The iliotibial band (ITB) is generally thought to contribute to anterior knee pain and is the focus for many physical therapy related treatments. ITB problems and anterior knee pain can be very complicated problems. Many biomechanical problems have been thought to contribute to anterior knee pain, including, but not limited to, foot problems, bone alignment abnormalities, leg length discrepancies, decreased muscle strength, muscle imbalance, poor flexibility, decreased balance, direct trauma, and low back/pelvic problems.
I don’t want to go into a long blog post about some of the controversies about the ITB and the best way to treat flexibility and functionality problems in this area, but nothing makes me cringe more than seeing a physical therapist instructing a patient with self-stretching using a foam roller. I do not believe this approach adds any value with any of my patients, and I would go as far to say that I have never had a successful outcome using this method.
It’s one of those things that “people” says works, but does it really work? The value of this approach lacks plausibility and does not justify putting your patients through that kind of pain to have poor to mediocre outcomes. If I see a person who has failed care at another physical therapy office for anterior knee pain, I can usually bet that the self-stretching on a foam roller was used.
Using a foam roller compresses sensitive tissues in between a foam roller and your femur. Yes, it hurts because you are depolarizing mechanical pain receptors located in your muscles and connective tissue by crushing them between two hard surfaces, and that’s on a good day. A bad day is the picture below…..actually breaking muscle and tissue cells causing bleeding, bruising, and damage. The pain you experience does not mean you are stretching anything, nor does the pain mean that the treatment is therapeutic. Increased bleeding is not going to heal you, but it is going to stimulate scar tissue formation and possibly make the ITB more restricted.
If the ITB is the source of the problem, there are many compelling ways to work the tissue that is comfortable. I tend to use several manual techniques that are very effective and does not cause much discomfort to the client.
If your ITB is bothering you, please make an appointment with a well-educated physical therapist before taking to a self-stretching home remedy. Your body will thank you.