What is the ITB?
Your ITB, or iliotibial band, is a very important structure. It runs down the outside of your leg, connecting your ilia (one of your hip bones) to your tibia, hence the name. It arises from the tendon of a muscle called the tensor fascia latae, and about 70% of your gluteus maximus tendon contributes to it, as well.
It is not a muscle, but a thickened band of connective tissue that helps with movement at the hip and stabilization at the knee. It transfers forces from the muscles in your hip down your leg, assisting range of motion of the hip and stability in the knee with activity.
Your ITB aids in extension, abduction, and lateral rotation of your hip joint. Almost more importantly, it is continuous with the tissue around your knee and plays a huge role in dynamic stabilization, especially when lifting the opposing foot off the ground, like during walking and running. During movement, your knees tend to shift medially (toward the midline), and the ITB is there to counter that force. When you abduct your hip (move away from the midline), the force transfers down your ITB and tightens the tissue around the joint, supporting it and counteracting the medial deviation.
There are two main issues with the ITB, and one usually leads to another. The first problem starts with a muscle in your hip, called gluteus medius.
This muscle is your main hip abductor, and is weak in almost everybody, from desk workers to body builders. When this muscle is weak and not pulling its weight, your tensor fascia latae muscle kicks your ITB into overdrive. But here’s the issue: your ITB is not a muscle. Because of this, it has no contractile properties, meaning it can’t fight back against the extra force being exerted on it. This leads to it becoming overstretched and elongated, and weak in its own way. When this happens, restrictions and adhesions between the ITB and your lateral hamstrings and quadriceps form, causing friction and compression between structures that normally glide against each other with ease. This leads to pain, often near the knee, but it can happen anywhere along the course of the band. Over time, these problems can lead to knee pain, hypertonic muscles, and decreased range of motion in the hip.
How can I make it better?
STOP FOAM ROLLING YOUR ITB. Using a foam roller has amazing benefits when used in the right situations but this is not one of them. When you roll your ITB, you are flattening and stretching a structure that is already overextended and weak. Instead, focus on rolling your quads and hamstrings, especially along the outer aspect near the ITB. This will help break up restrictions in the area, and create space between the muscles and the band, allowing for greater ease of movement. It is also important not to overstretch your ITB, and to focus on stretches that target the muscles controlling it, not just the structure itself. In addition, focus on strengthening your gluteus medius. Some of the best exercises for this are lateral leg lifts, single leg squats, and clam raises (all of which can be demonstrated by your practitioner). If you are experiencing IT band pain or issues, it might be time to start looking elsewhere for the cause.
by Teresa Noye, RMT