Image Source: cyclingweekly.co.uk.
A surprising number of people still say to me “my IT band is tight” and so they have been told to “roll-out” their iliotibial (IT) bands, and some even get beaten up with Graston Technique® to the IT band. The thing is though, it’s meant to be tight. That’s it only job.
To be a little clearer, the IT band stabilizes action at the knee and it does not have any contractile fibers (muscle cells). This is important: because it cannot actively change its length through contraction, so it can only create stability because it is tight.
So what are we being told and what should we instead be hearing?
The idea of changing the length of your IT band through stretching or manual manipulation is not only an incredibly painful process, it’s also entirely useless. You’ll be grimacing with agony, and the work you’re putting in won’t actually be doing anything. It is almost impossible to change the length of the IT band without surgery, and even then, why would you want to? You’ll be permanently destabilizing the knee. And you can’t change that back.
Part of the reason you can’t change it’s length is due to the fact that there are no contractile muscle cells within the fascial band. Additionally, and perhaps more profoundly you can’t change it’s length because it’s firmly and uniformly stuck down to the femur – all the way from the greater trochanter to the lateral femoral condyle. (Here’s a study of cadavers to prove it). So in theory you’ll also have to separate it from the femur before being able to lengthen it…which is just ouch. And permanent. And unnecessary.
So What Are People Really Feeling?
What someone means when they tell you your IT band is tight is that the muscles (which can build tension and readily change length) that attach to the IT band are tight, and they’re pulling on something that’s already as tight as it should be. This causes you to feel as though this tract of fascia is tighter, yet it’s really all the things pulling on it.
So What Should We Do Instead?
These muscles insert into the IT band and should therefore be the focus of your efforts in releasing what you feel to be a tight iliotibial tract:
Image Source: painscience.com.
- Gluteus Medius – this guy is one of the main culprits and just sits there waiting, like the evil sibling that gets you in trouble when you’ve done nothing but just sits back and watches you take the rap for it.
- Tensor Fascia Lata – another one of the big two culprits, the TFL inserts directly into the IT band (as does Gluteus Medius above). Sitting for large portions of our day means that the TFL is chronically shortened in a large number of us.
- Gluteus Maximus – a large portion of our most powerful muscle also directly inserts into the IT band and pulls on it.
- Vastus Lateralis – this is the lateral quadriceps (quintceps) muscle and it is generously attached to the IT band along its length, though it has less influence over the tension on the fascial band than the first three muscles listed here.
- Tibialis Anterior – less clinically relevant, but important to know nonetheless is that fibers of the IT band continue into the Tibialis Anterior muscle. Even though the tibialis anterior is typically tight in the majority of people, it is also difficult to significantly change it’s length with stretching.
- Biceps Femoris – the lateral hamstring is also connected with the IT band and similarly to Vastus Lateralis runs along the length of the fascial tract and therefore exerts some degree of influence over the “pull” on the iliotibial band.
So…
Instead of rolling your IT band or getting aggressive and painful bodywork on it, you’re much better off focusing on the above muscles. Especially Gluteus Medius, Tensor Fascia Lata and Gluteus Maximus. Not does it feel much nicer, it’s also far more therapeutic and useful to you.
(Additional Fun Fact: There’s no bursae under the IT band either, just in case you’ve ever been told you have bursitis there.)
If you liked this article, you’ll probably also get a kick out of “You Probably Think There Are 4 Quadriceps Muscles. Think Again.” and “Just Because It Hurts Doesn’t Make It A “Deep Tissue Massage“.“
I wanted to add some things 🙂
Two things I have seen work with my fitness clients – build inner thigh muscle to pull things back in to balance. If you’re taking a yoga class with tons of inner thigh stretches and then a spin class, the imbalance might lead to further discomfort. Also, twisted hamstring stretches can do wonders.
I read a study that took 25 cadavers and measured length of IT bands and concluded that length of IT bands has no correlation to pain and also that they could not be stretched (which means IT band “stretches” are a misnomer). I forget the specific details and can’t find the study now but at least it is something to think about.
Any idea about supination of the feet as a contributing factor?
Gwendolyn! 🙂 🙂
Thanks for these additions!
Yes, I read that study too – I should actually find it again and reference it here so we can both go back to it whenever we want 🙂
I wouldn’t expect supination to be linked with IT Band tension – I would anticipate it would be pronation that would actually be associated – lateral chain tightness would encourage pronation. Both as a symptom and a possible contributing factor.
(ps sorry about the late response on this!)
This really is a tough one sometimes to have clients understand they think that we should massage where the pain is and education is constant with ITB’s I will work glute muscles and TFL etc have to constantly reassure them that yes I know your discomfort is the lateral thigh over the band when you apply pressure to it. but they are usually shockingly happy with the results post treatments. On a couple occasions though I did run into the inflammation of the trochanteric bursa which has a pain referral area down the lateral thigh making it feel like their band hurts.