Hi Jesse,
I wanted to get your opinion about using the foam roller on the IT band with a firm roller. My understanding is that you can certainly massage and gently stretch the IT band, but it is supposed to be taut because it helps to support the lateral leg muscles. People feel a difference between the IT band and the quad muscles. They assume they need to loosen this up. So maybe there are no adhesions, but what they are feeling is the normal tension of the tissue. I think it is ok to roll it out gently, but not to push it. What do you think?
Thanks,
My Response
Thanks for the email. This is a great question. I’ve had it in mind to address this question for a few weeks now.
In the past few weeks a couple of different articles on using a foam roller on the IT Band have been posted online with different opinions on the benefits of foam roller self massage therapy.
In the first article, Stop foam rolling your IT Band, the author, Greg Lehman, is a bit critical of using the foam roller on the IT Band. He makes a good argument that there is very little benefit to rolling the IT band due to the fact that it is dense connective tissue with limited ability to be lengthened or change.
In the second article, Is Foam Rolling Bad for You?, Michael Boyle defends the use of a foam roller on the IT Band and makes an excellent case of the benefits on foam roller massage therapy.
I agree with completely with Michael Boyle’s article. I find foam roller massage therapy to be hugely beneficial to healing, recovery, and injury prevention. I also agree a little bit with Greg Lehman about the futility of using a foam roller on the IT Band.
Here is my take:
Most people spend way to much time with a foam roller on the IT Band at the neglect of the other and more beneficial areas of their legs, hips, and shoulders.
The IT Band is white, tendinous fascial tissue, which means it receives less blood flow and has less ability to “release” compared to muscle tissue such as the glutes. The IT Band is also incredibly strong. I’ve heard awesome anatomist and movement therapist, Kathy Dooley, say that if you connected the IT Band behind two trucks moving in opposite directions, it wouldn’t stretch or tear. If the power of two trucks won’t change this tissue, a foam roller on the IT Band probably won’t change it much either.
The IT Band attaches directly to the gluteals and tensor fascia latae (TFL), the tension in the gluteals and TFL pull through the IT Band down to the knee and ankle. Most pain that is felt in the IT Band, outside of knee (runner’s knee), and ankle is more than likely caused by dysfunction in the muslces located in the gluteals, TFL, and adductors. Adhesions do form in the IT Band, especially closer to the knee. However, in my experience as a movement therapist, I find the majority of adhesions which affect the IT Band are located in the dense tissue of the gluteals and TFL. Most people have minimal adhesions directly within the IT Band itself.
How this translates with using a foam roller on the IT Band
When you roll the IT Band and neglect the adductors, glutes, and TFL, you will only get temporary relief, not lasting change. As soon as you stand up, the restrictions in the adductors, glutes and TFL will once again pull through the IT Band.
You will get greater change in the IT Band tissue, increases in range of motion of the hips, and reduction of pain and discomfort by breaking down adhesions in the TFL, gluteals, and adductors. This is especially helpful for people new to using a foam roller, since rolling the IT Band can be very painful. If you spend a few minutes working through the gluteals and TFL first, when you roll on the IT Band it will be significantly less painful.
I believe that if you only roll out the IT Band and neglect other areas of your body, you could be asking for trouble. By loosening up just one side of the hips and knee, the opposing sides tighten to take up the slack. This could create imbalances in your movement patterns, as well as your body’s ability to stabilize the knee and hip joints. This is the big reason why I recommend to clients that they spend equal time addressing their entire body. The goal is to bring balance to the tissue, not to only work what feels good.
Personally, I do occasionally use a foam roller on the IT Band. It feels good and I can feel the benefit. But it is an area that I spend a minimal amount of time on. If I only have a short amount of time to roll, I roll the adductors, TFL, glutes, and calves. I won’t hit the IT Band at all.
Something to note: If you are using a foam roller on your IT Band to treat a painful condition, but you get only temporary relief and the pain continues to come back, then the IT Band is not the problem. In this case, I highly recommend seeking the help of a highly skilled movement therapist who can assess movement dysfunction and develop a personalized exercise program specific to your needs.
On another note, when I perform deep tissue massage therapy on a client, I rarely focus any time directly on the IT Band for the same reasons listed above.
Here are some articles with examples of how to perform foam roller therapy.
Foam Roller Massage Therapy For Beginners
Plantar Fasciitis Self Treatment for Fast Relief
Sciatic Pain Tips for Low Back Pain Relief
Hi Jesse,
I agree what you are saying, but specifically of ITB, foam rolling is just one part of the treatment. In my experience, the ITB should be displaced as much is possible. Meaning, manually has to be pushed sideways back and forth, like you would do on a formed scar tissue after a surgical insison. That will loosen up the band more effectively and gave a greater relief.
