If Your Iliotibial Band Is Non-existent, How Can There Be A Treatment Plan That Works?

If there’s no iliotibial band, how can there be a valid treatment plan that works with any level of consistency?


The way in which your iliotibial band (IT band) is shown in an anatomy book doesn’t even come close to what you’re relying on to move through the world.

And in more ways than one, that is worth knowing! 

If you’re not a clinician, you’re more than likely not thinking about heading over to your local cadaver lab to dive into dissecting all that can be found right underneath your skin.

Having dissected a few cadavers, I can tell you that you never know what you’re going to find.

To give you an idea of what I’m referring to here, there are certain muscles that are absent in a percentage of people.

There are also anomalies that certain bodies present with.

Anomalies that will have a significant impact on how you move.

Since you’re putting in the work to leave iliotibial band syndrome (ITBS) in your rear-view mirror, I’m thinking that you would like to be as productive as you possibly can during that time.  

If that is the case, you’ll want to start by going beyond what first-layer knowledge has to offer.  (answers coming.)

In fact, even though iliotibial band syndrome has been said to be the most common of all the running related injuries, it’s by far the easiest to work with.

If you hover over the image below, you’ll see the location of what is referred to as your iliotibial band.  The way that it’s represented in an anatomy book.


<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/06/Where-the-gluteus-maximus-attaches-to-the-iliotibial-band.jpg" alt="A posterior view of where the gluteus maximus muscle attaches to the iliotibial band" width="332" Height="379" /></figure>

For more information, hover over this image.

If you were to work your way through the various layers of skin and adipose tissue (read: fat) that contribute to the overall girth of your thigh, you would see a broad white sheath of radiant tissue that is called fascia.


In order to uncover how much surface area this relatively thin layer of tissue covers, you could use your hands to feel your way around until you’re left with nowhere else to go.

Just in case you’re aren’t sure where you left off, you just followed that white layer of tissue all the way around the entire thigh.

Therefore, the tissue that you just followed encases all of the muscles that run the length of your thigh. Some of which cross over your knee, and from various angles attach to your leg.

Rather than your iliotibial band being completely separate, and running from the outside of your pelvis and thigh to your leg, your iliotibial band is actually housed in the same tissue that you just felt with your own two bare hands.

Once separated from the fascia that it’s housed in, you could slide your hand onto the inside of that tissue (that’s shown in the image above), and you would feel how thick and strong that tissue really is.  

To give you an idea of the strength we’re talking about here, it has been said that fascia is as strong as steel.

Having seen and felt the iliotibial band when I dissected a cadaver, I have to agree that it is extremely strong!

Suffice it to say, it’s highly unlikely that it’s going to respond to stretching or foam rolling.

And from what I’ve seen, the muscle that is deep to what we refer to as the iliotibial band is not loving getting caught up in all of the chaos that goes right along with “ironing out the wrinkles” with a foam roller.  

To that quadricep muscle, foam rolling is a negative input.


At this point, I’m thinking that your eyes have been opened up to what your iliotibial band isn’t.  And are therefore questioning what you’ve been told about how to best deal what an expert has determined to be iliotibial band syndrome.

Or maybe they labeled your condition, “iliotibial band friction syndrome”.  

Which is also a myth!

For well over a decade now, I have followed the iliotibial band to the point at which it attaches to the femur.  And once I’m on it, I apply a friction massage stroke to that area of the iliotibial band.


<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/07/Showing-palpation-of-the-IT-band.jpg" alt="Palpating the point at which the IT band attaches to the femur" width="500" Height="281" /></figure>

For more information, hover over this image.


From there, I follow the iliotibial band right onto the leg.  Then I compress the same band of tissue against the bone and apply the same massage stroke there. (For more information, hover over the image above.)  

Since your iliotibial band has a direct attachment just above where you bend your leg at the knee, I can tell you that repetitive motion is not causing friction (e.g., running).

You have two muscles up at your hip that travel from your pelvis and sacrum to eventually attach to your iliotibial band.  

Which speaks to the need to avoid chasing the pain!  

You have 22 muscles that attach to your femur alone, and 3 times as many that attach to your pelvis.  And every single one of those muscles is just as important as the next.

Rather than ignore those muscles as a way to save time, the experts should be embracing them for their importance.

Because in order for there to be efficient motion throughout your chain, every single muscle has to be capable of playing its own unique role. 

