Treatment

Should I foam roll my IT band?

Foam rolling can be pretty awesome. I recommend it to many of my clients for a variety of issues, and as far as self-care methods go, it is one of the more versatile and easy to do. So I’m sure you can imagine that I enjoy seeing foam rollers making a rather widespread appearance. They’re in gyms, PT clinics, and lots of people are using them. But I cringe when I see people rolling up and down their IT bands at light speed.

I’m not entirely sure what’s up with the overabundance of foam rolling on the IT bands. It seems like everyone does it, though I’m not clear on where everyone learned their ‘technique’ and how they know that foam rolling the IT band is what their body needs. At one point, I sat in the gym I belonged to at the time and watched a number of people foam rolling. Every single one rolled up and down their IT bands, even the ones who didn’t roll any other areas at all.

Which bring us to the main question of this post: Should I be foam rolling my IT band?

What’s an IT band, anyway?

Your IT Band, otherwise known as the Iliotibial band or ITB, is a thick sheath of fascia (connective tissue) found on the outer thigh, roughly from the hip to the knee. It helps stabilize your knee, and the muscles that surround it (some even insert into it) play a role in extension, abudction, and lateral rotation of the hip.

You’re asking it to do a job when you’re walking, running, cycling, and doing just about anything else that involves your legs. You change the tension on it when you sit (which many of us do all day, at a desk). That’s a lot of different movements that it is involved in, so it should come as no surprise that it plays a huge role in may forms of hip and knee pain. A number of sources indicate that IT band syndrome is one of the leading causes of lateral knee pain.

itb

 

 

Should I foam roll my IT band?

The concept isn’t entirely ridiculous: If my IT Band is tight and causing problems, I should roll it to stretch it out, and then it won’t be tight anymore and I’ll get better. So where does this theory fail?

  • The IT band isn’t a muscle – it is connective tissue. Really, really thick connective tissue, that you can’t stretch much.
  • Rolling quickly up and down wouldn’t break up any adhesions in a muscle anyway (which is what most people seem to be doing)
  • The IT band may be playing a role in your pain, but there are a number of things that may put your IT band at greater risk for injury (such as gait abnormalities). You’ll need to get to the root of the problem, which may not be the IT band itself.
  • If you have inflammation in the area, you’ll likely just irritate it more by rolling up and down the IT band.

The idea that you can stretch out or ‘release’ your IT band is a nice visualization, but it doesn’t actually work that way. Furthermore, if you have pain in the area or have been diagnosed with IT band syndrome (inflammation/irritation of the IT band) and you roll the area, you’re likely to make it even more inflamed.  And more inflammation = no thanks.

What to do instead

So if foam rolling the IT band isn’t going to get you very far, then what should you be doing?

Stop Consulting Dr. Google

If you think you may be injured…..We all know we shouldn’t, but we do it anyway. We have pain, and we check with Dr. Google to see what it is. If you have persistent pain, go see a real doctor and use Google for cat videos instead.

Address the TFL

The tensor fasciae latae (TFL) is a small muscle that sits along the upper lateral hip, inserting down into the IT band, aiding in hip stabilization. It pulls upward on the IT band which increases tension.  You can help reduce tension on this muscle with static pressure on the muscle (either a foam roller that you’re not rolling on or a tennis/lacrosse ball will work well).

Should I foam roll my IT band

Take a look at both the TFL and the gluteus maximus in this photo

 

Glutes, glutes, glutes

Think about the location of your gluteus maximus (that’s the butt, for y’all that prefer the colloquial). It doesn’t ‘attach’ to the IT band technically, but it does share fascia, which means if it is tight and yanking your pelvis in an undesirable way, then it is likely affecting other structures in the area. Foam roll, use static pressure on sensitive spots, or stretch (try the figure 4 stretch below).

figure4

 

Foam roll your quads, adductors, and hamstrings: Many people think that the quads (front of the leg) and hamstrings (back of the leg) ‘attach’ to the IT band, which is incorrect. This is a very oversimplified description, but the IT band comes closer to lying next to/on top of the edges of some of these muscles rather than attaching to them. Slow foam rolling and/or static holds for the quadriceps, adductors, and hamstrings will help to balance tension in the leg overall, hopefully putting less load on the IT band.

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What can kinesiotape do for me?

By now, you’ve probably seen people wearing it. Brightly colored or black tape standing in stark contrast to the skin, applied to various areas of the body in sometimes dramatic pattern. More often, you probably don’t see it – because it’s hiding beneath clothing or shoes. Regardless of where it is or what color it is, you may wonder exactly what it does? And what is it?

Most of us are familiar with athletic tape – stiff(ish) white stuff designed to stabilize joints during athletic activity. This stuff is different. It is softer, more flexible, and stretchy. Most often, it is called kinesio-tape (the name Dr. Kenzo Kase gave it way back in the 70’s), but there are a ton of different (brand) names out there today.

A little background

The ‘original’ Kinesio tape was designed back in the 70’s in Japan by a chiropractor and acupuncturist named Kenzo Kase. He developed the first tape of this kind with the goal of increasing the efficacy and achieving longer lasting results from manual therapy sessions. The tape was designed to have a similar elasticity to healthy human muscle, breathe well, stay in place for longer periods of time, and lift the skin microscopically.

What does the tape do?

When a muscle is injured, it loses some of its elasticity. The tape is designed to help augment the healing process and offer support for joints while not restricting any range of motion. At least in theory, the tape extends the benefits of manual therapy by providing extended soft tissue manipulation. When applied, the tape is supposed to activate certain types of mechanoreceptors (little receptors in the skin that respond to light touch, sustained pressure, texture, tension, etc) that alleviate pain. The microscopic lifting of the skin that I mentioned earlier creates interstitial space which allows for a decrease in inflammation in the taped area.

Does it work?

Lots of people I’ve talked to have relayed positive messages regarding their own use of kinesio tape, but I always like to take a look at any studies that have been done to see more objective analysis rather just than anecdotal support. There are more studies out there than I can count, but I’ve selected a few just to give you an idea of what’s out there. I’d encourage you to search Pubmed to see additional studies on therapeutic taping.

  • This meta analysis of 10 studies concerning sports injuries concluded that “there was little quality evidence to support the use of KT over other types of elastic taping in the management or prevention of sports injuries.”
  • This study that compared nonelastic sports tape with kinesio-type tape (elastic tape)showed that elastic tapes offered no effect on muscle activation
  • This study looked at basketball players with chronic ankle sprains, and though it determined that taping didnt have a positive effect for the players in their functional performance tests, it had no negative effects, either.
  • In a study of healthy college athletes, it was determined that taping did not have any positive effect on performance.
  • This study  shows that taping offered some increase in dynamic postural control in healthy individuals.
  • Another study looked at healthy young women performing squat exercises, and determined that tape application prior to this exercise didn’t effect muscle pain or short sprint performance, but did help maintain muscle flexibility at day 2 of recovery.
  • This study looked at the typical asymmetrical gait of stroke patients and found that the application of the tape to the paralyzed parts offered improvement in gait (ie, it made it less asymmetrical).
  • One last one explores the effect of taping on lumbar spine flexibility. The subjects in this study showed increased flexibility in the lumbar spine at 24 and 48 hours after tape removal.

In short: mixed results. That’s the worst – right? Things are much easier when there’s a clear conclusion and subsequent action items. The good news is that kinesiotape (regardless of brand, color, or whatever) isn’t going to break the bank and isn’t going to hurt you. So go ahead and give it a try.

 

 

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