I.T.B.  The Iliotibial Band.  This is the line of connective fibres that run down the outside of your thigh, from your hip to the knee. It is not a muscle, but a sheath of fascia.  Its role is to absorb and distribute forces during mechanics like running.

If you’ve ever used a foam roller along the ITB… you probably know how sensitive this can be!  Maybe a physio, chiro or Doctor has told you that your IT Band is tight, and you need to loosen it to help with running or to relieve knee pain.

The FIRST thing you should know about this is…

OF COURSE, the ITB is tight!  IT HAS TO BE.  It relies on mechanical tension to absorb the forces and keep the body upright and moving.  If the ITB were loose at all, we would struggle to remain upright as we move.  It is the main connection between the knee and hip and requires taking a high workload.

ITB Friction Syndrome, has been labelled as the pain associated with ITB tightness on the outside of the knee.  That’s what was previously thought.  However, the ITB does not create friction because of tightness, rather it is suspected to compress on sensitive fat tissue at certain angles.  Pain associated with this is suspected due to other mechanical discrepancies with poor load transfers (commonly hip-related).

So why is it initially sensitive with foam rolling but generally feels better after a while?

Short answer: You have become used to it.

To explain further, foam rolling and other “myofascial release” techniques such as massage, Theragun etc. do not improve length of tissues or ‘release knots’.  (Your tissues don’t have real knots in them, but that is another topic).  If you wanted to change the structure of the ITB by 1%, it would require 9075Newtons of force.  That’s 925kg on your leg…or HALF A GIRAFFE… to change 1%.

Which makes sense, when you think about how long you sit on a chair and have no changes in tissue structure from that.  The main reason these techniques provide relief or improve range of motion, is due to a neuromuscular response = you’ve allowed your body to relax, reduced muscle guarding and improved pain pressure threshold.  This may TEMPORARILY improve your range of motion and circulation, but this is very short lived (only a few minutes).

Now, I’m not saying foam rolling the ITB is a waste of time, I believe it has its place, but it doesn’t work in the way we have been led to believe.  The real progress in addressing mechanical issues… is through an active mechanical approach… EXERCISE!

Exercise Physiologist/Coach Caitlyn Huth

References:
Chaudhry H, Schleip R, Ji Z, Bukiet B, Maney M, Findley T. Three-dimensional mathematical model for deformation of human fasciae in manual therapy. J Am Osteopath Assoc. 2008 Aug;108(8):379–90
Fairclough J, Hayashi K, Toumi H, Lyons K, Bydder G, Phillips N, Best TM, Benjamin M. The functional anatomy of the iliotibial band during flexion and extension of the knee: implications for understanding iliotibial band syndrome. J Anat. Mar 2006;208(3):309-16.

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