Facts on IT Band (iliotibial) & Massage for the IT Band in Santa Barbara, Ca.

The iliotibial band (IT band) is also known as the iliotibial tract or Maissiat’s band. It’s a long piece of connective tissue, or fascia, that runs along the outside of your leg from the hip to the knee and shinbone. The IT band helps to extend, abduct, and rotate your hip.

Have you been noticing pain on the outside of your knee, hip, or thigh without a known injury? If your answer is Yes, then you may be experiencing symptoms of Iliotibial Band Syndrome. Iliotibial Band Syndrome (IT Band Syndrome) presents as pain along the outside of the thigh from the hip to the knee.

Beyond the pain and discomfort, you may also hear audible snaps as the tissue frictions over the outer edge of the thigh bone. Your IT Band is a strong, thick, fibrous band of tissue that runs down the outside of your thigh. As you can see in the illustration below it extends all the way from your hip bone to the top of your shinbone as it melds with the musculature of your hip and thigh to assist with stabilizing both areas during movement.

With repeated bending and straightening movements of the knee, the IT Band may friction and irritate surrounding tissues, causing pain. It is most common for people who often perform the repetitive motion, especially distance runners, cyclists, or new recreational athletes.

Your physical therapist will be able to identify whether your pain is a result of IT Band Syndrome or another problem based on your symptoms as well as a physical examination assessing your strength, flexibility, gait pattern, and quality of movement.

Once your concerns are identified as IT Band Syndrome, you and your physical therapist will design a customized plan of care to address your imbalances and movement dysfunction.

The IT Band runs down outside of the thigh from the hip to just below the side of the knee. The iliotibial band (ITB, IT Band) or iliotibial tract is a reinforced band of dense fibrous connective tissue/ fascia in the thigh  connecting proximally to the Tensor Fascia Lata and Gluteus Maximus muscles, and distally to the lateral condyle of the tibia ( Gerdy’s Tubercle).

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome) is a common injury to the knee, generally associated with running, cycling, hiking or weight-lifting (especially squats).


  • Pain is gradual at onset and worse with activity
  • Pain felt at lateral thigh and lateral knee
  • Thickening, adhesions and fibrotic nodules ( like adhesions along the fascia) of the affected IT Band ( especially in the knee area where theres a lot of movement)
  • Hypertonicity and Trigger points in the Tensor Fascia Lata, gluteus maximus, hip flexors, rectus femoris leading to decrease circulation and shortening of these muscles
  • Inflammation at the lateral femoral condyle due to tight IT Band. There could be rubbing and inflammation at the hip due to trochanteric bursitis
  • With anterior pelvic tilt, lumbar pain, and SI joint hypermobility
  • Valgus or hyperextension at the affected knee
  • Pes planus

Iliotibial Band Contracture & IT Band Friction Syndrome

  •  ITB Friction Syndrome is inflammation and pain where the IT band crosses the lateral femoral condyle
  • ITB contracture is the shortening or thickening of the IT band
  • ITB Contracture and Friction Syndrome may occur unilaterally or bilaterally
  • The fascia surrounding Glute Max and Tensor Fascia Lata (TFL) join to form the IT band
  • IT band provides lateral support to the knee
  • When fascia is contractured, biomechanics of the knee and hip are restricted. Ankle and SI joint may compensate
  • Bursa between the greater trochanter and IT band may become inflamed ( trochanteric bursitis)
  • Trigger points in glute max and TFL may also contribute to ITB tightness

 IT Band Massage: CAUSES of IT Band Syndrome / IT Band Contracture

IT Band Friction Syndrome

  • Prolonged, repetitive activities where knee and hip are flexed – like running, cycling
  • Contributing factor – poor TFL stretching procedures, anterior pelvic tilt, tight TFL, glutes

ITB Contracture

  • Activities or occupations that place the knee and hip in flexion (cycling, horseback riding, prolonged sitting, running with pronated feet) and allows ITB and TFL to tightened
  • Postural Imbalance – anterior pelvic tilt/hyperlordosis
  • Prolonged wheelchair use, bed rest


  • Hypertonic IT Band creates an indentation in the lateral thigh
  • Unilateral IT Band contracture, lateral pelvic tilt can be seen on the affected side
  • The affected knee is valgus
  • Pes planus on the affected side
  • With bilateral IT Band contracture, anterior pelvic tilt due to short ITB and TFL
  • Hyperlordosis from anterior pelvic tilt, short hip flexors, rectus femoris
  • IT Band friction syndrome may show redness, edema at affected lateral femoral condyle
  • Lateral quads and hamstrings may be tight

