Foam Rolling The I.T. Band - Is That Really Going to Help

As a physical therapist, I sound like a broken record “Make sure you foam roll everyday!”, but there may be one body structure where foam rolling may not be much help. Based on today’s article title, you’ve probably figured out I’m talking about the iliotibial band ( commonly referred to as the I.T. Band). It’s worth discussing Iliotibial band syndrome (ITBS) as it accounts for 10% of all lower extremity overuse injuries in runners and up to 24% in cyclists,(2,3) and it’s a trip down memory lane for me as I proudly gave a presentation on ITBS during my UNC Chapel Hill Undergrad days over 9 years ago!

Iliotibial Band Syndrome

ITBS is just that - a syndrome, note a clearly defined diagnosis. It’s commonly thought to be related to friction between the IT Band and the femoral condyle. As the knee moves into ~30deg of knee flexion, the IT Band can compress and rub against the side of the knee. This knee flexion occurs during most dynamic activities including running, jumping, squatting, exercising, and playing sports. The IT Band is not a muscle. It is fascial connective tissue. It is not stretchable and it does not contract. In school they used to tell a story of hanging a heavy weight directly from a cadaver IT Band, and it didn’t stretch of lengthen.

Foam rolling the IT Band

So what does foam rolling actually do. There are many benefits to foam rolling tight muscles and connective tissues in the body:

• Increase tissue pliability by transforming tissue into fluid-like form

• Eliminating fibrous adhesions between fascial layers

• Restoring soft tissue extensibiility

• Increase tissue temperature through enhanced blood flow

A 2021 study, “The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial” by Pepper et al. published in the International Journal of Sports Physical Therapy looks to see if there is any benefits to foam rolling or stretching the IT Band to reduce IT Band stiffness. The study participants performed short, kneading like motions along the entire IT Band for 1 minute. This was done 5 times with 30sec breaks in between. The stretching group performed a contract-relax stretching method including 15-sec stretches. This was done 3 times with 30sec breaks in between.

Neither the foam rolling nor the stretching increased IT Band stiffness.

This agrees with other studies indicating that the IT Band tisse does not lengthen.(4,5) It is however worth noting that in this study the tensor fascia latae (TFL) did not decrease in stiffness. The TFL is the muscle attached at the top of the IT Band, and in previous studies, it has been shown to elongate when stretched and provide increases in range of motion.(4) This study used tissue stiffness rather than range of motion as the primary outcome measure.

So What Do I DO for my IT Band

Although it seems foam rolling has no direct effect on the IT Band, anecdotally, it still has its place in the rehab process. Patients often find relief with rolling the outer front portion of the quad where the fascia overlies between the quad and the IT Band. Similarly, foam roll the outer portion of the hamstring where the fascia overlies the area between the hamstring and IT Band. The seems seems to get bound up in these areas, and this connective tissue can be effectively mobilized with a foam roller.

MOST IMPORANTLY

Typically, ITBS is a result of faulty movement mechanics relating to glute inactivity or weakness. This contributes to poor frontal plane biomechanics resulting in overuse injuries including ITBS. ITBS cannot be solved by “rolling out.” The mechanics need to be fixed by an activation and strengthening program of the glutes to promote proper movement.

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Struggling with ITBS, hip pain, or knee pain? Want to maximize your health and compete better in your sport? Book a session with our sports physical therapist or sports performance coach today!

If you’ve had an injury and are in need of a return to play program, schedule a physical therapy session with us to get back to your sport. Get back in the game ready to meet your sport specific demands.

References

1. Pepper TM, Brismée J-M, Sizer Jr PS, et al. The Immediate Effects of Foam Rolling and Stretching on Iliotibial Band Stiffness: A Randomized Controlled Trial. IJSPT. 2021;16(3):651-661.

2. Jakobsen BW, Króner K, Schmidt SA, Kjeldsen A. Prevention of injuries in long-distance runners. Knee Surg Sports Traumatol Arthrosc. 1994;2(4):245-249.

3. Holmes JC, Pruitt AL, Whalen NJ. Iliotibial band syndrome in cyclists. Am J Sports Med. 1993;21(3):419-424.

4. Wilhelm M, Matthijs O, Browne K, et al. Deformation response of the iliotibial band-tensor fascia lata complex to clinical-grade longitudinal tension loading in-vitro. Int J Sports Phys Ther. 2017;12(1):16-24.

5. Seeber GH, Wilhelm MP, Sizer PS, et al. The tensile behaviors of the iliotibial band - a cadaveric investigation. Int J Sports Phys Ther. 2020;15(3):451-459.

Disclaimer: This SciSport blog post is a summary of an article printed in an academic research journal. The purpose of this blog post is to provide readers with academic and educational content in an easy-to-understand format. We take no credit for the material and knowledge presented, and we encourage readers to take a look at the original source provided in the References section.