I bet that got the attention of some people – especially runners who “stretch” their IT band (ITB) trying to fix their knee pain. Continue reading to find out more…
Let’s first discuss some of the physiology of the ITB and what it actually is. The ITB starts at the end of the tensor fascia latae muscle (which is on the outside of your hip), runs along the outside of your thigh and ends just below the knee on your shin. It is not a single, discrete entity (like the picture on the left shows). Rather, it is a dense connective tissue that is the lateral part of the fascia latae (the fascia that wraps around the entire thigh). The ITB has attachments all along the thigh – it doesn’t just attach at the beginning and end like a piece of rope (see the above picture).
A study in 2008 determined the amount of force it would take to lengthen some human fascia, including the IT band (the other two were the plantar fascia and some nasal fascia). The authors found that it would take about 2,000 lbs of force to lengthen your ITB 1%. They described this large amount of force as “far outside the human physiologic range.”
So there is no way that anything you or your therapist is doing is actually lengthening it! And this also means that a “tight” ITB is not the reason for your pain.
I find it necessary to quickly discuss foam rolling because I know a lot of you out there love to foam roll your ITB and think it works wonders. A foam roller compresses the ITB, but cannot stretch it (for the obvious reasons described above). Feeling better after foam rolling is probably due to a neurophysiologic response by your body/brain (we still don’t really understand how foam rolling “works” but that seems to be the most popular hypothesis).
If you like foam rolling your ITB and feel better after it, then go for it – just realize that you aren’t actually stretching anything. And my recommendation would be to limit it to 15-20 seconds at most on each side (in fact, that’s my recommendation for foam rolling any body part).
Although, if you are someone who likes to do static ITB stretches, my recommendation is to stop them because you’re just wasting time. Rather, perform some more appropriate mobility drills and/or exercises specific to your limitations.
I couldn’t end this post without briefly (emphasize briefly because there is so much to potentially talk about) discussing what you should actually be doing for your knee/hip pain instead of “stretching” your ITB. There are many potential problem areas that can be causing this type of pain – could be a mobility or motor control issue somewhere from the foot all the way up to the thoracic spine and anything in-between. Some of the common problems I see in people who have lateral knee and/or lateral hip pain and were told it was their “tight” ITB are: limited hip mobility (usually internal rotation), poor neuromuscular control of the lower extremity, and/or limited ankle dorsiflexion; in runners, could also be training error or running mechanics issue.