Foam Rolling the IT Band: Should You?

Foam rolling has become increasingly popular as a method of self-massage. In their effort to work out knots or tightness, practitioners diligently lie across foam rollers and (using their body weight as leverage) roll back and forth, attempting to soften the offending tissue into submission.

One of foam rolling’s most popular targets? The sturdy and unyielding IT band.

What is the IT Band?

Located on the outer thigh, the IT band, or iliotibial band, is a sturdy tract of connective tissue that runs from the outer hip (the ilium) to the outer knee (the tibia and fibula). Although it is often depicted in anatomical drawings as an isolated structure, it is continuous with the great web of connective tissue that encases the entire leg (and indeed the entire body) like a stocking.

Not only does the IT band run vertically, it also runs deep. The IT band plunges from its superficial wrapping of the leg muscles down to the femur, creating the fascial divide (called a septum) between the quadriceps and the hamstrings. The IT band provides essential support for the outer hip in moving and standing upright.(1) This support is more than passive; two muscles—the gluteus maximus and the tensor fascia latae—also insert into the top section of the IT band at the hip. Contraction of these muscles adds tension to the IT band, giving it a more active role in supporting the hip. From this point of view, the IT band could even be considered a very long tendon for these muscles.

When the IT band tugs or rubs on the outer knee, it can be painful. “IT band syndrome,” very common in runners and cyclists, describes a condition in which the IT band becomes irritated and inflamed due to friction on the outer knee. It may seem logical to assume that somehow “loosening” the IT band would help (for example, by rolling on a foam roller). The story, however, is more complex.

Before you hop onto that foam roller, here are some possible pros and cons you might consider.

The Pros of Foam Rolling the IT Band

1. Increase your range of motion.

Whereas static stretching impedes muscle performance, foam rolling has been shown in clinical trials to temporarily increase the knee and hip joints’ range of motion without impairing the performance of the muscles.(2) For this reason, researchers speculate that foam rolling could be useful as part of a pre-performance warm up.(3) One theory is that sustained pressure may help to reduce fascial adhesions and soften the targeted tissues.(4) Research is still not clear, however, on whether the increase in range of motion is sustainable beyond the short-term.

2. Rolling may rehydrate your tissues.

The reasoning behind this expected outcome is that compressing tissues is similar to squeezing a sponge—the pressure forces the fluid out, and when the tissue is decompressed, the fluids rush back in.(5) While this action doesn’t create new fluid, some researchers believe that the compression and decompression can assist fluid flow to congested areas, which may well be helpful to maintaining healthy tissues. (Note that there is some controversy around this research.)

In addition, compression of the tissues may assist blood flow to the area, and rolling has been shown to positively affect arterial hardness.(6)

3. Connect with your body.

Foam rolling is an opportunity to connect with your body and your visceral experience in a new way. “Connecting with every aspect, dimension, and texture of our bodies is a good thing in my mind,” says Gil Hedley, a noted anatomist and self-styled somanaut. (Hedley uses the word somanaut to describe “those who explore the inner space of the body, and discover there the rich terrain of themselves.”) Hedley continues, “If the intention of ‘rolling out the IT band’ is to bring [your] conscious awareness to that particular tissue-texture-layer, so that you can live there too, I'd say connect away!”

Your fascia is also home to many sensory nerves that facilitate proprioception (your ability to know where you are in space), and some research suggests that mobilizing fascia with foam rollers can assist in proprioceptive refinement.(5)

The Cons of Foam Rolling the IT Band

1. You may not want the IT band to stretch. Remember, the IT band is not a muscle; it is collagenous connective tissue. It is strong and tight so that it can hold us up and keep the hip stable. “IT bands should be tight because they are holding us together!” exclaims Hedley. “The [IT bands] are important sturdy structures.”

In other words, we don’t want a loose IT band; we need it to be stable in order to be functional.

2. You’re not getting to the real problem. Although the IT band gets blamed for knee pain, the problem is often originating elsewhere. For example, the gluteus maximus or tensor fascia latae (the muscles that insert into the band) could be tight and transferring their tension through the IT band to the outer knee. Or the functional stabilizers of the outer hip could be weak, and the IT band is stiffening up to compensate. In this situation, the practitioner wouldn’t see any relief until the outer hip is strengthened and the IT band can then go “off-duty.” Jill Miller of Yoga Tune Up, known for her therapeutic use of yoga balls in support of functional movement, cautions: “Prior to arbitrarily ‘rolling’ the IT band, I would ask anyone to consider if they feel odd sensations or pain in their bottom, hip flexors, or knee, and to use self-myofascial tools for those muscles first.”

