Foam Rolling: IT Band (should you stop?)

Have you ever heard of Moshe Feldenkrais?  What about foam rolling?  The infamous piece of foam, a proven miracle device found in discount bargain stores, promising to massage away all your aches and pains for a mere $5.  Well, thanks to Moshe Feldenkrais, the inventor of the Feldenkrais method (the foundation of the foam roller technique), personal trainers across the globe started using foam rollers to help clients perform self-myofascial release between sessions to reduce muscle pains and increase flexibility.  As with any evolving science, new hypotheses are questioning the efficacy of foam rolling for certain muscle groups.

One of our Core Values is to adhere to evidence-based practices.  Our views on foam rolling have not changed.  Research continues to support the value of foam rolling for transient or temporary improvements in soft tissue quality and flexibility.  What does that mean?  Foam rolling can be equally effective as static stretching for increasing flexibility.  Although the benefits may be short-lived, regular use, in conjunction with exercises to improve the function of the areas involved, can result in long-term, permanent improvements.  Foam rolling is beneficial in getting tight spots, or fascia, to release.  In other words, it can help you feel better, but won’t make you function better without supplemental intervention (i.e., strengthening). 

One area we used to heavily foam roll is the IT Band, or Illiotibial Band or Tract.  The IT Band is a thick band of fascial tissue that runs the length of the outer thigh, and inserts into the tibia, the thicker bone in the lower leg.  It serves as an attachment for your Gluteal Muscles (the large muscles of the back/side of your hip) and your TFL or tensor facia latae (a small muscle towards the front/side of your hip).  Together these muscles move your hip, but more importantly (along with the IT Band) provide stability for your knee. 

It's quite common for active people, especially runners, to have tightness in the IT Band or experience pain associated with IT Band Syndrome.  The IT Band is not muscle, and thus does not have contractile properties like a muscle, which lengthens and shortens.  The IT band is fascia, which can thicken as an adaptation to stress, and can create the feeling like a short/tight muscle.  Consequently, some trainers recommend to foam roll or stretch your IT Band regularly. 

Recently, medical and healthcare professionals began questioning this approach to treatment/prevention.  Although you might experience temporary relief, could stretching and rolling your IT Band have a deleterious effect on your body?  What if increasing the pliability of your IT Band lead to greater instability of your knee?  What’s been hypothesized is the tightness of the IT Band is a response to something else.  It may be more likely to be a response to weakness in the hip musculature, and thus a symptom, not a true problem.  This theory made sense to us.

Why are people suffering with IT Band discomfort?  Primarily it’s our sedentary culture which leads to significant decreases in the strength of the gluteal muscles.  Your glutes are highly active when you’re jumping, running and squatting.  Given that only 15% of the adult population in the US is sufficiently active it’s no wonder why people have tight IT Bands.  Moreover, many people who experience IT Band Syndrome are those who go from Couch to 5K or start an aggressive New Year’s Resolution fitness program.

Another reason is the act of sitting too much.  Sitting is a posture.  Our muscles adapt to our average daily position (or posture) to become more efficient at supporting us.  When we sit, our hip flexors adapt by shortening, while their opposing muscle (the glutes) respond by lengthening.  When a muscle lengthens it loses the ability to efficiently respond to stimuli and to contract efficiently.  So, we have a lengthened glute, which in response may cause the IT Band to stiffen to continue to provide stability at the knee.  This is a prime example of reciprocal inhibition.  When a muscle contracts, its opposing muscle must relax in order for your body to move.  If your hip flexors are short and in a chronically contracted state, they inhibit the normal functioning of your gluteal muscles.  As a result, your glutes don’t perform properly, the reaction may be for your IT Band to tighten to provide stability for your knee(s).  If you foam roll or stretch your IT Band, you risk creating instability in your knee, especially if you don’t also work to rebuild the glutes. 

Is there a more effective solution to IT Band Pain?  Instead of rolling or stretching your IT Band, here are three things you can do to prevent IT Band tightness:

1.       Stand up.  Make your conference calls mobile, use a standing desk, or get out and walk around the block every two hours. 

2.       Lengthen your Deep Hip Flexors.  This can be tricky so make sure you get professional guidance.

3.       Strengthen your Glutes.  Easier said than done, so get advice on which exercises are best for YOU.

 

This all sounds easy enough, right?  Under the right guidance, it can be.  Let us create the best plan to help you feel better today.

Chris Marino