If you’ve been stretching and foam rolling your IT Band for days but it still feels super tight and your knee still burns, then it might not be your ITB that’s the problem. The iliotibial band, also known as the iliotibial tract or ITB, is a stretch of connective tissue along the outside of your thigh. It assists in abducting the hip, but its primary function is to support the knee. If we stop to think and think about it for a minute, that’s pretty amazing! A structure that spans from the hip to the top of the lower leg is designed to hold just one joint in place. Aside from giving us an idea of how much we use our knees, this realization should also clue us into the type of stability that joint requires. With this in mind, it is easy to see why the IT Band would have about the same amount of contractile tissue as other ligaments and tendons - ie. not very much. If it has little ability to contract, it also has little ability to tighten or subsequently stretch on its own. It is a bit like trying to stretch the ligaments in your ankles to prevent sprains which we typically avoid as we want to maintain ankle support. But it certainly feels like the IT Band is tight and needs stretched sometimes, right? And that it does! It’s tension is just created somewhere else. This structure is called a band or a tract because it is both a ligament - connecting bone to bone - and a tendon that ties muscles to bone. It is the contraction and tension in the corresponding muscles that creates the tight feeling in the ITB.
Introducing the tensor fascia lata. The TFL is a muscle originates on the anterior superior iliac spine and the anterior portion of the iliac crest and inserts into the ITB. Its function is to tighten the deep thigh fascia (the people who named this muscle were very on the nose in this instance), especially at its thickest part: the ITB. In this way, it serves to stabilize the pelvis and knee in different positions, and is involved in several of the necessary movements for walking. Trigger points and tension in the tensor fascia lata will produce pain or burning sensations down the side of the leg. As you have guessed by now, stretching the TFL can be super useful in releasing tightness felt in the ITB. But I did say “muscles” attach to the ITB, so here is a test to see if the TFL is really the issue. How To:
Lean back against a wall so your entire torso from head to butt is making contact
Position your feet together about 2 inches from the base of the wall
While in this stance, flatten your low back to the wall
If you are able to flatten your back, your TFL is most likely in good shape
If you are unable to do this or feel pain or tightness in the front of your hips, come back to neutral
Stand with your feet about shoulder width apart, 2 inches from the base of the wall
Repeat your attempt to flatten your back
If you are able to do this without pain or tension, your TFLs could use some attention!
*Please note that not everyone will be able to make their back completely flush to the wall. This is not important. Pay attention to the feeling in the front of your hips. Now that you know if your TFL is the underlying issue, you’ll want to know how to stretch it! I’ll cover that in a few more posts after I discuss the other two muscles that could be the culprit. What were your test results? How did this work for you? Let me know in the comments! Share with someone who struggles with IT band pain
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