THE ILIOTIBIAL (IT) BAND may not be top of mind for most yogis. After all, the thick fascial tissue (similar to a tendon) isn’t typically aggravated by yoga alone. But if you love jump backs, or if you practice yoga to help balance a fitness regimen filled with high-impact or explosive activities (think running, hiking, dancing, or high-intensity interval training) you likely have an embodied sense of this fibrous structure, and you might say
it feels “tight.” And you’re right: The tendinous fibers of the IT band have a firmness that serve as a natural protector of your outer thigh. Yet before you use yoga to help “stretch” or heal your IT band, it’s important to know the basics about how this tissue can become irritated and what to do to help it feel better.
If you feel pain on the outside of your knee, particularly when bending it, this may be a sign that you’re dealing with IT Band Syndrome. For example, pain may occur when you walk up or down stairs or move into yoga poses that require a deep bend in one knee, such as Virabhadrasana II (Warrior Pose II). The source? IT band tension caused by imbalances in your tensor fasciae latae or gluteus maximus muscles—the two hip-based connection points for your IT band. When these muscles pull on your IT band, which connects into your knee’s joint capsule and the outside of your shin bone, it can lead to pain in your outer knee.
The good news? IT band issues are usually not very serious and respond well to strengthening and releasing tension in the muscles surrounding the tendon—especially your gluteus maximus and tensor fasciae latae, as well as the neighbouring quadriceps, hamstrings, hip flexors, and hip rotators.
COMMON CAUSES OF IT BAND SYNDROME
When any tendon is put under repeated stress from overworking or overstretching, little tears or traumas can occur, leading to injury and pain. When this happens in the IT band, it’s called IT Band Syndrome—and because tendinous tissue doesn’t get as much healing blood flow as a muscle, it can be harder to repair. What’s more, the IT band is packed with nerve endings, which is why foam rolling it can be very painful. Here, four common causes of IT Band Syndrome:
Excessive running, jumping, or cycling, particularly when knee and hip alignment is off. Keep in mind that any movement with poor alignment can lead to problems. That’s because part of the IT band’s purpose is to keep your knee optimally tracking as you move, so if your joints are consistently out of alignment (say, if your feet pronate when you walk or turn out when you ride your bike), it can irritate your IT band.
Overstretching or over-tensing your buttock muscles from exercise or poor habits (for example, sitting cross-legged or frequently wearing high heels).
Excessive sitting, which chronically shortens the tensor fasciae latae while overly lengthening the glutes, weakening your hips, hamstrings and gluteal muscles and aggravating your IT band.
Leg length discrepancies, which can place excessive strain on one hip, leading to IT band issues on the longer leg.
Body of Knowledge: Anatomy of the IT BAND
Also known as the iliotibial tract, the IT band is a multipurpose tendon that runs down the length of the outer thigh, from the top of the pelvis (ilium) to the shin bone (tibia). It connects the tensor fasciae latae muscle (a hip flexor) and gluteus maximus (the largest butt muscle, a hip extensor, and external rotator) to the outside of the tibia. The IT band is responsible for keeping your hips and knees stable, particularly during rapid, explosive moves like running and jumping. Think of the thick fascia of the IT band like a well-tensioned bridge that links the pelvis and knee. That fascia also envelops your quadriceps muscles and tapers into the knee joint capsule.
When the two muscles that attach at the top section of the IT band—the tensor fasciae latae and gluteus maximus—contract, it adds tension to the IT band, which helps to stabilise your knee-to-hip relationship. But too much use (or underuse) from one of these muscles can overstress your IT band and tug on your outer knee, leading to pain.
This is the uppermost and largest part of the hip bone; it’s a wide, flat bone that provides many attachment points for muscles of the hip and trunk.
TENSOR FASCIAE LATAE
This small muscle lies in front of the hip joint and is one of the connection points for the IT band.
This thick, fascial tissue serves as the tendinous insertion for the gluteus maximus and tensor fascia latae. It is the outer border of the vastus lateralis (outer quadriceps) muscle and acts as a fascial envelope for the quadriceps group.
Also known as the shinbone, it is the larger and stronger of the two bones below the knee.
The largest and most superficial of the three gluteal muscles, this is the main extensor muscle of the hip and the other connection point for the IT band.
Why foam rolling isn’t a cure
It seems logical that if you’re dealing with IT Band Syndrome, massaging the tendon with a foam roller might help. And while it will likely provide temporary relief afterward (there’s a good chance it’ll also hurt like heck while you’re rolling!), it’s my firm belief that arbitrary foam rolling of your IT band can do more harm than good. Here’s why:
For starters, excessive rolling can further irritate an aggravated IT band tendon, worsening existing micro-tears. Plus, some of the relief that comes after a foam-rolling session may be the result of stimulated stretch receptors in the vastus lateralis, the lateral quadriceps muscle that lies beneath your IT band. While this quad-tension relief can slightly relieve IT band pain, it doesn’t negate the potential additional damage caused by the foam roller. Finally, if you foam roll your IT band while ignoring the all-important gluteus maximus and tensor fasciae latae, you’re not addressing the underlying cause of pain.