IT Band Massage: PALPATION

  • Tenderness along with IT Band, especially distal 1/3, also at the greater trochanter
  • Affected IT Band thickened, adhesion present
  • On the affected side – hypertonicity and trigger points in the TFL and glute max.
  • On non – affected side – hypertonicity and trigger points in the hip flexors
  • If bilateral, hypertonicity and trigger points in TFL, glute max, rectus femoris, iliopsoas, adductors, and Quadratus Lumborum
  • With friction syndrome, inflammation, heat, swelling, point tenderness local to the lateral femoral condyle area

IT Band Massage:  ROM TESTING

  • Active Free ROM of the affected knee, hip, SI joint, and Lumbar Spine
    •  Reduced extension and adduction of the hip
    •  Painful knee extension with friction syndrome ( esp. in the act of extending the knee – tight band snaps to the lateral femoral condyle)
  •  Passive Relaxed ROM of the affected knee, hip, SI joint
    • Painful at the lateral knee with extension
    • Active Resisted testing of TFL, rectus femoris, glute max, glute medius, iliopsoas, Quadratus Lumborum

IT Band Massage:  SPECIAL Orthopedic TESTING

  • Thomas Test – tight ITB, TFL, rectus femoris
  •  Ely’s Test – right rectus femoris
  •  Ober’s and Modified Obers – tight ITB, TFL
  •  Noble’s Test

IT Band Massage Therapy Treatment

  • Fascial Techniques to ITB, in various directions and interspersed with effleurage ( to drain and because fascial work there is painful)
    • Skin rolling, Cross-hand spreading, C and S bowing techniques, J stroke
  • Cross fiber friction to adhesions, followed by ice and stretch
  • If friction syndrome is present, inflammation at lateral femoral condyle makes onsite fascial technique impossible. Use ice locally. Working on the proximal IT Band can reduce tightness in the distal IT Band until the inflammation is gone and on-site work is possible.
  • TFL muscle massage: treat hypertonicity, adhesion, trigger points by ( skin rolling, petrissage, stripping to the attachment at the iliac crest and around trochanter, GTO at trochanter where TFL distal musculotendinous junction located)
  • Glute max: massage for hypertonicity and trigger points
  • Repetitive effleurage to lateral leg and glutes to increase circulation
  • Contrast hydro can improve circulation
  • Rest of affected leg: treat iliopsoas, quads, hamstrings, adductors, muscles of the lower leg
  • Passive Relaxed ROM of hip and knee. Ankle, knee, hip, SI joint treatment with joint play itb massage, massage for its band, it band massage therapy, massage therapy for its band, massage treatment itb, massage treatment band

