IT Band Pain? Stop Foam rolling and DO THIS!
Feb 14, 2022
That pain in the side of your leg is driving you crazy! So you do what any contentious modern day human would do. You jump on google or YouTube (or Reddit, yikes!) and BAM you figured it out. The pain is coming directly from where the IT Band attaches to the hip. The pain must be from a tight IT Band.
So you do all the recommended things. Foam roll the IT Band. Stretch the IT Band. Play a little jazz music and do “other” things to the IT band. But…nothing works. You get some temporary relief but then it comes back. The same annoying pain in the side of the hip.
So what the *** is going on huh? If the pain is coming from a tight IT band, why aren’t any of these things helping with your hip and leg pain? Because pain in the side of the hip is rarely due a tight IT Band.
Instead, the pain is likely coming from weaknesses and other limitations in the major muscles surrounding the hips. By shifting your attention to how the main muscles of your hips function, you are much more likely to get to the root cause of your hip and IT Band pain.
In this article, I’ll break down the things that will help you finally see results in your lateral hip pain. But first, let’s talk about the things that WON’T work.
Stop Foam Rolling Your IT Band
What is the IT band?. According to the National Library of Medicine, the “iliotibial band (ITB) is a tendon that runs along the outside of your leg. It connects from the top of your pelvic bone to just below your knee.”
The IT Band is a tendon. Tendons do not get foam rolled, muscles do. That is already a perfectly good reason not to foam roll your IT band.
Another good reason is that research fails to show any significant changes to the IT band after foam rolling. Like in a 2021 study where researchers discovered that “a single episode of… foam rolling does not affect short-term ITB stiffness.”
Or a 2014 study where researchers tested pain levels before and after foam rolling the IT Band. Pain levels went down immediately after foam rolling. But within 5 minutes, pain levels went back to normal.
And this matches my personal and clinical experience with foam rolling. The pain gets better for a little bit. And then the pain comes back. Sometimes even worse than before. Most people want to get to the root cause of their hip pain and get rid of it permanently. Not just for 5 minutes.
Why IT Band Massages won’t Relieve Hip Pain
The research on massage therapy for pain is not promising. Most studies show little to no effect on pain levels. I wrote an entire article analyzing whether massage therapy improves hip pain which you can read here.
It seems that the biggest value from massage therapy is that it relaxes the nervous system. Because pain comes from our brain (and therefore, the nervous system), this can be why many people experience a reduction in pain after a massage.
Everyone experiences pain for different reasons. IT band and hip pain are no exception. A contributing factor for some people’s pain pattern CAN be an overactive nervous system, stress and/or tension. By getting a massage that relaxes the entire body (and mind), pain relief may be experienced.
But it’s important to understand what massage does NOT do. Massage does not reverse tightness, increase circulation, detoxify, reduce muscle soreness, release fascia or reduce inflammation.
Massage also does not come without side effects; especially deep tissue massage which can cause even more soreness. Rarely, deep tissue massage has caused a rare condition called Rhabdomyolysis that can damage the internal organs.
This is VERY rare and my intention is not to scare you. Go ahead and get a deep tissue massage but I believe it’s important to understand what you’re getting out of it.
This is my intention with all of my content. I don’t have all the answers. No one does. But in our society of information overload, it’s difficult to know what’s true. And I think it’s important for you to have the relevant information so you can make an informed decision.
So put on some gentle music, dim the lights and hire that masseuse that comes to your house. Just know that it might not help your hip pain. And if it does help, it’s probably because you were finally able to relax. And that can tell you a great deal about your pain pattern.
Stretching the IT Band MIGHT Help with Pain
Stretching any tendon in the body is controversial. Some experts say it’s a sure way to make pain worse. Others say it’s completely safe. So what should we believe?
For starters, there is rarely a black and white answer in the movement and pain world. We listen to people we trust and then do our best to make an informed decision. My personal approach is to look at relevant studies, seek guidance from trusted resources and then experiment with my own body.
Let’s analyze the research first. In a 2021 study, researchers discovered that “a single episode of stretching. . .does not affect short-term ITB stiffness.” While an older study from 2007 discovered that “ballistic stretching can significantly increase tendon elasticity.”
Ballistic stretching is when bouncing movements are used to push the body into deeper ranges of motion. This type of stretching is shunned by many mainstream therapeutic and fitness communities.
My view is that ballistic stretching might be helpful for more advanced practitioners. But most people reading this article or looking to get out of hip pain are not professional athletes. They just want to start feeling better and get out of hip and IT band pain.
And I don’t believe that stretching will get them there. But by exploring stretching, we are shifting our mindsets in the right direction. We are taking ownership over our bodies and our pain patterns. We are not relying on a massage therapist or foam roller to “break up knots.”
