I have multiple clients who have been told that their IT bands are too tight.  They are told to and taught to foam roll the outside of the thigh.  Foam rolling, some say, is the way to lower tension in the IT bands.  Well, this simply is not true.  I know, I know, a lot of professionals are recommending foam rolling the outer thigh as a treatment and/or cure for tight IT bands, and, if you have been foam rolling like a maniac, I am sorry to tell you that it is unlikely to produce any lasting results.

There are some professionals who do not believe the IT bands can become too tight.  The IT bands, iliotibial bands, are made up of fascia, a type of connective tissue.  The IT bands are thick fascia that run from the upper posterior hip bone to the top of the tibia, the largest bone in your lower leg.  IT bands stabilize your knees and are supposed to have tension.  The question that has been asked for quite some time is, can fascia become tighter than it is meant to be? Is this possible?  There is research in both directions.  If you have felt or you have an IT band that feels shortened or tight, then you know that some physiological mechanism allows excess tension in IT bands.


How you address this excess tension should be determined by what has caused it.  This is where we run into issues with foam rolling.  It is a one size fits all, a recommended-to-anyone-with-a-tight-IT-band type of treatment.  Maybe the treatment recommended to you was to stretch your IT bands.  Well, this is controversial as well.  Can fascia be stretched?  Research tells us fascia cannot be stretched, yet we many of us feel better when we stretch.  Fascia surrounds and invests all of our muscles, so even if we are muscle focused in our stretching, the fascia must stretch if the length of the muscle changes.  Now, we could argue all day about whether the length of muscles actually change.  Instead, let’s say that when we stretch, some physiological mechanism decreases our pain and makes us feel longer.

Does stretching help the IT bands?  Sometimes.  It depends, again, on what the issue is.  For example, let’s say that your IT bands hold excess tension because you have dead butt syndrome (also known as dormant butt syndrome or gluteal amnesia).  Dead butt syndrome means your gluteal muscles are not firing well or not firing at all.  Gluteus maximus attaches into the IT band.  One of the opposing muscles to gluteus maximus, and the other muscle that attaches into the IT band is tensor fasciae latae.


When gluteus maximus is not firing, tensor fasciae latae becomes much tighter than normal.  The lack of tension in gluteus maximus allows the IT band to shift anterior.  At the same time, the excess tension in tensor fasciae latae pulls the IT band anterior.  This can create excess tension in the IT band.  What is the solution?  First, you must figure out why gluteus maximus is not firing and correct the issue.  SMRT therapists can help you do that.  Next, specific gluteal exercises may be needed to restore tonal balance between gluteus maximus and tensor fasciae latae.  Personal training, private yoga therapy, private pilates therapy can all help to design a program for your issue.


Another example of what may cause excess tone in your IT bands:  the IT band begins at the upper posterior hip, as stated before, and ends on the lateral or outside upper tibia.  Tibial alignment and position are crucial to maintaining correct IT band tone and correct spacing at the knee joint.  What effects the tibia?  Tension in the muscles in the lower leg.  Ankle mobility, alignment, and range of motion.  The foot.  What can be done if the tibia is the problem with your IT band?  Specific, targeted bodywork and/or acupuncture.  Aligning the tibia will also correct the spacing in your knee and shift how your knee is moving/tracking, which will also help the IT band to have optimal length.


Excess tension in IT bands can absolutely and easily be decreased with the right treatment.  I have a client who was told at 36 that she would likely need knee surgery due to excess tension in her IT bands.  She was in constant pain that moved from her knees to her hips and back again.  After only one SMRT session, her pain changed so dramatically that she began dancing and hiking again.  She has not had knee or hip pain for over a year.


Written by:  Dawn Lewis, owner at SMRT Pain Relief Center and Full Circle School of Massage

Date: 11/7/19

For appointment please call 720-667-4959 or go to http://smrtpainreliefcenter.com/