Iliotibial band (ITB) foam rolling has become a controversial topic that has garnered much debate recently. The short answer, yes you can roll the IT band! However, there are a few key points to make your foam rolling more effective. Understanding the basic anatomy and function of the ITB can help frame effective intervention. It is made of dense regular connective tissue that is anchored down the lateral side of the femur from the iliac crest of the hip down to the knee. It is mostly comprised of collagen which provides immense tensile strength but also includes some elastin that provides the ability to stretch and return to original length, much like a rubber band. As with other dense regular connective tissues the ITB is avascular meaning it has a poor blood supply. This is important to understand because without blood supply injuries to tendons and ligaments take longer to heal.
Functionally the IT band is involved in several different movement patterns, mainly abduction, flexion, and internal rotation at the hip. It also helps to stabilize the knee laterally. The multiple actions of the ITB involve it in various injuries including ITB syndrome, bursitis, knee and hip pain. Most critics against foam rolling the IT band claim that doing so puts your knee at greater risk of injury by decreasing stability. This claim has little evidence to support it. The high tensile strength from collagen makeup provides the ability to absorb high amounts of force without any permanent deformation to the tissue. The forces absorbed in running and jumping are significantly higher than the force of body weight during foam rolling. There isn’t much contractile tissue in the ITB to change the length of the tissue so it is unlikely that it would decrease stability.
This is not to say that foam rolling will fix your pain and that anything goes. There are a few tips to be more effective. Direct your myofascial release to the muscles surrounding the IT band. The main muscles to focus on are the tensor fascia latae (TFL), gluteus maximus and gluteus medius since they insert into the IT band. Using other self-myofascial release tools like a lacrosse ball can also help target these areas more directly than the broad surface of a foam roller. When rolling directly on the ITB stay up higher towards the hips down to the mid-thigh. Avoid rolling across the knee joint, lateral epicondyle of the femur and lateral condyle of the tibia. First, rolling on bony landmarks can be very discomforting and second there is little soft tissue in that area to target, so rolling would not be effective. An easy reminder is that if its bone, leave it alone. Rolling the biceps femoris and vastus lateralus can also help.
When in doubt always seek expert medical opinion, especially if you are in pain or suffering acute or chronic injury. A lot if issues with the ITB come from overuse/ overtraining and an accurate medical diagnoses is essential to ensure long term relief. Scottsdale Sports Medicine prides itself in a holistic management of all our patients, from the chronically ill to the in season athlete.
Alex Edwards, CEP, CSCS
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