Should you foam roll your IT band? This is a question that has perplexingly persisted at the forefront of arguments within the rehabilitation and fitness fields for several years.
The topic took social media, annoyingly, by storm last week, as everyone linked to a recent post from Dr. Andrew Franklyn-Miller: Ilio-Tibial Band: Please do not use a foam roller
To provide a quick backdrop, the iliotibial band (or IT Band) is a thickening in the fascia on the outside of your thigh. If fascia is an unfamiliar term, just think of the thin clear film that’s wrapped around your chicken breasts.
That white band is actually just a thickening of a tissue that encompasses the entire thigh and spreads continuously above and below throughout the entire body. (Image from athletico.com)
Fascia, like all structures within the human body, responds to stress. In an effort to provide improved lateral stability to help accommodate the loads of single-leg stance, the fascia lata (which surrounds the entire thigh), is thicker on the outside. This thickened band of tissue has been cut out with a scalpel in cadavers and given its own name (i.e. the IT Band), leading to a number of misunderstandings common to isolationist approaches to anatomy.
The IT band has direct connections to the gluteus maximus and the TFL (tensor fascia latae; one of your hip flexors), and extends down to blend with structures on the lateral knee.
Because it’s common for people to have lateral knee discomfort, the IT band often gets blamed as the culprit, leading to recommendations to smash the IT band with a foam roller, and then stretch it.
Clearly, this is a misguided approach. There is sufficient evidence to suggest that the IT band doesn’t elongate appreciably (which Dr. Franklyn-Miller cites in his article), meaning you can’t really stretch it.
Further, blaming a thickened part of fascia for lateral knee pain without consideration to factors like ankle mobility, tibiofemoral rotation, hip range of motion, hip control, capacity of the muscles controlling the hip, leg, and foot, total volume of work placed on the system, among others, is about as sensible as Billy Madison’s take on Reflections of Society in Literature.
Of course, leave it to the internet to perpetuate a wide-spread over-reaction. This is a classic case of throwing the baby out with the bathwater.
Just because the IT Band doesn’t elongate appreciably and likely has very little, if anything, to do with lateral knee pain, doesn’t mean using a foam roller on the lateral thigh doesn’t have value.
It’s interesting to me that so many people would ignore positive feedback from people that have foam rolled the area and have felt better both immediately afterwards, and over the long term. I imagine the conversation goes something like this:
Self-Proclaimed PubMed Expert (SPPME): “I know I told you to roll that area last week, but now you shouldn’t.”
Human: “But I actually feel a lot better after I do it.”
SPPME: “Yes, but last week I read an article on Facebook that says it doesn’t do anything.”
Human: “But I feel better after I do it.’
SPPME: “You’re not getting it. The article cited several studies that took a dead person’s leg through common orthopedic tests and it CLEARLY showed that the IT Band didn’t stretch.”
Human: “Did the cadaver foam roll?”
SPPME: “Of course not. Dead people can’t foam roll.”
Human: “Then I guess they couldn’t report feeling better afterward either. I’m outta here.”
Not so subtly hiding underneath the IT Band is the vastus lateralis, the biggest of your four quadriceps muscles. This muscle wraps around ~50% of your femur, from the middle of the front part all the way around to the middle of the back of your femur.
Image from http://www.corpshumain.ca
It, like every other muscle in your body, still has blood flow. It still has neural inputs and sensory receptors providing feedback about the resting tension in the muscle. It can still develop trigger points.
Foam rollers and other rolling implements, can generally be used to accomplish three things:
- Facilitate circulation by rhythmically compressing the tissue, similar to “effleurage”, a common technique used in Swedish massage
- Provide feedback to the nervous system about areas that may be harboring unnecessary tension
- Attempt to address trigger points using pointed compression, similar to ischemic release techniques used commonly by manual therapists
ALL of these things can still be accomplished by rolling your lateral thigh. You can still roll this area, just don’t call it your IT band.
Even better, instead of plowing directly over your IT band, try rolling directly in front of it and directly behind it. This will allow you to more directly address your vastus lateralis, which is ultimately what you’re targeting when you roll the outside of your thigh anyway.
To your success,
Kevin Neeld
HockeyTransformation.com
OptimizingMovement.com
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Yes you should roll the IT band because its not the only muscle located on the side of your leg. You should understand that muscles connect to the ITband or are afixed under the IT band and need to be released. Rolling the IT band also brings hydration to that area as well which is critical to all muscles/fascia. Roll the damn thing yes!
Mitch-Did you read the article or just the title? To clarify a few points from your comment, the IT Band isn’t a muscle; it’s a thickened band of fascia. There’s only muscle underneath it; the vastus lateralis. The TFL and gluteus maximus blend with the IT band further up. “Release” is a nebulous term. I’m not sure what most people mean when they say it, but if it’s intended to refer to a decrease in tension, this is 100% governed by the nervous system’s interpretation of whether tension is necessary in that area. Rolling with a foam roller is simply a sensory input to tell the brain where it’s holding tension, providing an opportunity for the brain to re-evaluate if that tension is necessary.
Kevin – yes I read the article. I understand that the it band is fascia which isn’t the only fascia in the body yet it it most likely the thickest from what I’ve come to understand. Integrated with all our muscles is fascia which unofficially can be looked at as a sensory organ in and of itself. “Release” is nebulous like “exercise” should only included the saggital plain?
I think the connection with “release” of the muscles and the nervous system as you say is to make new associations that have somehow failed through sitting too much, not having full range of motion in your joints and associated muscles or any other lack of tensegrity in the fascia and muscles. So big questions is what else does someone do to provide sensory input if its not foam rolling or using a racketball? Massage therapy or the wife or girlfriend! Of course there is also the obvious of plain out “movement” but if muscles are stuck and fascia is tightly winding up our muscles … there really is only one thing to do and that’s to “deeply” massage the muscles … including any related fascia connected to the muscles.
Isn’t exercising, walking or even eating the same sensory input to the brain in every case?
I agree with most of your article and wasn’t saying things in negative terms really.
FOCUS ON MOBILITY
Thanks for clarifying Mitch. I’m not sure I understand your point about exercise only included in the sagittal plane. We may just not be seeing eye to eye on mechanisms here, despite a similar outcome in methods, but I think suggesting that foam rolling is doing something mechanical to the fascia is a mistake. The forces and time required to actually deform the fascia, in any lasting sense, won’t be met by traditional foam rolling routines. The “loose” feel that follows foam rolling is more likely from the things I mentioned in the article, not actual changes in the structure of the fascia itself. Hope this makes sense.
Great Article Kevin! So if rolling the IT band is a bad idea, how would I go about rolling or stretching for Patella Tendinitis and Patella tracking disorder?
Donald-I never actually said rolling the IT Band is bad. I would strongly recommend getting assessed by a good physical therapist (not one that pulls out a “patella tendonitis rehab sheet” and just takes you through the same template exercises they take everyone through), and following their instruction. In my limited experience working with patellar tendonitis and tracking issues, there’s often something not doing it’s job above or below. Basic assessments that look at ankle mobility, hip mobility, single-leg stability, and lower body strength would likely shed a lot of light on the issues you’re having.
so the muscles above and below affect the it band right? So wouldn’t it be safe to say that its the deeper muscles underneath and around connecting to the it band that are essential muscles to use the racketball on? Lets also not forget the fascia connecting to your skeleton >> tfl, iliacus, rectus fimoris, gluteus medius, piriformis etc etc
All of those can influence tension around the IT band, and just about everywhere else in your body. That was one of the points of the article; it’s silly to vilify the IT Band.
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