Foam Rolling Your ITB - Like Trying to Soften a Steel Cable With A Rolling Pin!

Foam Rolling Your ITB – Like Trying to Soften a Steel Cable With A Rolling Pin!

“I’m using a foam roller on my tight ITB” is a statement that we commonly hear as physiotherapists. And after hearing this statement 3 days in a row last week, I thought it was time to expand and explain in detail why I feel that the process of foam rolling an ITB is a completely useless endeavour.

Foam rollers are a staple in many people’s recovery and self-care routines – most people we deal with have a roller of some size lying somewhere around the house. They’re affordable, portable, and often marketed as a fantastic remedy for tight muscles and especially for the iliotibial band (ITB). Walk into any gym, fitness studio, or sporting environment, and you will find someone rolling around in agony as they “roll their ITB”. Yet, despite this popularity, foam rolling the ITB is not something I recommend you should be doing. To understand why, first we must know a bit more about the ITB itself.

What Is the Iliotibial Band?

The ITB is a thick, dense band of fibrous tissue running from the hip down to the knee. It plays a critical role in stabilising the knee during activities like walking, running, and cycling. The ITB is full of collagen, which helps resist elongation and deformation. Collagen gives us “stiffness”. The Gluteus Maximus and Tensor Facia Lata (TFL) – an important muscle situated at the front of the hip – both attach into, and help form, the upper part of the ITB. It is a commonly held belief that a “tight” ITB is the culprit behind knee pain, thigh pain or hip discomfort, and that foam rolling will help loosen or lengthen it. However, the ITB is a highly resilient tissue designed for strength and durability, much like a strong cable, which makes it far less pliable than a muscle. Many people will state “I have a tight ITB and I need to roll it” – of course it’s tight, it’s meant to be, it is a cable!

Why Foam Rolling the ITB Is Ineffective

Research suggests that fascia/tissue like the ITB requires enormous force to even slightly deform. Studies have demonstrated that applying manual or mechanical force to the ITB does not produce lasting changes in its length, flexibility, or tension. Here’s why:

1. Density of the ITB: Studies have shown that the ITB is one of the densest connective tissues in the body. It just does not deform or stretch.
2. Thickness and Functionality: The ITB’s design isn’t accidental. The body built it to resist mechanical strain, especially along the lateral thigh. Much of the ITB’s tension is managed by the muscles it interacts with—primarily the gluteus maximus and the TFL mentioned above. You are better off spending time addressing these muscles rather than the dense ITB itself.
3. Lack of Long-Term Benefits: Even if some relief is felt immediately after foam rolling, studies reveal that these effects are temporary and result more from an altered nerve perception than true changes to the ITB’s structure. These transient effects are often due to slight pressure on nearby muscles rather than any alteration in the ITB itself.

The Neurological Effect: Why You Feel Temporary Relief

One aspect worth noting is the neurological impact of foam rolling. While it won’t physically change the ITB, foam rolling can temporarily alter pain perception. By stimulating mechanoreceptors—sensory receptors that respond to mechanical pressure—foam rolling creates a temporary feeling of reduced discomfort. However, this is not a structural fix but a momentary alteration in the way the nervous system interprets pain. I often explain it to patients like this – imagine applying an excruciatingly painful stimulus to yourself for 5 minutes. Then take the stimulus away – you will automatically feel better (the relief of the painful stimulus being removed). I feel the pain relief people experience after foam rolling is exactly this phenomenon: create as much pain as you can, stop, and guess what – you feel relief!

Alternative Techniques for ITB-Related Discomfort

If foam rolling isn’t helpful, what is? There are more effective strategies to address ITB-related discomfort, specifically targeting the root cause rather than attempting to change the ITB itself.

1. Targeting the Gluteal Muscles: The gluteus maximus and gluteus medius are key in maintaining the correct tension and position of the ITB. Strengthening these muscles stabilizes the pelvis, reducing unnecessary strain on the ITB. For some people, some stretching or strengthening of these muscles may help reduce the tension in the ITB.
2. Targeting the Tensor Fascia Latae (TFL): This small muscle at the top of the ITB often contributes to tension in the band. Gentle stretching and/or strengthening exercises for the TFL can help alleviate pressure without needing to directly manipulate the ITB.
3. Improving Movement Patterns: Often, the root of ITB discomfort lies in biomechanical imbalances, like excessive hip adduction (the thigh moving inward) or internal rotation during activities like running. Consulting with one of our physio’s to identify and address these imbalances can provide long-term relief without relying on ineffective foam rolling techniques.
4. Foam Rolling Adjacent Muscles: While foam rolling the ITB itself is ineffective, rolling out the quadriceps, hamstrings, or gluteal muscles may improve overall muscle pliability, which may indirectly reduce perceived tightness in the ITB.

Conclusion: Choose Effective Strategies for ITB Relief

The evidence is clear—foam rolling the ITB is ineffective for achieving long-lasting relief or functional improvements. In fact, it really is ineffective for anything more than the immediate perceived relief of removing the painful stimulus.

Instead, focusing on strengthening key muscles and improving movement patterns offers more promising, evidence-based results. The ITB serves as a resilient, stabilizing structure, and trying to change it through foam rolling will likely yield frustration rather than relief. Consulting with a trained physiotherapist will allow you to manage ITB-related discomfort more effectively, ultimately leading to sustainable relief and enhanced performance in daily activities.

Remember the make up and characteristics of the ITB make it literally impervious to mechanical manipulation through an external force. Attempting to roll it out with a foam roller is comparable to trying to soften a steel cable with a wooden rolling pin—basically impossible and a waste of time!

Anthony Lance

SSPC Physiotherapist

References available on request.