To Roll or Not to Roll..... the IT Band
Do you roll the IT Band? If you do, you are not alone, even I have been guilty of doing the same thing in the past. I suffered from the dreaded IT Band Syndrome and still have flair ups every so often.
If you are still foam rolling the IT Band, PLEASE STOP!!!
I have been doing some research on IT Band Syndrome and came across a great article by Dr Brian Tiu, about why the IT Band isn't the problem for lateral knee pain and how foam rolling the band itself could be one of your issues.
The part that caught my attention at first was when Dr. Tiu stated:
"Essentially, the IT band is nothing more than a fibrous reinforcement that is non-contractile with a tensile strength of steel and anchored firmly to cortical bone."
Compression NOT Friction
When I was in school the teachers and the text books all spoke of IT Band "Friction" Syndrome. The thought was at approximetly 30 degrees of knee flexion, which is common in running and cycling sports, that the distal portion of the IT Band would flip back and fourth over the outside bone of the femur (Femoral Condyle) causing friction and inflammation.
Well new research is out stating that the band is anchored to the femur which prevents the band from moving front to back and the pain and inflammation is caused by a compressive force of the band over the fat pad and condyle of the femur. When the tibia internally rotates during flexion it causes the the band to pull across the condyle this is due to its attachment point on the tibia.
Essentially what the two articles are saying is that the compressive force of the IT band against the underlying structures leads to the symptoms but isn't necessarily to blame.
Whats the Cause?
There are few different causes that need to be professionally assessed, the research article notes
"structural issues that may cause the ITB to become excessively tight may be due to a shift in the pelvis, hip flexor imbalance, gluteus medius dysfunction, bowed legs (genu varum) and dynamic knee valgus."
In my clinic the first thing we do is thoroughly assess the pelvic alignment and the muscles strength of the glute med. And quite often in runners (that are not strength training a minumum of twice a week, which i'll discuss in the future) that present with the IT band symptom picture, we find malalignment on the side of pain and a definite decrease in strength in the glute med.
So all the information above is saying the IT Band can't be stretched and pointing toward compressive forces causing the symptoms. So why in the world are people foam rolling the it band directly, hoping it will stretch out, meanwhile causing more compression and pain? They shoud be dealing with the actual issues and causes.
Food for thought!