I’ve had tremendous success with the Graston Technique and I.T.B. Syndrome patients/athletes. Foam rollers/rolling works great too – and I have my people do that on their own at home.
Foam rolling, The Graston, or anything else for that matter, should follow the guideline of whatever works best for each individual.
It’s not a matter of WHO is right, but rather WHAT is right.
Aaron J. Forbes
Certified Spinal Fitness Specialist Level III
POWERCORE XL
Great subject. Great article. It is certainly not about who is right, but about what is right. Every ” body” is different. Every “body” should be treated differently. I tell everyone who will listen, “the secret to pain-free living is rolling.” I teach my clients to fall in love with it…above exercise, above stretching. The trick is to teach them how to make rolling exercise. Concerning whether or not to roll the it band, definately…if they are tight. I am a firm believer in rolling the tendonous junctions. My experience has proven them to be the culprits of muscle imbalnce. I roll my IT Band, deep, and with a pvc pipe and am able to greatly reduce the tension. I hardly ever roll it though. I agree with James on the the manipulation protocol of the TFL, glute and adductors to restore proper tension in the IT Band. If you are going to roll it, I suggest starting with a foam roller, then a medicine ball, and finally to a pvc pipe. This will help you slowly work through the layers to get to the root of the tension. The more you roll, the less sensative the area will be, and the faster the you will be able to relax. Rolling is an art. It is not something to be rushed. You must take your time, breathe, and use your mind to RELAX. I specialize in all joint pain and injury. I am able to take away most pain in one hour. I can repair most injuries in 4(including initial free assessment.) I can completely rebuild the entire body and restore proper lengh tension relationships in 12 hours or less for most people.
Good take on the IT Band about how you go to other places in the chain. I still wonder if you can objectively “stretch” or roll out the IT Band anyway. That thing has enough tensile strength and rigidity to use as a tow strap on the back of my truck.
Here’s another piece of the puzzle. What about sthe biomechanical issues that could be causing the IT Band or hips or adductors to tighten up or get symptomatic? It doesn’t happen out of a vacuum. The tightness and soft tissue restrictions are COMPENSATIONS not CAUSES. For example, if the right LE is shorter then they compensate by externally rotating the LE at the hip (toe out a little) to functionally lengthen the leg. Then the entire hip complex gets tight, especially the hip external rotators. If the ER muscles are tight this limits hip internal rotation that should happen with every step during gait/running/cutting and the IT Band or ACL or Achilles gets chewed up. Yes, treat the compensations with foam rolling and eccentric loading, but the CAUSE must adderessed as well.
Will a heel lift help in that case? Been doctoring for 3 years for that, and now I think it turned into Periformis & TFL pain. Two chiropractors gave me conflicting instructions on the heel lift as to which side. Also have gl. & H.S.tendinopathy.
Hi Diane,
Generally, I would only advise the use of a heel lift if there is significant dis-ability, neuropathy, and/or a true leg length discrepancy (diagnosed via imaging only).
Without knowing your individual background and injury history, I can’t offer any advice specific to your needs. At least not in the comments sections. I can offer much more during a consult. In which, I would be happy to offer a few different therapeutic perspectives. You can schedule a free consultation
at the link below.
https://theartoffitness.fullslate.com/services/537
Jesse James
Thanks, and one area people may want to think about is how to reduce overall neural tension with the foam roller. When one lies on the foam roller, I prefer the Smartroller since it is more anatomically friendly for this, and gently rocks side to side in small movements adjusting to their breath
Great article. I agree that the entire hip joint/region must be addressed to affect change. The ITB is only one component.
Thanks Stephanie.
Jesse James Retherford
https://tao-fit.com
I accept the good practice measures that have been submitted so far. This is something I would like to add which might not be evident from the standard texts and manuals. I have found ITB pain or sensitivity associated most frequently with an issue of “stickiness” located on the boundary between the ITB and the Vastus Lateralis (VL) rather than in the body of the ITB itself. Working specifically along this boundary with lateral, cross fibre (thumb?) pressure designed to separate the two bodies, is less uncomfortable and delivers significant relief.
The presence of ITB issues can inhibit the recruitment of the quad (or perhaps just the VL) muscles. Releasing any stickiness along this boundary can improve leg extension strength immediately. I would strongly recommend that therapists encountering this condition should first investigate and then follow up any issues along the ITB-VL boundary before applying pressure to or rolling along the white tissue itself, if only as an investigative mechanism prior to standard treatment to the area.