itbrOLLINGThe foam roller is a common self-massage tool used by many recreational and professional athletes and sportspeople. The concept behind the use of a foam roller is to try and replicate what a good deep massage would do – loosen the muscle tissue, create some blood flow, and hopefully reduce the tightness that often comes as an unwelcome side effect of a regular athletic or fitness program. Using the foam roller on muscles of the lower limb is not generally a pleasant experience, but one that has some scientific evidence and a lot of anecdotal evidence behind it.
One of the more agonising areas to use the foam roller on is the ITB, or iliotibial band, which runs down the outside of your thigh from the hip to just below the knee. But does foam rolling the ITB actually work? In this article we will outline our thoughts on why you might be better off using the foam roller on structures other than the ITB. And we’re sure that our thoughts will bring welcome relief to the many people who spend countless hours in agony rolling their ITB’s.
To understand our thoughts, you need to know what the ITB is, and what it does.

What Is The ITB
The Ilitiobial Band is a long thickened band of fascia (or connective tissue) that runs from the pelvis (or ilium) to the lower knee region (tibia). As the wording “connective tissue” implies, this bandITB provides a strong connection for muscles to attach to, providing stability for those muscles in the thigh. The ITB is very similar to a ligament in that it doesn’t do any contracting – it simply transfers and transmits the contractile forces of the muscles that attach along its length. The critical muscles that attach into the ITB are the tensor fascia latae (TFL) and gluteus medius and maximus (see illustration). These are big, strong, powerful muscles that exert a lot of force through the ITB. If the force of these muscles is excessive on the ITB, the tension will cause potential issues lower down in the ITB, around the knee and quadriceps muscles in particular, but also up around the hip as well.

Because the ITB is a dense band of inelastic tissue, it doesn’t really make sense to try and loosen it, or relax it, or make it longer – those aims are near on impossible in this type of tissue. What does make sense is to ensure that the TFL, gluteals and even lateral quadriceps are all loosened – thereby not transmitting excessive forces into the ITB. (But it’s not quite as simple as just doing this to resolve your ITB issues, as many of the muscles, Gluteus Medius in particular, also require very specific strengthening, not just release techniques…but that’s a whole new story!).

Where we have found the foam roller to be most beneficial is around the lateral hamstring and quadriceps regions, as this can help loosen tight muscle tissue, stimulate blood supply, and probably even break down some tethered (“stuck”) connections between these muscle groups and the ITB. It is possible to use the foam roller on the Gluteal and TFL muscles, but we strongly recommend the use of a spikey ball (or similar massage tool) as these are more precise in targeting the trigger points that lie deep within these upper hip muscles.
So in summary, it is our belief that foam rolling the ITB doesn’t make a lot of sense, in fact it is quite possible you are contributing to the problem by further stretching a battered, over-tensioned, and irritated structure.

Try sticking to foam rolling the muscle groups of the thigh – quads and hamstrings in particular – and get the spikey ball onto your TFL and Gluteal muscle groups, and see what results you get. But remember, this area is an extremely difficult and complex area to manage, so if you get an increase in pain with these suggestions then you should stop immediately and get a thorough assessment from your physiotherapist.