How to use your ITB roller for recovery
Foam rolling for runners
By Doug James – Podiatrist and Physiotherapist – intraining running injury clinic
There are two “F words” that scare runners – ‘fractures’ and ‘foam rollers’ – and both can be painful. Most people would happily avoid self-inflicting pain, but then runners aren’t ‘most people’. The foam roller is often used in between – or in lieu of- sports massage sessions. Regular sports massage is often used as a preventative treatment for sporting injuries, though can be costly to have on a regular basis. Instead, many athletes choose to use a foam roller for self-massage and maintenance.
One of the most common reasons runners use foam rollers is to massage their ITB. This is such a popular use for them that foam rollers are frequently referred to as ‘ITB rollers’. But is the name justified? Research shows that using a foam roller to try and lengthen your ITB is a waste of time [1,2,3]. As the ITB doesn’t contain any contractile tissue it will barely lengthen or stretch with rolling or massage. In fact, the ITB is so inflexible, that it takes around 1000kg to make it stretch a mere 1% , and this amount of force is unlikely to be achieved through use of a foam roller.
While massaging the ITB may not achieve the intended outcome of stretching it, there is still benefit to using a foam roller. Where it may help is by reducing discomfort and the perception of tightness in muscles. There is also some evidence to suggest that using a roller for massage after a challenging training session may result in less muscle soreness (DOMS) and earlier return to pain-free training. Additionally, foam rolling muscles can help to temporarily improve joint flexibility [1,2,4,5].
What is the optimal duration for rolling?
A small study showed that foam rolling the hamstring muscles for 5-10seconds gave reasonable short term improvements in flexibility/length. While this short duration may seem appealing, a more detailed analysis of a larger number of studies suggested that 90 seconds of rolling per muscle group may be more useful. Rolling a few times per week may offer some relief from muscle soreness.
Key muscles to foam roll for runners.
Runners experience muscle soreness in different locations based on intrinsic factors (genetics affecting muscle tone and length, running technique, experience, injury history) and training load factors (training volume, and recent session type – eg intervals/hills). Runners are often categorised as ‘Glute dominant’ or ‘Quad dominant’ and this may have some bearing on which are the likely ‘tight’ muscles. Most runners will benefit from the following rolling techniques, which can be personalised by spending more time working on specific muscles that feel tight or sore.
To begin, position the foam roller in the middle part of the muscle. Gently roll backwards and forwards along the length of the muscle being careful to avoid rolling over any bony parts such as hip bones or knee caps. If you find a particularly tender location within a muscle, try resting this spot on top of the roller while breathing gently for 20-30 seconds. Resume rolling the rest of the muscle after this for a total time of 90 seconds or more.
Position the foam roller under your bottom. Gently roll backwards and forwards being careful not to roll the sitting bones where your hamstrings attach.
Glutes – progression.
For a more aggressive approach, cross one leg over the other and concentrate on rolling the gluteal muscle on the crossed leg side.
Position the roller in the midsection of the back of your thigh. Gently roll backwards and forwards between the back of your knee and stop before you reach your buttocks.
Hamstrings – progression.
For extra pressure, cross one leg over the top of the other and focus on rolling the leg closest to the floor.
Place the foam roller under both calf muscles and roll back and forwards between the top of the Achilles tendon and the back of your knee. You may not feel much massage pressure with this technique, so it’s often better to cross one leg over the top and focus on one leg at a time.
Anterior / Front: Position yourself facing the floor resting on your forearms with the roller under the mid part of your thighs. Rollback and forwards between your knee cap and the top of your thighs. For additional pressure, lift on leg up while rolling the other side.
Lateral quadriceps (Side of the thigh) / ‘ITB’:
As stated above – this will NOT stretch your ITB! Lay on your side resting on your hands or elbows with the roller under the mid part of your thigh. Position one foot on the floor for support. Gently roll yourself backwards and forwards between the bony part of the outside of your knee and the bony lump on the side of your hip.
Progression: lift both feet off the floor and keep your legs parallel.
Try the above rolling techniques and see how you feel afterwards. It is often uncomfortable the first few times you try this, but it does become less painful with regular practice. It is important to note that ITB Syndrome (pain on the outside of the knee) is rarely helped by foam rolling. It is usually symptomatic of a muscle strength imbalance, running technique flaws, and training errors. If you have been suffering from ITB Syndrome or other injuries please contact the intraining running injury clinic for an appointment.
 Hall, M., & Chadwick Smith, J. (2018). THE EFFECTS OF AN ACUTE BOUT OF FOAM ROLLING ON HIP RANGE OF MOTION ON DIFFERENT TISSUES. International journal of sports physical therapy, 13(4), 652–660.
 Cheatham, S. W., Kolber, M. J., Cain, M., & Lee, M. (2015). THE EFFECTS OF SELF-MYOFASCIAL RELEASE USING A FOAM ROLL OR ROLLER MASSAGER ON JOINT RANGE OF MOTION, MUSCLE RECOVERY, AND PERFORMANCE: A SYSTEMATIC REVIEW. International journal of sports physical therapy, 10(6), 827–838.
 Chaudhry, H., Schleip, R., Ji, Z., Bukiet, B., Maney, M., & Findley, T. (2008). THREE-DIMENSIONAL MATHEMATICAL MODEL FOR DEFORMATION OF HUMAN FASCIAE IN MANUAL THERAPY. JAOA. 108(8):379–390.
 Sullivan, K.M., Silvey, D.B., Button, D.C., & Behm, D.G. (2013). ROLLER-MASSAGER APPLICATION TO THE HAMSTRINGS INCREASES SIT-AND-REACH RANGE OF MOTION WITHIN FIVE TO TEN SECONDS WITHOUT PERFORMANCE IMPAIRMENTS. International journal of sports physical therapy, (8)3, 228-36.
 Hughes, G.A., & Ramer, L.M. (2019). DURATION OF MYOFASCIAL ROLLING FOR OPTIMAL RECOVERY, RANGE OF MOTION AND PERFORMANCE: A SYSTEMATIC REVIEW OF THE LITERATURE. International journal of sports physical therapy, 14(6), 845-859.