The faster the muscle can pull, the better your function will be.  

Since your muscular system is your first line of defense against an injury, a faster contraction is optimal!  

Every muscle has to be capable of stabilizing all of the motion that is available to you.   

If you really want to clear the pain that your iliotibial band is bringing on every step, it makes a lot more sense to think globally. 

If for no other reason than the pain that you’re feeling is the symptom.  And it takes a lot longer to address the symptom than it does to get to the source.

<figure><img src="https://www.engagingmuscles.com/wp-content/uploads/2016/07/Foam-rolling-for-ITBS.jpg" alt="Foam rolling for ITBS" width="500" Height="375" /></figure>

Photo Credit: LA Sports Massage via Compfight cc

According to conventional wisdom, the tight muscle is bad.  And because the tight muscle has been perceived as being so bad for so long, the code within the culture is for a muscle to be released.   

Or for a “knot” to be undone.  Or for your iliotibial band to be stretched out.

All of which, are nothing more than stories (read: marketing).  

As Seth Godin wrote in his book, ALL MARKETERS ARE LIARS Tell Stories (affiliate), Worldviews are the reason that two intelligent people can look at the same data and walk away with completely different conclusions–it’s not that they didn’t have access to the data or that they have poor reasoning skills, it’s simply that they had already put themselves into a particular worldview before you even asked the question.  Marketing succeeds when enough people with similar worldviews come together…

Since you’re most likely asking the question, “Why does my iliotibial band feel so tight?” 

Your question fits right into the worldview of many experts.  And their tribes.   🙂  🙂   🙂  🙂 

Before you got to a place where you started to believe that tight muscles are bad, the cultural code within the various tribes had already been to view muscle tightness as something that needed releasing.  

No questions asked!  

For a few dollars more, the local massage franchise is right there to provide you with an answer (read: story) as to why your iliotibial band is tight.

Since they see themselves as a business that can offer a “deep” tissue massage for a few dollars more, they’ll continue to have their licensed massage therapists push beyond what both of your muscles are capable tolerating.  

And within a few hours, your iliotibial band will tighten up all over again.  

Can you see the vicious cycle here?   

 ➡ More pressure doesn’t automatically indicate that deeper is better.   

Whether the licensed massage therapist that’s leaning all of their weight into your tight muscles knows it or not, for that very reason, massage therapy continues to be marketed poorly.  

It’s also important to consider that your iliotibial band is that tight for a very good reason: to protect you from further injury.


When it comes to what it’s going to take to improve your ability to perform at a level that you’ve become accustomed to, and at the same time clear the pain that you’re feeling on the outside of your knee; it’s important to consider that there are positive inputs, and there are also inputs that your muscles perceive as being negative.

An example of a negative input that you can probably relate to is when you rolled out your iliotibial band with a foam roller for the first time. 

It was painful.  And even though it got to be less and less painful each time, if you didn’t do it on a continuous basis, it would tighten up again. 

Every step of the way, those tight muscles are there for you.

And that’s why you’ll feel your iliotibial band tighten up while you’re sitting for prolonged periods of time.

It’s also the reason why you feel your iliotibial band tighten up on the same mile of every run.


To give you a sense of what you’re actually dealing with, among all of the other types of tissues that are underneath there, you have muscles that are capable of providing a pulling force at joints that allow for movement in multiple directions.

Joints that rely on muscles to pull at the right time to prevent injuries.  


Although you might not be consciously aware of all of the things that have to take place in order for you to move in all of the different ways that are available to you, I think it’s worth mentioning that you have muscles that are capable of decelerating, stabilizing, and accelerating various motions simultaneously.

Going back to my last post on “custom” orthotics, the experts that want to sell you those pebbles for your shoes aren’t considering that there are muscles throughout your trunk, pelvic bones, thighs, legs, and feet.

Muscles that are capable of decelerating, stabilizing and then accelerating all of those joints throughout your foot.

By blocking motion of your foot, those custom orthotics are driving abnormal motion that is forced.  By forcing motion in the wrong direction, those 33 joints that are supposed to be capable of moving in three different directions at the same time have no other choice but to move less.

And at the wrong time!

At this point, you’re probably wondering how supporting your feet can negatively impact your iliotibial band, plantar fascia, knee, lower back, and anything else that is required to move you through space: your ability to absorb shock and dissipate the forces that gravity and the ground are capable of bringing on every step comes down to timing.

