Fitness Anatomy

You Can’t Stretch the IT Band (& What To Do Instead)

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There’s a new obsession with stretching and foam rolling the IT band. Over the past few years, I’ve heard the name kicked around more at gyms like it’s a new buzzword.

I have to say, I’m concerned with what I’m hearing.

So let’s talk. Today we’re going to clear up the rumors and learn why you can’t stretch the IT Band (and what you can instead that actually works).

Disclaimer: Always seek proper instruction before initiating an exercise program. Not everything is great for everyone! Consult with your qualified health care practitioners for an exercise program tailored to your needs. Stay healthy and injury-free! Read the full disclaimer.

WHY YOU CAN’T STRETCH THE IT BAND

Let’s dig into a little anatomy and physiology.

For starters, the IT band is short for iliotibial band. Also known as, ITB, and iliotibial tract.

The name literally describes the broad area of the body this important player covers.

It’s a thick layer of dense connective tissue that runs down the lateral (outside) aspect of the thigh. It’s not a muscle; therefore, it does not contract/relax like muscle tissue.

The Iliotibial Band is a longitudinal fibrous reinforcement of the fascia lata in a knee muscle. Part of anatomy human body. Illustration.
Artworkstudio BKK on Bigstockphoto.com

The ITB covers a lot of ground and is a major stabilizing structure for the lower body. First hand from feeling the ITB in a cadaver lab, this puppy is like a strap that just won’t quit.

Chaudhry H. et al. concluded the amount of force required for a 1% stretch to the ITB was somewhere around 2000 lbs and therefore, “outside the normal physiological range.” The science version of you can’t get there from here.

It wasn’t meant to stretch; it was meant to stabilize. 

At the pelvis, the ITB attaches to a small muscle called the tensor fascia latae, or TFL. Not only does it sound like a foamy drink at a trendy coffee house, tensor fascia latae is also super fun to say. But maybe that’s just me.

The ITB also joins with fibers from the glut max (the large and powerful butt muscle.)

Based on anatomy, you can already see how this tissue can cause a lot of problems when things get out of whack.

WHAT IS IT BAND SYNDROME?

IT Band Syndrome presents as pain along the lateral (outside) of the knee along the distal end of the IT Band. This condition is common with runners and cyclists.

ITB syndrome is a result of repetitive movements and a breakdown in mechanics and causes you to think your ITB is tight.

THE PROBLEM WITH IT BAND PAIN

Here’s the monkey wrench: as humans, we live and move in 3D.

Just because there’s pain in one area, it doesn’t mean that’s the root cause of the problem. And the reality is, what caused one person’s ITB issue may not be the cause of another’s.

There are many ways the body likes to cheat to get the movement it needs.

Several different issues can cause problems that manifest as an ITB issue, so it’s crucial to get evaluated by a physical therapist to figure out why you’re having issues.

POSSIBLE CONTRIBUTORS TO IT BAND SYNDROME

  • Hip muscle weakness, especially glutes or stabilizing muscles
  • Internal rotation of the leg with activity
  • Lack of range of motion at the hip
  • Excessive pronation of the foot increasing internal rotation of the tibia (lower leg)
  • Breakdown of form when fatigued
  • Overtraining, especially running or cycling
  • Running on uneven surfaces
  • Too much sitting

People can present differently, which is why the treatment for your brother/mother/friend/neighbor might not work for you.

So when I hear things like “stretch your ITB” or foam roll your ITB as a blanket cure-all statement, it makes me cringe.

Running Cycle Anatomical Illustration Isolated Over White Contains Clipping Path Running Cycle Anatomical Illustration Isolated Contains Clippi
© PixelRockstar.com

WHAT TO DO INSTEAD OF IT BAND STRETCHES

This is where I do my plug for physical therapy and tell you that if you have pain, stop foam rolling your ITB and get to a PT for a proper biomechanical evaluation.

Put the pieces of your puzzle together.

While you can’t stretch the ITB, you can stretch/strengthen the muscles that attach to the ITB and have an effect on the overall alignment of the lower extremity.

Rebalance by strengthening the muscles in the area that are not pulling their fair share of the workload.

A whole host of alignment issues, weakness, or flexibility issues can be changing the forces acting on your ITB and voila. Pain.

This is what a physical therapist will help you with depending on what your particular issues are.

STRETCHES THAT HELP IT BAND SYNDROME

There are many stretches touted as “ITB stretches.”

Since we already covered it’s physiologically impossible to stretch, what are they actually doing?

They are stretching other hip/lower extremity muscles that attach to or are near the ITB.

So while you will likely forever hear stretch your ITB in a fitness class *sigh*, at least you understand what you’re doing and what you’re not.

