Suffering with iliotibial band syndrome (ITBS)? Why the foam roller is not the answer…

• Posted onjofrancis
• in Running
• onJune 29, 2016
• No Comments.

In endurance sport ITBS is a common complaint. It presents as pain/soreness down the outside of your thigh and/or the outside of your knee on activity, commonly during running and cycling. Many of you may have or know someone who has hit the foam roller to try help this problem. To case the upcoming points let me give you a very brief anatomy lesson!

The iliotibial tract (iliotibial band) is a tendon and cannot contract, this means it’s length does not change. It is not possible to “release it” with stretching, with the foam roller or massage. The tensor fascia latae is the only direct muscular component of the iliotibial band high on the outside of the thigh. It attaches the iliotibial band to the outside of your pelvis. Targeting this section might help “a bit”, but let me ask you to consider a key question. Is foam rolling the outside of your thigh treating the actual cause, even if you hit the tensor fascia latae, or other muscles close by that might be a bit tight? Simple answer, no!

You need to ask yourself why are the muscles around my iliotibial band becoming tight and pulling on it in the first place, whether this is by your knee or hip. If you can get to grips with this, then you will be fast on the way to understanding that simply trying to roll away the symptoms only for them to come back all too soon is not the answer.

The muscular structures on the outside of your thigh can tighten up and pull on the iliotibial band if they become overloaded or overworked. This happens when the muscles that stabilise around your hip joints and pelvis fail to do their job because of weakness or the onset of fatigue – see (B) in the image.

If the above is happening (B) however subtle it might be then the structures on the outside of the thigh will pull on iliotibial band excessively and eventually cause pain. Additionally, if building your training volume too quickly and you overwork (fatigue) those hip stabilisers in a given session then the above can start to occur and the result over time will be the same.

So a word of advice please don’t waste your time on the foam roller for this problem, instead treat the causes:

• Strengthen your buttock and core muscles and key areas in your thighs.

•  Improve how you move – whether this be running or on the bike. Technique is everything and changing this if needed is key. Gaining sufficient strength to achieve this is your first step. You can’t run or pedal well if you are not strong in the right places!

•  Optimise your post workout recovery strategies with recovery strategies that have proven benefit:
  • Ice bath – submerge the target area for 5-10mins after any intense or high volume workouts.
  • Compression kit – there is evidence of benefit on muscle recovery, if worn post exercise for at least 24-48hours!
•  These simple yet evidence based recovery strategies will go some way to helping you train with less accumulative fatigue, which as described above can cause problems.

• Remember the key message here is if your technique is an issue then no amount of ice baths and compression kit will help. Sort out the cause, strengthen where you are weak and learn to move better! If you do, then you will be able to resolve this problem and many other injuries that might be holding you back.

Run FIT sessions:

If you want to know about appropriate strengthening and want to know more about reviewing your run technique email mike@thetrilife.com for information on our Run FIT sessions.