Foam rollers & IT-bands?
Pain or discomfort radiating along the side of the hip, leg or knee for those that participate in running and cycling can be a common re-occurring issue. Often the iliotibial band or IT-band as it is more commonly known as can be the source of this pain.
What is the IT-band?
Essentially it is thick connective tissue (fascia) running along the outside of the hip down to below the outside of the knee. Muscles of the hip, gluteus maximus inserts from behind and tensor fascae latae (TFL) inserts from the front. The IT-band increases the mechanical pull these muscles have on the hip by extending their reach down to the knee, allowing them to perform flexion, extension, lateral and medial rotation of the hip. As well, helping to stabilize the hip and knee.
While running the hip and knee move through repetitive flexion and extension aided in part by the IT-band. Inflammation due to friction as it slides over the outside of the knee during flexion and extension can occur.
Foam Rollers
Using a foam roller on the IT-band has commonly been prescribed as the solution to the lateral knee pain experienced with IT-band inflammation. Unfortunately the rationale for this advice is incorrect. Foam rollers have primarily been useful for releasing painful taut bands of of muscle tissue referred to as trigger points. As mentioned before the IT-band is connective tissue and therefore can not be stretched with foam rolling.
The key to reducing IT-band inflammation and pain along the lateral aspect of the knee is focusing on what is happening to the muscles at the hip that attach to the IT-band.
A common issue is muscle imbalance, weak glute maximus and over active TFL. An over active and tight TFL will pull on the IT-band, increasing tension along the lateral aspect of the tight and knee. With repetitive hip and knee flexion/extension during running/cycling, the increased tension of the IT-band over the knee causes it to friction over the knee. The reason foam rolling the IT-band hurts so much is because its already inflamed, foam rolling is just adding insult to injury.
Release the tight muscles of the hip. Strengthen the weak muscles of the hip & your IT-band problems will cease to exist.
But don’t throw out that foam roller yet, you can still use it to reduce tightness in the muscles of the hip that act on the IT-band.
Here is a simple exercise and stretching program address the common issues leading to IT-band syndrome.
3 sets of 12-15 reps per exercise.
4 x 1 minute hold per stretch. Click pictures to enlarge.
Strengthen the hips
Often the extensor and abductor muscles of the hip, glute maximus and medius are weak compared to the muscles that perform hip flexion. This muscle imbalance creates abnormal tension on the IT-band resulting in friction at the knee. These exercises will strengthen hip extension and abduction.
Stretch the hips
The tight flexors of the hip include TFL, iliopsoas and rectus femoris (one of the four quadriceps muscles). Relieving the tension in these muscles will ensure a long term solution to IT-band tension and pain.
The IT-band can be seen above as a thick band of white connect tissue along the lateral aspect of the hip to knee.
