You Can’t Stretch Your IT Band

I bet the title of this article got the attention of some people – especially runners who have been told their knee pain is due to a tight IT-band and have been constantly “stretching” it….and don’t see results.

It’s unfortunate that people out there (including some medical professionals) think the reason someone has pain in the front/side of their knee is a “tight” IT-band…and that the “solution” to this knee problem is to foam roll it, stretch it, massage it, etc.

Let’s first, very briefly, discuss some of the anatomy of the ITB and what it actually is. The ITB starts at the end of a muscle on the outside of your hip (the tensor fascia latae muscle), runs along the outside of your thigh and ends just below the knee. It is not a single, discrete structure. Rather, it is a thick piece of tissue that covers most of the outside portion of your thigh, weaving around all over the place.

A study in 2008 determined the amount of force it would take to lengthen the IT-band was essentially superhuman.  They found out that it would take ~2,000 lbs of force to lengthen your IT-band 1%. They described this large amount of force as “far outside the human physiologic range.”

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So what does that all mean?  Basically that there is no way that anything you or your therapist is doing is actually lengthening it! And this also means that a “tight” IT-band is not the reason for your pain.

I find it necessary to quickly discuss foam rolling because I know a lot of you out there love to foam roll your ITB and think it works wonders. A foam roller compresses the ITB, but cannot stretch it (for the obvious reasons described above). Feeling better after foam rolling is probably due to a neurophysiologic response by your body/brain (we still don’t really understand how foam rolling “works” but that seems to be the most popular hypothesis).

If you like foam rolling your ITB and feel better after it, then go for it – just realize that you aren’t actually stretching anything. And my recommendation would be to limit it to 15-20 seconds at most on each side (in fact, that’s my recommendation for foam rolling any body part).

Although, if you are someone who likes to do static ITB stretches, my recommendation is to stop them because you’re just wasting time. Rather, perform some more appropriate mobility drills and/or exercises specific to your limitations.

What To Do

I couldn’t end this post without briefly (emphasize briefly because there is so much to potentially talk about) discussing what you should actually be doing for your knee/hip pain instead of “stretching” your ITB. There are many potential problem areas that can be causing this type of pain - could be a mobility or motor control issue somewhere from the foot all the way up to the thoracic spine and anything in-between. Some of the common problems I see in people who have lateral knee and/or lateral hip pain and were told it was their “tight” ITB are: limited hip mobility (usually internal rotation), poor neuromuscular control of the lower extremity, and/or limited ankle dorsiflexion; in runners, could also be training error or running mechanics issue.

So stop "stretching" your IT Band, get your movement checked out and get rid of that nagging hip/knee pain.

And remember, you don't need a prescription to see a physical therapist (read more about that here)

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