FIGURE 4 GLUTE STRETCH

woman on a yoga mat demonstrating a figure 4 stretch, stretches to help IT Band syndrome
Copyright Maura Blackstone

HOW TO PERFORM

  • Lie on your back with your knees bent
  • Cross one ankle over the opposite knee and flex the foot (this helps protect the knee joint)
  • This may be enough of a stretch, or you might choose to push the knee away gently.
  • To intensity the stretch, you can grab ahold of the opposite leg either with your hands or a strap and draw the knee closer to your chest. 
  • Hold 20-30 seconds.
  • Repeat 2-3 times. 

TENSOR FASCIA LATAE (TFL) STRETCH

woman on a yoga mat demonstrating a TFL stretch
Copyright Maura Blackstone

HOW TO PERFORM

  • Lie on your back with your knees bent.
  • Cross one ankle over the opposite knee. 
  • Drop both knees to the side.
  • Hold 20-30 seconds. 
  • Repeat 2-3 times. 

HIP FLEXOR STRETCH

woman on a yoga mat demonstrating a kneeling hip flexor stretch
Copyright Maura Blackstone

HOW TO PERFORM

  • Kneel on a blanket for knee joint comfort. 
  • Step one foot forward at a 90-degree angle. (The kneeling leg will get the stretch.)
  • Upright your posture and roll the pelvis under (tuck under or posterior tilt are other cues).
  • Maintain this position as you translate your body slightly forward until you feel a pulling in the front of the hip and thigh. 
  • Hold for 20-30 seconds, keep breathing deeply.
  • Repeat 2-3 times.

QUAD STRETCH

woman demonstrating a standing quad stretch
Copyright Maura Blackstone

HOW TO PERFORM

  • Set your balance either on one foot or holding on to something stable.
  • Bend one knee and hold the foot or back of your shoe and gently pull toward the glutes.
  • Don’t allow the knee to move away from the body; try to keep it in line with the standing leg for best alignment. 
  • Hold for 20-30 seconds.
  • Repeat 2-3 times.

LUMBAR ROTATION

woman demonstrating a supine thoracic rotation stretch
Copyright Maura Blackstone

HOW TO PERFORM

  • Lie on your back with the knees bent and feet on the floor
  • Arms can be extended to the sides in a comfortable range for you
  • Drop your knees to one side as far as they go comfortably
  • Maintain this position for 5-10 seconds and then rotate to the opposite side
  • Alternate between both sides for 10-20 repititions

Visit the hip flexibility library for more ideas and foam rolling options.

STRENGTHENING EXERCISES FOR IT BAND SYNDROME

The strengthening exercises that you need will depend on what lead to your IT Band syndrome in the first place.

There are many strengthening exercises that can benefit IT Band syndrome focusing on strengthening the glutes and other hip muscles – using good form of course!

Here are just some ideas:

CAN FOAM ROLLING HELP MY IT BAND?

Foam rolling the IT Band is a very polarizing topic across the board even among physical therapists.

Bottom line, there’s not a ton of research yet.

What we do know is foam rolling seems to improve joint range of motion pre and post-exercise.

Foam rolling can be a useful component of rehab or a general exercise program, but foam rolling an ITB alone is not going to fix or prevent issues.

Knowing what areas to foam roll to help the ITB is crucial!

It may be useful in releasing trigger points in muscles affecting the mechanics of the ITB, like the glutes and TFL (tensor fascia latae).

One of my favorite foam rollers is the Trigger Point Grid foam roller. It’s small and compact but packs a punch!

Visit the hip flexibility library for foam rolling tutorials.

TIPS TO PREVENT IT BAND SYNDROME

  • Maintain a good balance of strength and flexibility, especially in key muscle groups around the hip
  • Use a foam roller on surrounding muscles to keep everything mobile
  • Avoid overtraining, especially with running
  • Progress mileage properly and caution with uneven surfaces
  • Wear proper footwear and replace at regular intervals, including inserts
  • Use good form during strengthening and other exercise activities
  • Don’t skip warm-ups
  • Avoid “too much sitting” – Read The 7 Best Foam Roller Exercises to Combat Poor Desk Posture

FINAL THOUGHTS ON THE IT BAND

So what can’t we do?

Stretch the ITB itself. Because, science.

What can we do?

Stretch, strengthen, and restore proper mechanics of the tissues that caused the “tight” ITB in the first place.

So spread the word.

Related Reads:

Featured image credit: Jacob Lund / bigstockphoto.com

References and Resources

Chaundhry H, Schleip R, Ji Z, Bukiet B, Maney M, Findley T. (2008) Three-dimensional mathematical model for deformation of human fasciae in manual therapy. Journal of the American Osteopathic Association. 108(8),379-90.

Cheatham SW, Kobler MJ, Cain M, Lee M. (2015) The Effects of Self-Myofascial Release Using a Foam Roll or Roller Massager on Joint Range of Motion, Muscle Recovery, and Performance: A Systematic Review. International Journal of Sports Physical Therapy. 10(6), 827-838.

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