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Foam Rolling the IT Band

Elyse Harrop, DPT

If you’re a runner, at one point or another you’ve probably heard the suggestion to “roll out your IT bands” to prevent or help decrease lateral knee pain. You cringe, and say “ok let’s get the agony over with.” Let’s look at what the IT band is, and whether this often painful technique is vital to your knee health as a runner.

The iliotibial band, as the name suggests, has connections at the top of the pelvis, attachments throughout the lateral side of the femur, and at the lateral knee. It’s made of fascia, which is a stabilizing tissue that is vital to helping us stabilize our legs when we are upright. It’s often purported that lateral knee pain with running can be caused by the IT band “rubbing” back and forth along the outside of the bottom piece of the femur. Foam rolling has been suggested along the IT band to “break up adhesions” and “stretch” the fascia, so we get less pain.

While this sounds great in theory, from studies performed on cadavers, we have learned that it would take up to 2,000 lbs of force to create a change in the fascial tissue! There is no “rubbing” of that IT band back and forth; it’s connections are too strong. Pain is usually caused by compression of a highly innervated (and sensitive!) fat pad underneath the band when we run. If we can’t make a change in the fascia, what do we do about that knee pain? Try rolling the muscles around the IT band instead, like the lateral quadriceps, hamstrings, and glute muscles. This will help increase blood flow to the area and, probably most importantly, influence your nervous system and help decrease the sensation of pain in the knee.

It is important to realize that while the knee may feel great after these foam rolling sessions (with your new technique, avoiding the actual IT band), this is not a stand alone treatment. Your PT will likely perform a running assessment and prescribe a strengthening program to address any deficits or muscle imbalances they see, in order to help prevent recurrence of pain in the future.

Save yourself some pain, and lay off those IT bands with your foam roller. Your knees will thank you!