3. You could make the problem worse. Rolling out the IT band could cause damage to the muscles that lie beneath it. The IT band is the fascial covering for one of the quads (vastus lateralis). When you roll out the IT band, you are essentially mashing up the muscle under it. For healthy tissue, this may be fine. However, too much compression can create micro tears that can lead to scarring (and further stiffness!). If the IT band is already inflamed and unhappy, then it may not be a good idea to beat it up with a foam roller. “The tissue is a very sensitive one to grind or drag along with pressure, and commonly causes painful sensations,” says Hedley. “And while we certainly want our IT bands, and every other tissue of our bodies, to be awake and alive and participating in the flow of the whole being, plowing down on them repeatedly because they hurt is a questionable habit and may represent evidence of faulty thinking more than a faulty IT band.”

Jill Miller echoes this note of caution: “Rolling on any tissue, especially if done with excessive force, can be harmful. If the pressure is light, it’s most likely not going to cause harm.“

Conclusion

We are still in the early stages of understanding the relationship between fascia, fitness and functionality. However, Hedley, Miller, and Amy Matthews (movement therapist and founder of “Embodied Anatomy,” whom I also consulted for this article) all concur on one basic point: connecting with your body is good, but foam rolling that’s forceful enough to cause sharp or lingering pain may not be helpful. Although rolling out the IT band is never comfortable, you should heed your body’s warning signs and stop if you feel a lot of discomfort.

Be wary of the mindset that pain somehow equals gain. Hedley describes this mindset in action: “At one level we sometimes ‘go for pain’ because it seems ‘real’ and we take it as confirmation that—sure enough—[the IT band] must be ‘too tight’ because grinding on it hurts... so I will grind on it some more even though it hurts, because obviously I must need it, because it hurts.” This kind of cyclical thinking may well set us up for inflammation, tightness, and dysfunction.

Also, notice how you feel after the foam rolling session. “You probably won’t know [if the session was effective] until the next day,” says Miller. “More pain is not a therapeutic response.”

When it comes to foam rolling out your IT band, every yoga teacher’s favorite adage remains true: listen to your body.

Footnotes 

1. Beals, R. K. The iliotibial tract: a review. Current Orthopaedic Practice, 20(1), 87–91, 2009.

2. Bradbury-Squires, D. J., Noftall, J. C., Sullivan, K. M., Behm, D. G., Power, K. E., & Button, D. C. Roller-Massager Application to the Quadriceps and Knee-Joint Range of Motion and Neuromuscular Efficiency During a Lunge. Journal of Athletic Training, 50(2), 133–140, 2015.

3. Halperin, I., Aboodarda, S. J., Button, D. C., Andersen, L., & Behm, D. G. Roller Massager Improves Range of Motion of Plantar Flexor Muscles Without Subsequent Decrease in Force Parameters. International Journal of Sports Physical Therapy, 9(1), 92–103, 2014.

4. Kalichman , L., & Ben David, C. Effect of self-myofascial release on myofascial pain, muscle flexibility, and strength: A narrative review. Journal of Bodywork & Movement Therapies, 2016.

5. Schleip, R. Fascial plasticity – a new neurobiological explanation: Part 1. Journal of Bodywork & Movement Therapies, 7(1), 11–19, 2003.

6. Okamoto, T., Masuhara, M., & Ikuta, K. Acute Effects of Self-Myofascial Release Using a Foam Roller on Arterial Function. The Journal of Strength & Conditioning Research, 26(1), 69–73, 2013.

7. Freiwald, J., Baumgart, C., Kühnemann, M., & Hoppe, M. W. Foam-Rolling in sport and therapy – Potential benefits and risks. Sports Orthopaedics and Traumatology, 32(3), 267–275, 2016.

8. Kline, C. M. The surprising iliotibial band. Journal of the American Chiropractic Association, 2011.

9. Beardsley, C, MA., Škarabot, J, BSc., Effects of self-myofascial release: A systematic review. Journal of Bodywork & Movement Therapies, 19(4), 747–758, 2015.

10. Healey, K., Hatfield, D., Blanpied, P., Dorfman, L., & Riebe, D. The Effects of Myofascial Release With Foam Rolling on Performance, Journal of Strength and Conditioning Research, 28(1), 61–68, 2013.

11. Peacock, C. A., Krein, D. D., Silver, T. A., Sanders, G. J., & Carlwitz, von, K.-P. A. An Acute Bout of Self-Myofascial Release in the Form of Foam Rolling Improves Performance Testing. International Journal of Exercise Science, 7(3), 202-211, 2014.

12. Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. The Effects Of Self-Myofascial Release Using A Foam Roll Or Roller Massager On Joint Range Of Motion, Muscle Recovery, And Performance: A Systematic Review, International Journal of Sports Physical Therapy, 10(6), 827–838, 2016.