Instead of traditional stretching, I recommend experimenting with joint mobility drills. It’s not as intense as ballistic stretching but it gets the body moving and starts getting nutrients into all of the important structures, including tendons. To get you started, try the hip drop drill. From all of the hip mobility drills, it’s one that really puts an emphasis on the IT Band:
Let’s now talk about other things that will help with your hip and IT Band pain.
Exercises that CAN help with IT Band Hip Pain
It is important to understand that the location of the pain is not always where the problem is. Too often, I see people focus too heavily on the location of the pain. This can actually make the pain even worse by aggravating an already sensitive area (like foam rolling or stretching the IT Band).
But the location of the pain can provide insight into our pain patterns. If we are concerned about the IT Band, we should start investigating that area of the body.
We learned that the IT Band is a tendon and does not respond well to stretching and foam rolling. But what structures around the IT band can we manipulate better? Muscles! And the muscles around the IT band are some of the strongest and most powerful muscles in the body.
If the muscles that surround the IT Band are weak, stiff or otherwise restricted, how will this feel? What will this do to our hip and other joints? It can cause discomfort. It can cause stiffness. And it may certainly cause sensations of pain.
The below sections are broken down by muscle. These are the main muscles that surround the IT Band. I’ll provide an exercise that tests the muscle's ability in a certain movement. I’ll also provide a “minimum intensity” of reps and hold time that I think most beginners should be able to accomplish.
These are beginner level exercises. So if you fail to reach the minimum intensity, you know you are weak in this muscle group. The test can also be treated as an exercise. So if you fail the test, spend a few weeks trying to get better at the exercise. See what happens to your hip and IT Band discomfort once you get better at the exercise.
Gluteus Maximus and IT Band Pain
When you’re investigating issues with the IT Band or hip, it would be wise to improve glute max function. It is arguably the strongest muscle in the body and deserves your attention. Try the below glute bridge exercise to test your glute max function.
- Minimum intensity - 3 reps, 2 second holds in each stop.
- If unable to perform, shaking or extreme difficulty occurs then this is a weak spot for you. Try performing this exercise daily for less reps and shorter hold times until you can get to the above intensity
Quadriceps and IT Band Pain
Many of the tutorials online on improving IT Band pain or IT Band syndrome fail to mention the quadriceps. Which is kind of crazy considering that it’s one of the largest muscles in the body and it surrounds most of the IT Band.
- Minimum intensity - 5 reps + 2 second hold at end range.
- If unable to perform, shaking, cramping or extreme difficulty occurs then this is a weak spot for you. Try performing this exercise daily for less reps and shorter hold times until you can get to the above intensity.
Hamstrings and IT Band Pain
Another huge and important muscle group are the hamstrings. And once again, oftentimes overlooked. Try the below exercise to test your hamstring function in knee flexion.
- Minimum intensity - 5 reps + 3 second hold at end range.
- If unable to perform, shaking, cramping or extreme difficulty occurs then this is a weak spot for you. Try performing this exercise daily for less reps and shorter hold times until you can get to the above intensity.
Special Note on TFL and IT Band Pain
Most tutorials on improving IT Band pain focus on the Tensor Fascia Latae (“TFL”). And at first glance, this makes sense. The IT band connects to the TFL and because the TFL is a muscle, it can be stretched and strengthened better than the IT Band.
Unlike the muscles above, the TFL is a smaller muscle that takes more of a supportive role in most movements. It is not a true prime mover like the glutes, quads and hamstrings. Does that mean it’s not important? Of course not! Every muscle in the body is important and has critical functions.
But my goal in this article is to help you find your low hanging fruit. You will get much more bang for your buck by focusing on the larger muscles first. Once people can perform the above exercises with function, pain levels often improve.
If the pain lingers then I’d recommend starting to analyze the TFL and take a more nuanced approach to your pain pattern. I wrote an entire article on the TFL which you can read here. That should help you get started if you’re interested in troubleshooting your TFL.
Conclusion
Early in my journey out of chronic hip pain, I put a great deal of attention on the specific area that hurt. I foam rolled the area. I stretched it. Strengthened it. And did everything I can to "fix" it. But it wasn't until I zoomed out and started looking at how all the other hip muscles functioned that I started seeing results.
I notice the same thing with most of the clients I work with. There is so much emphasis on the painful area. And any work we do on that painful area just aggravates it even more. Once we step away and focus on how the surrounding muscles function, we start seeing the results we want.
I recommend you do the same. Try the exercises in this article and see if a more global approach will help you too. If you've been foam rolling and stretching the IT band for weeks or months (or years!) and not seeing any results, maybe it's worth a try?
