Is it worth rolling the ITB?

Foam rolling has become commonplace in many warm ups and treatment protocols, and in some cases, to great effect. One common practice is to use a foam roller over the iliotibial band. My question has always been, is the pain worth it? Luckily the literature has come up with an answer (at least for immediate changes in stiffness) and was published in June 2021 in the International Journal of Sports Physical Therapy. The investigation used Shear Wave Ultrasound Elastography to determine even small changes in the stiffness of the iliotibial band. The authors measured stiffness at multiple locations along the iliotibial band but were unable to detect any changes at all. The rolling methods used were to roll from top to bottom for a total of 60s, rest for 30s and repeat 5 times, so they really had a good go at rolling the iliotibial band. It would be interesting to see if longer time rolling, rolling multiple times per day, and or reassessing after rolling for an extended period of time (multiple weeks) might make a difference in iliotibial band stiffness. Foam rolling could be effective in “releasing” myofascial restrictions/adhesions. However, the literature suggests this “release” phenomenon does not accurately describe the mechanisms associated with foam rolling.

For now, using foam rolling on the iliotibial band as a warm up or to decrease stiffness is out (but maybe not forever). That said, if you enjoy the sensation, if you feel like it helps and it relieves pain then it at least appears to be safe. I personally will continue with my stance that the benefit does not outweigh the discomfort so will keep it out of my programming.

A lot of protocols for the iliotibial band (and many other areas of the body for that matter) including foam rolling, stretching, massage and many other interventions are not well tested, if at all, and usually prescribed based on anecdotal reports or unfounded theories. If you are unsure about an exercise or want some justification for its inclusion in your program, especially when it causes pain and discomfort, then make sure to ask about it.