The Iliotibial Band (IT Band or ITB) is a long tendinous piece of tissue on the outside of the thigh. It runs from the ilium (on the pelvis) to the tibia (shin bone), crossing both the hip and knee joints. At the top, it blends with a muscle known as TFL (tensor fascia lata).

The Notorious IT Band

The ITB area can feel tight, often in people who do a lot of running. In an attempt to relieve the discomfort, they might reach for their foam roller and roll over the length of the ITB. It’s not a comfortable exercise, and it might not actually be that effective either. This is not a muscle, and it doesn’t stretch like one. Some studies suggest that, to stretch the band by 1%, you would need to apply 900kg of force. So maybe rolling and stretching the band is unhelpful, but that’s alright, because the ITB is not in control of its own tension.

The Muscle in Control

The ITB is more like a ligament or tendon than a muscle. If you had a sore ligament anywhere else, you probably wouldn’t be looking to stretch it, because it’s there for support. The ITB is the same: it’s there to support the knee. Its attachment to the tibia and patella mean that tension through the ITB can secure two of the four bones of the knee. Of course, this protective mechanism is not always helpful, but it can definitely be impactful.

Unlike other ligaments, the tension in ITB is variable. The TFL muscle is the puppeteer, and if the ITB truly needs to be less tense, it would be TFL that needs to be stretched or rolled.

Problems Associated with a Tense IT Band

One common ailment associated with a tense IT band is hip bursitis. You can read a full post on hip bursitis here. Bursitis is irritation of bursa, and bursa are the body’s anti-friction pads. They’re found all over the body, usually anchored onto bone where tendons or muscles run nearby. The bursae around the TFL and ITB area can be irritated by the aforementioned tension, and they can take a long time to settle down even once the root cause has been addressed.

On the other side of the coin, a tense IT band can be an indicator for a pre-existing knee problem. That might be something mild that has led to the body moving differently to avoid the pain. Or it could be an instability issue or arthritic knee. In any case, when you present to your osteopath with an ITB problem, you can expect some questions and examination of the knee.

For runners who experience ITB discomfort, there are extra considerations. If the knee is happy, is there a problem further afield, like a vulnerable ankle that sends a jolt up through the leg? Or is it as simple as replacing running shoes? Bring your shoes to your appointment so we can see how your foot hits the floor and let us treat your pain as part of a whole body picture.

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