One of the most painful things you can use a foam roller for is releasing your Illiotibial band (ITB). I have seen people grind it out for months – rolling back and forth down the side of their leg, everyday, to try and release off the tension in the ITB that causes the painful flicking sensation on the outside of the knee when they run. And the worst part is, most of the time they rarely notice any change. 

The ITB is a thick band of fascia (connective tissue) that doesn’t contract like a muscle, it simply provides tension between joints and muscles. It helps create a stable lateral (outside) portion of the lower limb, tying together the tension created at the hip with the knee (very simplified).

Once you realise that the ITB doesn’t respond like a muscle, and doesn’t generate tension in itself ,then targeting it to reduce tension starts to seem a little counterintuitive. So if the ITB doesn’t make itself tight, then the logical explanation would be that it is too tight because of the structures that attach to it, right? Based on that logic – if you stop the pull coming from the connecting muscles, the ITB tension will reduce… 

It is important to note that iliotibial band syndrome (ITBS) is an inflammatory condition. And as a result, the critical component of treatment is (unfortunately) rest. The main priority at the outset should be to reduce the inflammation and aggravation by offloading the tissue. And when I say offloading I don’t simply mean putting your feet up for a couple weeks and eating cake. I mean releasing the tissues that are causing the tension and nastyness around the lateral knee along with some reduced loading through modifying/limiting aggravating activities.

What does that mean? It means you should shift your attention to surrounding structures – it will be slightly less painful and potentially far more beneficial. 

The key areas you want to focus on when rolling are (rolling techniques with lacrosse ball and foam roller are shown in this order in the attached video)
1. Glutes (med/max/min)
2. TFL (tensor fascia late)
3. Vastus Lateralis
4. Lateral Head Gastrocnemius
5. Tibialis Anterior

As a basic protocol, spend 1-2mins per area 1-2times daily. This is a time commitment of a maximum of 10-30mins if both legs are problematic. Everyone can get that done.