IT Band Massage: SELF CARE

  • Deep moist heat to loosen IT Band ( if there is no inflammation)
  • Contrast hydrotherapy to increase circulation
  • Ice to lateral femoral condyle with acute friction syndrome
  • Self-massage to IT Band and TFL (foam roller)
  • Stretch TFL, especially if seated for long periods. ( with arms raised, affected leg behind, front leg lunged down, bend sideways)
What does an IT band do?
It’s a long piece of connective tissue, or fascia, that runs along the outside of your leg from the hip to the knee and shinbone. The IT band helps to extend, abduct, and rotate your hip. It also helps to stabilize and move the side of your knee while protecting the outer thigh.
What causes a tight IT band?
Iliotibial (IT) band syndrome is often caused by repetitively bending the knee during physical activities, such as running, cycling, swimming, and climbing. The IT band is a group of fibers that run the length of the upper leg, from the hip to the top of the shin. When overused, the IT band can become tightened.
Is IT band syndrome serious?
IT band syndrome may begin as mild pain and intensify if left untreated. The best treatment is often to stop doing the activity that is causing the pain. In more severe cases, surgical options may need to be considered.
What do you do if you hurt your IT band?
Foam roller: Lay sideways on a foam roller and roll back and forth from the top of the knee to the bottom of the hip. Metzl recommends runners do this each day for two or three minutes on each side to break up the tight flesh—or for as long as you can tolerate the excruciating pain.
What happens if you tear your IT band?
Injury to or irritation of the iliotibial band—called iliotibial band syndrome—may cause an aching or sharp pain often felt on the outside of the knee. Sometimes, the pain spreads to the thigh and/or hip area. Diagnosis of IT band syndrome is often done clinically through a detailed history and physical examination.
Can your IT band snap?
The most common symptom of IT band syndrome (sometimes referred to as “ITBS”) is the pain located on the outer side of the knee that increases as a person runs, cycles or performs other exercises with repetitive leg motion. A person may also experience a feeling of clicking, popping, or snapping on the outside of the knee.
What does a torn IT band feel like?
Aching, burning, or tenderness on the outside of your knee. Feeling a click, pop, or snap on the outside of your knee. Pain up and down your leg.
HOW LONG DOES IT Band take to heal?
Rest, of course. Treatments can take a few weeks to a couple of months to fully heal IT band syndrome; four to eight weeks is the common recovery time. It was caused by overuse in the first place, so it needs time to recover and relax.
How do I loosen my IT band?
Stretching the IT band and the connected muscle is fairly simple. Just cross your legs, keeping the affected leg in the back (position 1). Lean away from the painful leg until you feel a stretch along the side of the leg (position 2). Hold that for 30 seconds and repeat 5 times.
How long does it take for IT band pain to go away?
So what can a runner do to treat and recover from IT band pain? Rest, of course. Treatments can take a few weeks to a couple of months to fully heal IT band syndrome; four to eight weeks is the common recovery time. It was caused by overuse in the first place, so it needs time to recover and relax.
How do I stop my IT band from hurting?
IT band syndrome treatment includes the following:
  1. Rest, ice, compression, and elevation (RICE).
  2. Anti-inflammatory medications, like ibuprofen (Advil, Motrin) and naproxen (Aleve), may be helpful. …
  3. Home treatment can involve stretching, massage, and the use of foam rollers at the site of pain and inflammation.
Is walking bad for IT band syndrome?
Runners will often develop Iliotibial Band Syndrome (ITBS) after running on uneven terrain or downhill. The pain, located on the lateral (outside) leg or knee, can be very debilitating to the point that running or hiking activities have to be stopped. Even walking becomes difficult.
How do I make my IT band heal faster?
How to Aggressively Treat IT Band Syndrome
  1. Stop Running. 1 of 6. Running exacerbates ITBS pain, typically at the knee insertion point, during the acute injury phase. …
  2. Cross Train With Cycling or Pool Running. 2 of 6. …
  3. Massage the Injured Area. 3 of 6. …
  4. Increase Strength. 4 of 6. …
  5. Sleep More. 5 of 6.
Should you stretch your IT band?
‘You can’t really stretch the IT band, but you can stretch the muscles around it.
How do I warm up my IT band?
Avoid any deep tissue release in the warmup since you don’t want to irritate the muscles before you head out to run or race. For instance, with the IT band, focus on using short, light circular rubbing up and down the leg. Again, you’re not trying to release the tension in the targeted spot but rather warm it up.
Can Squats cause IT band syndrome?

When a person bends their knee, the IT band moves to support it. If the IT band becomes inflamed, it can rub on the outer knee and cause pain, especially during movements that involve the joint, such as squatting. IT band syndrome often affects runners.
Can a chiropractor help with IT band syndrome?

Treatments for Iliotibial Band Syndrome

If the pain from iliotibial band syndrome lasts for more than two weeks even if you are only stretching, your regular exercise routine, and ice and you don’t see much improvement, a chiropractor can help. Treating the tightness in the iliotibial band is the key to healing.

How do you avoid IT band issues?
Here are some steps you can take to prevent ITB syndrome:
  1. Most importantly, always decrease your mileage or take a few days off if you feel pain on the outside of your knee.
  2. Walk a quarter to half-mile before you start your runs.
  3. Make sure your shoes aren’t worn along the outside of the sole.
Can shoes cause IT band syndrome?
IT band syndrome can result from any activity that causes the leg to turn inward repeatedly. This can include wearing worn-out shoes, running downhill or on banked surfaces, running too many track workouts in the same direction, or simply running too many miles. Weak glutes can also contribute to IT band syndrome.
Is heat or ice better for IT band pain?
Heat should be applied before and during stretching for at least 5-10 minutes, and ice treatments should be employed using a cold pack applied to the area for 10-15 minutes or using an ice massage, which involves rubbing ice over the inflamed region for 3-5 minutes or until the area is numb. Changing the length and intensity of your exercise routine. Massage and/or heat therapy. These treatments can help loosen the IT band and surrounding muscles.
Will ibuprofen help IT band pain?
The acute stage of therapy is aimed at reducing inflammation in and around the ITB. This will reduce pain and any associated swelling. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen are very useful in this regard.
Changing the length and intensity of your exercise routine. Massage and/or heat therapy. These treatments can help loosen the IT band and surrounding muscles.
How do you sleep with IT band pain?
Sleep position
  1. If you regularly wake up at night from hip pain, the way you’re sleeping or your mattress could be to blame. …
  2. Sleep posture can also cause pain.
  3. Try sleeping on your back or, if you’re a side sleeper, sleep on the side that doesn’t hurt and put a pillow between your knees to keep your hips aligned.