Instead of foam rolling, try Ball Plow
First, use therapy balls on your gluteus maximus and tensor fasciae latae. Place the balls between your muscles and the floor, then ease the weight of your body onto the balls, taking deep breaths as the balls sink deep into your tissue. Stay here for 2 minutes per muscle group. As you lie on the balls, try tensing and releasing these muscles a few times to further relax the muscles and their connections to the IT band. Then, use therapy balls on the outside of your thigh, which will help to improve hip mechanics and ultimately restore proper IT band function—without risking additional damage.
It’s important to avoid trying to “roll out” or “loosen” your IT band, as it could worsen its condition. Instead, use the therapy balls to target the mobility of the muscles underneath the IT band: the quadriceps. In the following release exercise (“Ball Plow,” below), moving the therapy balls in super-slow motion helps to coax mobility into these deeper muscles. The balls will likely come in contact with your IT band at times, so limit your pressure at highly sensitive points. Attempt to apply pressure that helps to create a relaxation response in the deep thigh muscles below the IT band.
The practice below will help you to home in on the right spots. If rolling feels painful, back off. This should feel like a tolerable stretch, leaving the area feeling warm and refreshed.
1 Rest on your side and place a pair of Yoga Tune Up Therapy Balls (or other small, pliable balls) on the outside of your thigh, toward the junction between your quads and hamstrings, nestling the balls into a region that is directly below your IT band.
2 Let the balls sink in for 10 breaths. Imagine that they’re docking themselves between your quads and hamstrings.
3 Moving slowly, use the weight of your thigh to guide the balls forward (across the thigh, not lengthwise). You’ll use the deeply docked therapy
balls to move your quads around your femur, mobilising the lateral (outside) quad away from the hamstrings and creating a stretch between the bone and your quads. If done correctly, it will feel like a large hand is pivoting your thigh muscle around the bone.
4 Therapy balls will naturally roll (they are spheres, after all). Try to minimise rolling by using them to plow the entire section of muscle, which will cause your thigh to internally rotate.
5 Repeat for up to 10 minutes, moving slowly from the outside of your thigh toward the middle, then switch legs.
3 poses for a healthy IT band
When it comes to your IT band, not all yoga poses are created equal.
Some lengthen the IT band’s muscular attachments, and others will reinforce their strength and stability.
The following poses will help you get to know your IT band—and help heal and prevent problems.
To feel the IT band in your body, try …
Prasarita Padottanasana Wide-Legged Standing Forward Bend, variation
The twisting motion in this unique variation will help you feel the origin and insertion points of your IT band, from the outside of your hip to your knee, providing a deep stretch in your glutes, lateral hamstrings, lateral calf muscles, and ankles.
How to Step your feet 2–3 feet apart and hinge forward until your hands touch the ground, keeping a neutral spine. If you have trouble touching the floor, place your hands
on a block or a chair. Walk your hands to the right, allowing your whole body to revolve
so your feet and head face away from their starting points. Stop when your hips and thighs reach their max rotation. Your right leg will be in front of your left. Hold for 5–10 breaths, then repeat on the other side.
If your IT band is hypermobile, try …
Vasisthasana Side Plank Pose
If you have a hypermobile body type, isometric poses that boost stability are key to helping build strength and keeping your IT band safe. This pose will activate the lateral stabilisers of your hips, including the gluteus maximus, medius, and minimus, while also prompting your tensor fasciae latae to stabilise your IT band. Both legs work equally hard in this Vasisthasana variation, making it an especially powerful hip strengthener that improves IT band stability.
How to Lie on your left side, placing your left forearm on the ground and driving your scapula toward your hip. Line up your feet with your shoulders. Activate your outer foot so that your ankle stays strong, rising up into Side Plank Pose. Lift your right foot away from your left so your feet are hip-width apart. Hold for up to 1 minute, then repeat on the other side.
If your IT band feels tight, try …
Anantasana Side-Reclining Leg Lift, variation
If your IT band and hips feel tight (read, if Child’s Pose makes you sweat), you’ll want to improve the mobility of the muscles connecting to your IT band, which will help maintain their strength and enhance their range of motion.
How to Lie on your left side and stretch your left arm out up along the floor, parallel to your torso. Bend your left elbow and support your head in your palm. Keep your right hip parallel to the left, raising your right leg as high as possible without rotating your hip. Then, flex your right hip forward, keeping it raised. (Your toes should never point toward the ceiling.) Slowly lower your right foot to the ground without rotating your hips. Then, lift your right foot off the ground again, taking 30 seconds to return it to its starting position. Each leg lift should take approximately 1 minute. Do 3 on the left side, then repeat on the other side.
About the author:
Jill Miller is the creator of Yoga Tune Up and The Roll Model Method, and author of The Roll Model: A Step-by-Step Guide to Erase Pain, Improve Mobility, and Live Better in Your Body. She has presented case studies at the Fascia Research Congress and the International Association of Yoga Therapists Symposium on Yoga Therapy and Research. Learn more at yogatuneup.com. Model Kat Fowler, E-RYT 500, is a yoga and meditation teacher and a Yoga Alliance Continuing Education Provider in New York City. Learn more at katfowleryoga.com.