The iliotibial band, or IT band (ITB), is a dense band of fibrous fascia that runs along the outside of your upper leg, originating from the gluteus maximus and tensor fascia latae muscles and connecting to the tibia.
The ITB predominantly functions to maintain pelvic and knee stabilization and assists in abduction, extension, flexion, and lateral rotation of the hip.
IT band pain or discomfort in the ITB is widespread with runners, particularly if you have recently started running, suffer from muscle weakness, or are in the midst of a high training volume.
So how do we take care of it? For many years, trainers may have often prescribed foam rolling your IT band as a solution to tightness or pain. If you have ever had to foam roll your IT band, you know it hurts a lot.
As runners, we can often be found guilty of a “No Pain, No Gain” mentality, but pain isn’t always warranted or necessary.
Should You Foam Roll Your IT Band?
The answer?
No, probably not.
Foam rolling is a form of self-myofascial release, with myo referring to muscles.
The IT band is not a muscle; it is a thick band of fibrous fascia (connective tissue) and, unlike muscle, isn’t packed with blood vessels and muscle tissue; as such, the supposed benefits of foam rolling don’t make sense.
Instead, you should focus on foam rolling the muscles around it alongside other preventative measures.
The subjective benefits one feels when foam rolling their ITB are likely to do with the “placebo effect,” as it does feel like it’s helping. There is utility in this sensation itself, and if the feeling of rolling your ITB makes you feel better or more confident in your running, then by all means, do it.
The problem is that although placebos may make you feel better, they do not often address underlying issues, like excessive training volume or muscle weakness.
How to Correctly Foam Roll Your IT Band
Let’s not throw out the baby with the bathwater; foam roller exercises can be beneficial. A 2019 meta-analysis that looked at the effects of foam rolling on performance and recovery showed a small reduction in muscle pain sensation and a slight promotion in blood flow.1Wiewelhove, T., Döweling, A., Schneider, C., Hottenrott, L., Meyer, T., Kellmann, M., Pfeiffer, M., & Ferrauti, A. (2019). A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery. Frontiers in Physiology, 10(376). https://doi.org/10.3389/fphys.2019.00376
In some cases, foam rolling can really hurt, so you have to ask yourself whether it is worth the excruciating pain. Although the negatives can often outweigh the positives when foam rolling directly over the ITB, there are specific ways to foam roll the area that can help ease ITB tension.
The the right way to effectively foam roll the area is to target the muscles that the ITB connects, namely the gluteus maximus, gluteus medius, and tensor fasciae latae, as well as the vastus lateralis.
Here are a few tips to bear in mind for when you’re foam rolling:
- Use gentle pressure, and build it up over time. Using excessive pressure on a tight muscle will not help it relax.
- Use a foam roller with a soft surface.
- Support your body weight with your feet and hands. Allow more body weight to drop into the foam roller when required.
- Roll over a small area at one time and focus on your breathing.
- If you need less pressure, you can prop the foam roller up against a wall and lean into it.
- Avoid any extremely sore areas.
Why Does My ITB Hurt?
Further understanding the underlying cause behind the pain or tension in your ITB is crucial.
Pain or discomfort in the ITB is not always due to it being ‘tight.’ In fact, the ITB is supposed to be tight; it is made up of collagen fibers, the strongest protein found in nature. If it were not held together in tension, we wouldn’t be able to stand!
There are multiple possible causes of ITB pain, such as muscle weakness or tightness, training methodology, and running gait.
Here are 3 of the most common:
#1: Muscle Weakness/Tightness
If the gluteus maximus, gluteus medius, and tensor fasciae latae muscles are excessively tight or weak, they may not be able to sufficiently support the ITB when you are running.
Mechanically, this can lead to increased hip internal rotation and knee adduction. Meaning when you are running, your hips drop, and your knees turn in, compressing the fat pad and bursa tissue between the IT band and the thigh bone.
Excessive internal hip rotation and knee adduction are found to be significant risk factors for runners with ITB syndrome.
This means pain in the IT band or IT band issues are often linked with knee pain, hip pain, and low back pain.
Incorporating a progressive strength training plan aimed at strengthening the gluteus maximus, gluteus medius, and tensor fasciae latae will help reduce internal rotation and excessive compression, thus alleviating the compressive forces experienced by the fat pad.
Keep scrolling below for strengthening exercises aimed at the hip abductors.
#2: Running Gait
Running gait refers to your running stride when you run.
During the stance phase, when your foot hits the ground, excessive pronation in your foot (when your foot rolls in) can cause your lower leg to turn in more, leading to the ITB pulling tight and compressing against the outer part of the knee.