Common treatments include:

  • Flexibility and mobility work: dynamic stretching, static stretching, and foam rolling.

    • Key Points: Your dynamic, static, foam roll stretches should address the muscles that connect into the IT band: tensor fasciae latae, vastus lateralis, and glutes vs rolling directly on the fibrous tissue (see anatomy photo above).

  • Progressive strength training addressing the muscle groups of the core, hips, thigh, and lower leg.

    • Key Point: You should not reproduce your pain and/or snapping with any of your exercises addressing the quadriceps, hamstrings, glutes, and hip rotators.

  • Biomechanics training to address movement pattern dysfunction and gait abnormalities.

    • Key Point: Often movement patterns such as your gait, squats, and step-ups can be retrained in a mirror with the guidance of your physical therapist.

  • Activity modification like relative rest, reducing mileage and repetitive stress movements will help reduce friction and inflammation in the tissues as you heal.

    • Key Point: Rest is relative. If your body is used to running 40 miles per week, rest may be reducing your mileage to 20 miles per week.

IT Band Kinesio Taping

IT Band Exercises

Does cycling help IT band syndrome?
“Also, it’s good to maintain good spinal mobility through an exercise class such as yoga. “Additionally, strength training off the bike that targets your glutes and the muscle chains associated with cycling will help to fortify the muscles against ITB syndrome.”
Why shouldn’t you foam roll your IT band?
This includes the tensor fasciae latae muscle, which is found on the outside of the hip. If you have a lot of tightness in or around your IT band, foam rolling may be extremely painful and can even cause more discomfort. This is especially likely if you do it incorrectly. Plus, it may not be that effective.
If you do roll how long should I foam roll my IT band?
Foam rolling the areas around the IT band helps the muscles and tendons in the thighs work like a well-oiled machine. Here are the three foam rolling exercises that Stevens recommends. You can perform them daily before or after a workout, or for general maintenance and recovery. Spend about one minute on each muscle.
4 Corrective Exercises to Strengthen, Treat IT Band Syndrome
  • Hip Bridge with Resistance Band. An effective yet simple exercise, to begin with, is the hip bridge utilizing a resistance band. …
  • Side-Lying Hip Abduction. …
  • Lateral Band Walk. …
  • Side Plank. …
  • Standing IT Band Stretch.

PLUS, Try These-

Massage for IT Band

Can a massage help IT band syndrome?
YES, Absolutely, but usually not because the IT band itself needs to be massaged. In fact, massage on the IT band would be contraindicated during an acute episode of pain. However, massage will help release the hip muscles, thereby creating relief in the ITB itself! The bordering Hamstrings and Quads can be released as well, thereby “ungluing” the ITB from them and allowing the ITB to move freely.
How do you massage ITBS?
Start by stripping it with the heel of the hand always start near the knee and work upwards.

Given current research, treatment for ITBS should be in phases. The first phase requires a proper diagnosis and the identification of any causative factors. Once this is established, the next phase is aimed at reducing the pain. Rest may have to play a part during this phase, which also may include physical therapy modalities, ice, and stretching three times a day. Cross-training that does not aggravate the condition can be done to maintain fitness.

Deep tissue massage along the full length of the ITB can be started in this phase; Dr. Fredericson refers to this as mobilization of the tissues, and it is a necessary step before moving on to the all-important third phase of strengthening the hip and thigh muscles. Fadil recommends very frequent massage: up to every day for elites, and 2 or 3 times per week for recreational runners. If you cannot afford the expense or time of going to a certified massage therapist, a foam roller can work very well for self-massage (see www.smiweb.org obtain rollers).

There is no cookie-cutter massage routine for iliotibial band syndrome (nor hopefully, a cookie-cutter routine for any issue). Each individual is unique, and although the pain from this syndrome may be located in the same place on numerous clients, the response to it depends on the individual. Some people have high pain tolerance, some are stoic or stubborn about pain, and people with a low pain tolerance may seem more debilitated by it.

Regardless of modality, warm the area and do not work beyond the client’s comfort level. Some therapists think they need to go to the bone, regardless of the problem or how tender the client is, and that is not being client-centered in any way. The idea that light work is not as effective as using a heavy hand is false and outdated.

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Do We Need To Massage The ITB?


Therapeutic Swedish Massage, Sports Massage Therapy in Santa Barbara, Goleta

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