Why you need a tight ITB!


Our articles are not designed to replace medical advice. If you have an injury we recommend seeing a qualified health professional.


Did you know that babies don’t have an Iliotibial Band?!

Honestly, it’s true. Look, research says so…

I use this as an example with patients of how the body adapts to the stresses placed upon it. Muscles, tendons, bones and joints all adapt to running providing there’s regular stimulus and sufficient time to adapt.

As infants grow and start to weight-bear the ITB gradually develops and becomes a strong, complex structure with many key roles.

It has extensive distal attachments including the patella and patellar tendon, lateral femoral epicondyle, fibular head and Gerdy’s Tubercle on the tibia. It’s attached to TFL and Glute Max proximally and to the femur along its length.

The ITB is considered the “most robust contributor to anterolateral knee stability” (Burnham et al. 2016). It stabilises the hip during walking, running and impact and plays a ‘pivotal role’ in patellofemoral stability (Geisler and Lazenby 2017).

Recent research has shown that stretching and foam rolling do not change ITB stiffness or range of movement (Pepper et al. 2021). This is probably a good thing as we need that tightness and tension for stability and to store and release elastic energy.

If it’s such a strong structure why does it hurt with ITB Syndrome (ITBS)?!

Current thinking is that sensitive tissue that sits beneath the ITB may be compressed during repeated movements leading to pain, as covered below in this slide from our ITBS series.

Image adapted from Baker and Fredericson (2016)

Visit clinicaledge.co/itb to access this free video series covering assessment and diagnosis of ITBS, exercise progressions and return to running.



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