It is not always possible to prevent overpronation, at least not in the short term. In these cases, people can reduce its impact by using supportive footwear.
In the long term, following an exercise plan aimed at strengthening the foot can lower the risk of injury/excessive pronation.
#3: Training Methodology
Iliotibial band injuries are common. The most prevalent injury is Iliotibial band syndrome. IT band syndrome affects between 5% and 14% of runners each year.2van der Worp, M. P., van der Horst, N., de Wijer, A., Backx, F. J. G., & Nijhuis-van der Sanden, M. W. G. (2012). Iliotibial Band Syndrome in Runners. Sports Medicine, 42(11), 969–992. https://doi.org/10.2165/11635400-000000000-00000
The vast majority of running injuries are down to training methodology; when we run too much without adequate rest or recovery, we are at risk of developing non-traumatic overuse injuries.
The most common risk factor in runners is usually down to a sudden increase in training volume.
All runners are prone to overuse injuries, whether you are new to running or a seasoned veteran. If you regularly run, check for recent inconsistencies or spikes in your training, and if you’re new to running, start slowly.
It is crucial that we allow our body sufficient time to adapt to new training stimuli.
If we don’t, the muscles and tendons can accumulate stress, which will eventually present itself as an injury.
ITBS can be very painful and can put you out of the game for a long period of time, and this can be very irritating.
If you don’t try to remedy the problem, the swelling will go down . . . but when you get back on the road, your injury will flare up again. It can be a cycle of injury that would put anyone off running.
6 Stretches and Exercises to Loosen The iTB
As always, it is better to get on top of an issue before it gets worse. With this in mind, here are 6 exercises and IT band stretches to add to your training regime.
#1: Standing/Side Lying Leg Abduction
Standing or side-lying leg abduction is a great way to isolate and engage the glute medius.
- Either lie on your side or stand up. Loop one end of the resistance band around your active leg and the other around your ankle on the ground.
- Lift your top leg up to the side until you are near 45 degrees. Pause for 1 second, then return your leg to the starting position.
3 sets, 12 repetitions
#2: Resistance Band Squat
- Loop a resistance band just above your knees. Keep your feet shoulder-width apart; feet turned slightly out.
- Sit your hips back into a squat and lower until your hips are parallel with the knees. Or as far as you can comfortably go. Hold for 1 second and come back up.
3 sets, 15 repetitions.
#3: Standing TFL Stretch
The ITB Stretch will allow you to stretch the muscles at the ends of your IT Band.
- Standing up, cross your left foot over your right foot.
- Lift your right arm up to the sky and reach over to your right side.
- You should feel a stretch down the outside of your left leg. Hold for 20-30 seconds.
- Do the same movement on your right side.
- Repeat this 3 times.
#4: Sitting TFL Stretch
To perform a TFL stretch:
- Sit on the ground with both legs outstretched in front of you. Bring your left knee towards your chest and cross your left leg over your right, placing your left foot on the floor on the outside of your right leg.
- Gently pull your left knee to the right as your body twists to the left.
- You should feel a stretch on the outside of your left hip.
- Hold for 30 seconds, and then repeat this on your right leg.
- Do this 5 times on each leg.
#5: Figure Four Stretch
The Figure Four stretch will focus on your glute muscle.
- Lie on the floor
- Bend your right leg and cross it over your left leg so your right ankle is lying on top of your left thigh.
- Interlace your fingers behind your left leg and gently pull your legs towards yourself.
- Hold this position for 30 seconds, then repeat on the other side.
- Do this 3 times on each side.
#6: Quadricep Stretch
- Standing next to a wall (you might need it for balance), bend your left knee and hold your foot behind your hips.
- Keeping your core engaged so as not to fall forwards, pull your ankle up and back until you feel a stretch down the front of your thigh.
- Hold for 30 seconds, and then repeat on the other side.
- Do this 2 more times on each leg.
Conclusion
There you have it; the common causes and helpful solutions to get ahead of your ITB issues. If you are looking for information on other common runner injuries, check out our injury guides here.
Some aches and soreness from running are usual and can often be prevented through strength training. However, if you are worried about the pain, whether it be runner’s knee or pain in the quads, hamstrings, IT band, hip flexors, or anywhere else, don’t hesitate to speak to a physical therapist who can provide you with a sports physical therapy treatment plan.
Your standing tfl stretch instructions for step 2 needs to be corrected to state “raise your right arm” not left. Otherwise good article.
great catch that! Cheers.