacerbate the arthritis pain (or so I am told).

                  Physio involves massage of the tight areas of the IT band and rolling it out with a rolling pin. As in a "usually used for baking" rolling pin.

                  FWIW, mine seems to have some on with increased attendance at fitness class and does not seem related to riding at all.


                  • #10

                    Ow, I can relate. I have been suffering from IT band pain for the past few weeks due to increased riding and a strong attempt to get both of my boys to put their right hind legs under their bodies. Unfortunatly, my right leg has taken a beating as well.

                    My massage therapist has been really helpful in working out the pain and rolling the fascia. Stretching also works, but the ones lying down and crossing the legs work best for me.

                    Riding is definitely one of the ways to get IT band pain, as my trainer also suffers. You are not alone.
                    \"I refuse to engage in a battle of wits with someone who is unarmed.\"--Pogo


                    • #11
                      Broader horses will also stress your legs, in addition to increasing the frequency of the ride.

                      I'm a runner. An oft-injured runner who is really not conformationally built to be a runner. I'm a bit of a train wreck, actually; typical female, my pelvis starts me out far apart, but then I'm knock-kneed and THEN I also supinate, that is I run on the outsides of my feet. So there are three bad angles there.

                      I've had ITBS, which was easily treated with stretches. I never used a foam roller, but heard they are the bomb for it as well. Some stretches you can try: cross one foot over the other so the outsides are touching, then do a hamstring stretch (touch your toes, or try to), then switch. Find a counter or table that is about crotch high, put your leg on there with the knee bent and heel as close to your crotch as you can get it, then lean forward over the leg. You WILL feel a stretch, this is your hip flexor. Switch legs. Do these for at least one minute each. All those people who do those rinky-dink 10 second stretch and go things aren't doing themselves any favors.

                      Unfortunately, my ITBS was overshadowed by a suspected quad tear, both on the left leg, which supinates more. When I ride now, if I have to get TONS of leg on some nappy beast, I will get serious knee pain.
                      COTH's official mini-donk enabler

                      "I am all for reaching out, but in some situations it needs to be done with a rolled up news paper." Alagirl


                      • #12
                        I have ITBS, runners knee and some awesome tendonitis in both my knees, so I can definitely understand where you're coming from. I was running (training for a 10k) and riding last year, and after the race I took some time off, and when I got back into both of them I started having some serious knee pain, and got it checked out early this year.

                        I've been in PT for about 2 1/2 months now (twice a week) and it's helped, and I've learned lots of good stretches, and the massage really helps, even if it does hurt like the devil sometimes. It also helps to lay on your back, raise one leg up straight and pull it to your chest (or as close as possible) and get the stretch in the back of your quad/thigh, and then try and let it stretch over to the other side of your body to stretch the outside.

                        Runners world online has some great stretches and advice for ITBS/Runners knee, so I would definitely check that out!
                        Worry, doubt, fear and despair are the enemies which slowly bring us down to the ground and turn us to dust before we die.

                        ~ Douglas MacArthur


                        • #13
                          I work mainly with soldiers (who do lots of running!) and riders, and see ITB issues with both. You've gotten some great suggestions- and Runner's world is a great resource for handling ITBS.

                          My husband has chronic ITBS, the foam roller and ice massage have made the biggest difference in helping him to maintain his 6 minute mile. He does the ice massage whenever he does running workouts. I keep paper dixie cups filled with water in the freezer. Tear off the paper cups in strips, rubbing the ice down the outside of your leg in small circles. It should take about ten minutes to melt down. Afterwards, put on sweatpants or something else warm. I use this myself and find it quite effective. You also might want to talk to a PT to see if you're rotating at the knee
                          Equestrian Photography


                          • #14
                            i have been diagnosed with itbs and it actually got BETTER after i started riding on a more regular basis and stretching after i rode. my ITB "clicks" in my hip area sometimes after a long ride and used to get sooo sore that my leg felt stuck in place sometimes. i had ultrasound therapy which helped for a while, cortisone shot in my hip which helped sort of but wasnt worth it and then i found the weirdest thing that REALLY helped- i started wearing those sketchers shape-up shoes while going on walks and they seems to really stretch that part of my leg and whatever muscles they tone are helping a lot to support my knee/hip. they also made my back feel awesome because they rock my weight back and make me walk more correctly. they are hideous and expensive and your friends will make fun of you for wearing them, yes, but worth a try.

                            also- lose the fancy jointed stirrups and go back to plain old fillis irons if you havent already- this helped a ton too. most of my pain was in the hip and radiated down to the knee so take all this only as what worked for me! i also sort of think ITBS is an "easy" diagnosis for the docs to make when riders come in with our strange aches/pains from our sport and they don't really know whats going on- so be careful!

                            hope something works for you! good luck!
                            Jazz- 4.9.01 OTTB, loved since 12.6.09
                            Skip- 3.3.91 APHA, i miss you buddy