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Why does my IT Band hurt so much?!

Updated: Dec 1, 2020

And what can I do about it?

There is no getting away from it. It’s a revolting feeling when you lie on that foam roller and your stomach churns like it’s the worst pain you’ve ever felt… for about 5 seconds. “Roll your ITB” is one of those standard phrases your coach or therapist will throw around like it’s the simplest thing in the world. And you know it’s good for you, but just like drinking spirulina, it doesn’t go down well.


So why is that?

Your iliotibial band is a thick ribbon-like strip of connective tissue called fascia, that runs laterally down your thigh from the tensor fasciae latae muscle in the hip, around the knee, to the top of your tibia (shin bone). Its function is primarily to stabilise the knee joint.


It feels like fascia is a new thing that physical therapists and personal trainers have started talking about all of a sudden…

“If your fascia is tight it will prevent you from moving freely”

“You should be rolling your foot to avoid getting plantar fasciitis” and so on.


But of course, we’ve always had fascia, it’s just that its role in the free movement of the human body is only just being fully understood and the application of fascial techniques is becoming more widespread as its critical, holistic properties are realised.


But what is fascia and why does it want to kill me when I press it?


Fascia, is a web of watery, sticky, viscous substance that binds all our bodily systems together so that we literally stay in the shape to which we are accustomed. (Grab a chicken breast with the skin on. Now pull the skin up away from the flesh, and you will see a thin pale film of a springy substance that can be stretched, but holds its shape. This is Fascia).


It doesn’t act like muscle in that it won’t stretch easily. It’s designed to withstand force. So when you’re told to stretch your ITB that’s not what you’re actually doing. You are making it more pliable, which in turn means it can move around and within the muscles it encases more smoothly, in turn allowing your muscles, tendons and ligaments to respond effectively.


Why does my fascia get ‘tight’ and cause me pain?

Many things can cause the breakdown in this vital tissue;

  • Trauma – knocks, bangs, cuts, scar tissue will all have a damaging effect

  • Dehydration - when you have less fluid in your system, the fascia becomes sticky and sticks to the muscle around it preventing free movement

  • Medications - can disrupt the equilibrium, causing hormonal imbalances or dehydration

  • Aging - and the body’s natural depletion of collagen can mean a loss of elasticity

  • Nutrition - poor nutrition can be the root cause of many dysfunctions in the body


Some common fascial disorders

  • Knee pain especially when running

  • Plantar and Palmar fasciitis (this is INCREASINGLY common. With many more people working from home, a change in physical environment means wearing no shoes, and in turn no support for feet that are used to being in closed shoes)

  • Fibromyalgia

  • Capsulitis of shoulder

  • Hernia

  • Hypermobility

  • Rheumatoid Arthritis

  • Sprain

  • Tendinitis (Tendinopathy)


What can I do to make my ITB less painful?

There are several ways you can avoid fascial disorders and stay in the healthy fascia gang:

  • Keep moving – everything, every body part, walk, exercise, stretch. By moving your fascia will stay hydrated, supple and happy. If you stop for long periods, your fascia can become cemented in place and prevent free movement

  • Yes rolling and stretching the whole leg and hip area - related to just moving, but more focused on particular areas. Although rolling can be very painful so go with caution

  • Get regular massages – a therapist will free the network of fascia and muscle around the whole area to allow smooth movement and support the ITB

  • Myofascial release and Cupping - application of different techniques to massage, to open up and move fascia rather than muscle release - usually too painful on the ITB but can be effective around the leg and glutes

  • Structural Integration (Rolfing) - looks at the whole postural system and focuses on the structure of fascia throughout the body

  • STAY HYDRATED. Enough said.


Some IT Band rolling and massaging tips:

  • Remember to BREATHE. If you hold your breath when rolling or massaging your ITB you will tighten up and make it worse. Take a deep breath in, and breathe out on the roll i.e. painful bit

  • Go slowly, and when you feel the pressure stay at that point for a minute or two, breathe and try and relax into it. The discomfort will ease, then move on

  • Remember it’s all connected, no muscles work in isolation so also work on your glutes, quads, hamstrings and TFL (if you can get to it comfortably)

  • Do it as regularly as you can bear. It helps

  • Allow a massage therapist to do it for you, they will be more effective!





If you are struggling with your IT Band, for example getting knee pain when you run, I recommend using a foam roller regularly (but don't beat yourself up with it!), and also come for a sports massage or stretch therapy session and let me do the hard work for you. Often by working the whole body system this can help your ITB directly, and you may feel immediate relief. Plus I won’t make you drink spirulina.


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