Therefore, every bone in your foot has the potential to move at the right time, in the right direction, and at the right joint.

When there is no artificial support or a false sense of strength in the form of custom orthotics, who are you going to rely on for all of that motion?

Answer: You can rely on your muscles and the control center (read: brain) that they’re all connected to via circuits.  

Whether we’re talking about iliotibial band syndrome or plantar fasciitis, or even anything in between, you should be able to rely on your muscular system to prevent you from losing to the unstoppable pull of gravity.

And you should hold yourself to that standard of preparedness! 

Because even though your muscles are being ignored by the expert – doesn’t make their role any less important. 

“I thought, ‘this is weird – I hope no one sees me.’  But the sensory input was tremendous. It’s like I had been wearing earmuffs, then I took them off and realized I was hearing a symphony.” – Barefoot Bruce


Rather than your foot adapting to the ground like it was originally meant to, instead, it’s being forced to adapt to those pebbles in your shoes.


This adaptation response was brought on by a negative input in the form of custom orthotics.

A negative input that put the muscles that are bigger and stronger at a serious disadvantage.  Which means your muscles are going to be less efficient at performing their unique roles within the chain.

Said another way, all of that pure potential energy that can be stored in muscles through movement in all three directions is lost.  And because of that, there is much more of a workload placed on muscles throughout your chain.

In order to cover the same amount of ground, you’re most likely working much harder than you want to be.

[ Sidebar: Since your body is so good at adapting, it’s not uncommon to cover the same amount of ground, and not feel any pain.  It’s when your body can no longer adapt that you have pain.]

To find the root cause as to why your iliotibial band, plantar fasciitis or anything else is suddenly bringing a sensation that we experience as pain, it’s imperative that there is a better flow of communication between your brain and the muscles that the circuits connect to.


Rather than follow a fixed pattern or cookie-cutter approach as to why you have pain on the outside of your knee, the experts could be spending their time addressing the muscles that are under-performing.

Muscles that are under-performing for you.

Which aren’t the same muscles that were under-performing for the 10 people that walked in with a painful iliotibial band before you!

“In a profound way the circuit is the movement: it dictates the precise strength and timing of each muscle contraction, the shape and content of each thought.  A sluggish, unreliable circuit means a sluggish, unreliable movement; on the other hand, a fast, synchronous circuit means a fast, synchronous movement.”


– Daniel Coyle, Author of the Talent Code


It’s as if the expert doesn’t want to acknowledge that they’re working with a series of beautiful self-organizing systems that are capable of adapting.  

And because these self-organizing systems are so great at finding the best way to adapt, is all the more reason that they’re in need of a different input.

An input that’s capable of having an immediate impact on your ability to function in a way that has become less and less familiar to you.

Not just any input, but rather, a positive one! 🙂 



If you found this post on iliotibial band syndrome to be educational, and you feel like somebody that you know could benefit from the information that I have provided here, I would greatly appreciate you sharing this post. You can do this by emailing it to a friend, family member, colleague or feel free to share it on Facebook. 

A BIG thanks in advance.  🙂

Thanks for taking the time to read this post!  If you enjoyed this post, please subscribe to Engaging Muscles.  You can also like Engaging Muscles on Facebook, subscribe to my YouTube Channel or feel free to connect with me on Twitter @rickmerriam.

Affiliate links for the books that were mentioned in this post:

All Marketers Are Liars Tell Stories by Seth Godin

Tribes by Seth Godin

The Talent Code by Daniel Coyle

Photo Credit: LA Sports Massage via Compfight cc

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I have held a license to practice massage therapy for over 20 years. For the first 18 years of my career, I was a nationally certified personal trainer. During that time, I completed thousands of one-on-one personal training sessions. I went on to teach biomechanics to personal trainers, group exercise instructors, and physical therapists throughout New England. I worked as a sports massage therapist at ESPN. Over the last few years, I have been quoted in Runner’s World UK, Massage Therapy & Bodywork, Massage Magazine, IDEA Fitness Journal, Massage & Fitness Magazine, and The Guardian Liberty Voice. I have also served as an applied biomechanics consultant for the fitness staff at Canyon Ranch, The Greenbrier, and ESPN. For the last 8 years, I've been teaching applied anatomy & kinesiology at Parker University. I have a private sports massage therapy practice in Dallas, Texas.