Tight IT band?
Why are we in love with rolling out IT band?
People looooove rolling a foam roller on their IT bands. I used to love it too. You have to roll out that tight IT band, right? My opinions on it have changed substantially over the years. The following info is one of the main reasons why.
A good friend of mine, Dr Brian Tiu, wrote a great article on why your IT band isn’t the problem with lateral knee pain and how your foam roller could be one of the problems. You can find the article HERE.
What is going on with the IT band?
A lot of people used to think that their “tight” IT band created some sort of “friction” across the outside of the knee, as if the thick band of connective tissue was sliding back and forth. That probably isn’t what is going on and the concept of that happening is likely an artifact of being an easy-to-conceptualize-idea.
As Dr. Tiu states:
Essentially, the IT band is nothing more than a fibrous reinforcement that is non-contractile with a tensile strength of steel and anchored firmly to cortical bone.
This means that the IT is a super strong band that doesn’t lengthen and it is firmly attached to the bone. It isn’t a flexible band that can slide around all over the place.
So what is happening then if rubbing, sliding, and friction aren’t the problems?
As Dr. Tiu states:
Initially, the presumed model for ITB “friction” syndrome was that the iliotibial band repetitively shifted (rubbed) forward and backward over the lateral femoral epicondyle – causing “friction” and subsequently inflammation of the ITB.
However, I would question this view as this syndrome is one of compression as opposed to friction.
Basically he is saying that the IT band can compress the tissue underneath it, which may be leading to the symptoms. But that doesn’t mean the IT band is to blame. It is just the messenger.
So what is causing the IT band to be a bad guy?
From the article:
structural issues that may cause the ITB to become excessively tight may be due to a shift in the pelvis, hip flexor imbalance, gluteus medius dysfunction, bowed legs (genu varum) and dynamic knee valgus.
So if the above mentioned reasons are WHY the IT band is compressing the tissue below, doesn’t it make sense to address those versus compressing it MORE with a foam roller?
Once again Dr Ryan, you are spot on. Well done.
I thought IT Band was, in great part, a tendon of the tensor fascia lata and, secondarily, the gluteus maximus. That’s why, when people complain of “tight IT band,” I do muscle release work on the TFL and GlutMax. … Usually works for me.
ALSO, if a person has “knock knees” (knee valgus) it is very often NOT the commonly thought excess AD-duction of the femur at the hip, but AB-duction of the LEG from the knee down.
Reducing tension in TFL and Glute Max reduces the lateral pull through the TFL, in turn reducing abduction of the LEG at the knee. … At least, that’s what VERY often works for me. …
And you should see the eyes roll in embarrassment when highly trained therapists, including PTs, realize they should have “seen” that long ago. But everyone was so conditioned to think “the knees are knocking” (adducting) rather than “the legs are abducting.”
(NOTE: In medicine, there is no “upper leg” or “lower leg.” There is the THIGH (from hip to knee but what many people call the “upper leg”) and the LEG (from knee to ankle but what many people call the “lower leg.”) I am using the medical terminology above, not the layperson language.)