Updated: Mar 3
Are you suffering from knee pain? Does your pain get worse with walking or sitting for long periods, or simply just going up and down the stairs? Are you frustrated by not being able to run or bike as far because pain is limiting you? Have you been foam rolling your IT Band to “loosen” it, but not seeing the change you are looking for? Foam rolling your IT Band is one of the big mistakes people make that could be making your injury worse. Learn the other 5 unknown mistakes to foam rolling here in our free download.
This nagging pain on the outside of the knee could be irritating the tendon and lead to an injury called Iliotibial band syndrome (ITBS). If you experience pain, “a knot” or feel “tightness” in an area, you may have been advised to work it out, or “roll” it out. While foam rolling is beneficial at relieving this common injury, how and where you are foam rolling could be doing more harm than good. Just by making a few simple adjustments, can turn your IT band pain from nagging to nonexistent, and get you back to performing the activities you love, pain free.
Although it can be a very difficult injury to resolve, ITBS is very treatable. We see a wide variety of people in the East Brunswick, NJ area with this chronic, annoying type pain and see a full resolution of their symptoms using our 4 step process. It’s important to know and understand the reason as to why your IT band is becoming irritated (by knowing the structures and their functions) to find the underlying cause of your symptoms and what you can do to resolve this injury.
“The team at Create Your Core has gotten me back to running half marathons and I couldn't be happier. I sought them out after developing knee pain which was preventing me from running. The team took the time to listen and assess what was causing my pain and gave me a clear and easy to follow plan to strengthen my knee. I was really impressed by the level of care, thorough follow up and how quickly I was able to get back to doing my long runs. I'd highly recommend them!” - Jennifer
What Is Iliotibial Band Syndrome?
ITBS is characterized by pain between the knee and hip that increases with activity from the result of the connective tissue (or ligament) rubbing together against the thigh bone.
Irritation and inflammation can occur from excessive friction from the IT band being overly tight and rubbing against the bone, causing pain when moving the knee and/or hip. It is most commonly a result of overuse from repetitive movement, such as cycling, running, repetitive walking up and down stairs, wearing high heels, or sitting for long periods of time. You may be at increased risk for developing ITBS if you have
Preexisting tightness in your IT Band
Weakness in the hip, gluteal, and/or abdominal muscles
Lack of flexibility
A prior injury to the knee, hip, or IT band
Sit excessively, for long periods of time
Bowlegged or hyperextended knees
Leg length discrepancies
ITBS can affect anyone but typically affects people who exercise regularly. Often, it is due to mistakes in training that can be corrected. Some of these training mistakes could be…
Not performing a proper warm up or cool down
Straining your body or pushing past your limits
Wearing improper shoes
Increasing training too quickly
Improper or poor form and body mechanics
Why You Shouldn’t Foam Roll Your IT Band
The IT Band is a thick, fibrous connective tissue and its purpose is to stabilize and move the side of your knee as well as act as a natural protector of the outer thigh. Tendons are not intended to be stretched and therefore, cannot be “tight”. Overstretching can cause destabilization, potentially weakening the joint’s integrity, causing irritation, aggravation, and possible further injury. If you have tried to stretch your IT Band, you probably did not see any long-term changes or benefits.
The reason why you feel short term relief and improved mobility after rolling the IT band is because the compressive force stimulates the nervous system causing a temporary increase in flexibility. However, it does not change the structure or integrity of the tendon and therefore does not improve mobility, lengthen, or loosen the ITB.
So, to answer the question, “Should I be foam rolling my IT band?”, the answer is no. Continuously applying firm pressure and rolling over the ITB can cause further micro tears of the fibrous connective tissue, causing further irritation, pain, and even visible bruising.
By painfully rolling out your IT Band to reduce your symptoms; this method is treating the symptoms rather than the true underlying causes. This is a “cookie cutter” type approach that likely won’t solve the problem due to its numerous potential causes. Each case is different. Our patients with knee and hip pain span a wide variety of body types and activity levels. From marathon runners to sedentary desk workers. A large variety of people develop this debilitating condition and make their way to our clinic to resolve their issue.
Finding The Root Cause Of Your Pain
A Physical Therapist, can make a diagnosis through asking you a series of questions about your medical history and activity regimen. They will perform an examination assessing your movement (or range of motion), strength, and flexibility throughout your body (specifically your ankles, knees, and hips and lumbar spine). They may also take you through a series of special tests and functional movements to recreate the symptoms you are experiencing to help guide their treatment and intervention.
If you suspect you have IT band syndrome or are struggling with stubborn knee pain, it won’t cost you a dime to find out what’s causing it. If you’re in the Middlesex County area, click here to request a FREE in-person consultation with one of our knee pain specialist physical therapists.
What Exercises Can I Do For My Knee Pain?
It is important to optimize the mobility and strength of the surrounding structures of the IT Band for this powerful tendon to perform its job probably.
The IT Band inserts into the gluteus maximus and tensor fascia lata (TFL) muscles and is the outer border of the outer quadriceps muscle (the vastus lateralis). It is important to address the muscular structures that surround the tendon that could be causing the underlying issue (TFL, glutes, quads, hamstrings). Below is a guideline of movements and exercises to help the possible underlying causes to your knee pain.
1. Foam Roll the surrounding muscles of the IT Band
Instead of foam rolling directly on the area where you feel pain, move the roll a few inches over onto the surrounding muscles (TFL, quads, hamstrings, glutes, and calves).
Not sure if you are foam rolling correctly? Here are the 5 Unknown Mistakes to foam rolling and how to fix them.
2. Optimize hip and ankle mobility
The joints above and below the knee are meant to be mobile. Achieving full mobility of the ankle and hip allows the limb to move and perform to its full capabilities.
These two exercises are designed to improve your ankle and hip mobility.
Ankle PAILs and RAILs
Hip Extension and Internal Rotation Self Mobilization
3. Strengthen the surrounding structures
Maintaining strength throughout the body is important to allow for the structures to continue to function properly. Improving strength to the muscles surrounding the IT band helps maintain balance and stability throughout the knee and hip, reducing unwanted muscle compensation that can lead to pain. Focus on strengthening the hip rotators, and posterior chain (glutes and hamstrings).
Using a resistance loop band can strengthen the muscles throughout the hip and improve the tracking and movement of the knee.
Standing Hip Abduction
Standing Hip Extension
4. Work With a Physical Therapist
If you are looking for a more specific guide in resolving your knee pain once and for all, working with a Doctor of Physical Therapy is your answer. Our Physical Therapists are trained in working with orthopedic injuries and will provide you with a personalized step by step guide to resolve your pain for good and get to you back to performing the activities that you enjoy. Treatment strategies may consist of manual therapy to reduce muscle tightness and increase range of motion, corrective stretching and strengthening techniques throughout ankle and feet, hips, glutes, and abdominals to restore optimal movement, correct form, and pain-free activity.
You can get started in the right direction towards a pain free knee by scheduling a FREE, no obligation, in-person consultation with a Doctor of Physical Therapy here.
You deserve to live the life you want without aches and pains. Create Your Core is here to help you achieve your goals!