Brian Schiff’s Blog

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Brian, curious your thoughts on these other ideas about the IT band.

http://saveyourself.ca/blog/0360.php

http://thebodymechanic.ca/2012/03/17/stop-foam-rolling-your-it-band-it-can-not-lengthen-and-it-is-not-tight/

Kory,

Very interesting posts indeed. I think both of those authors raise some valid points in regard to the science behind rolling the tissue and what people are trying to accomplish. Certainly, the nervous system is heavily involved in pain and adaptation to it. I tend to agree that actually stretching the ITB and increasing length is a tough proposition. I do like to think that pressure from rolling can improve oxygen/blood flow (perhaps by some mild inflammation effect similar to Graston) as well as ironing out a few kinks so to speak prior to active warm-up/higher demand activity.

Unfortunately, science does not always clearly support clinical success with sound evidence. I do know that I tend to blame asymmetry, muscle imbalance and biomechanics more than a tight ITB. I do feel you can experience a true friction syndrome if mechanics are poor. Addressing synergistic muscle dominance, limb asymmetry and foot biomechanics is always a must for runners. The ITB likely gets much of the blame as a site of pain, while other structures and tissues are at fault. In the end, I have seen good resolution of pain with massage and rolling along with single leg strengthening designed to improve hip/knee control as well as raise the threshold to impact tolerance on the affected side.

While rolling and stretching are not a miracle cure by any stretch, I am not at a point where I want to exclude them. How do you feel?

A quick P.S. to this comment – I have seen patients who presented with a certain amount of lateral drift if you will on the Thomas test (I measure with the goniometer and this indicative of TFL tightness) be able to reduce this angle markedly with Graston and/or MFR and rolling to the ITB, glutes, piriformis muscle groups in concert with single leg training exercises over a course of a few weeks. Just more food for thought.

Yes, I don’t think I would throw out the use of foam rollers at all. I think providing appropriate sensory input into our system is many times very helpful. Plus the increase circulation is also a plausible event going on.

My thought is that being overly aggressive may not yeild you any better results then a more gentle roll. You see some pretty fancy rolls out there with all sorts of pointy things and such, I don’t know that they provide any change in outcome other then increased cost and maybe a little more pain while doing them. Would be a relatively easy study, have one group roll the “heck” out of the IT band very aggressively and let the other take a more gentle approach and see if we see a difference in their pain and function.

Any time we touch the skin, whether with our hands, a foam roller, some tape, etc., we are going to get input into the neuro system which often times will lead to a change in output with pain perception, action programs and stress-regulation.

I purchased his book, for seeavrl reasons. I have suffered from lower lumbar back pain for 40 years. Forty years ago, the Veterans Administration Hospital strongly recommended surgery. And meanwhile provided grocery bags of pain killers.But I also lived and worked in an African village for two years. I knew Esther was on the right track. The functional posture and strength of both men and woman in the tribe in which I lived, was awesome. Esther’s photographs beautifully capture the functional poise that I witnessed many years ago.I bought this book with great hopes. Sadly, some of the ideas in this book only injured my back further.But I can also say the same for the dozens of back books and seminars which I have read or attended over forty years. Whether the subject is Tai Chi, Yoga, or Pilates, I always find that some exercises seem to help, but there are unhappily always a few exercises that do further injury. And there is the rub.I am also amazed that Esther does not show the ancient village squat. This is a glaring ommission. A westerner can not live, or travel, in the 3rd world and not observe the ease and frequency with which villagers young and old can assume the village squat.Generally, Westeners just can’t seem to squat like this for any length of time. I am mystified that this functional and popular position is not captured in her photographs.I would love to see Esther take her beautiful but beginning research a step further.Thankfully, I eventually found right here at Amazon some back books and DVD’s which have given me relief from back pain for the first time in 40 years as well as a new found ability to run and ice skate again.Admittedly, my search was a long journey, but I found the best self help yet in the books and DVD’s of Peter Egoscue. Book by book, I became so impressed with the results, that I eventually bought every book and DVD Peter has written or produced.My back problems are largely confined to the lower lumbar area, due to injuries sustained in Vietnam in 1970.Ironically, Peter Egoscue is also a Vietnam veterean who sustained injuries while on duty. Peter embarked on his own search to heal himself.What a marvelous, simple and sound approach he has pioneered. Not one of Peter egoscue’s procedures has ever caused my back further injury or pain!Good luck with your own search for back health.

Exactly! science does not always clearly support clinical success with sound evidence