The iliotibial (IT) band is a thickening of the fibrous tissue that surrounds the muscles in the thigh. It runs from the hip down to the outer part of the knee. The IT band attaches to the TFL muscle at the hip which acts to tense the IT band.
Tightening of the TFL/IT band can be treated fairly easily with different muscle techniques, fascia release techniques, adjustments, kinesiotaping, etc., but to truly address the cause, hip stability needs to be addressed. There is a reason the TFL muscle/IT band is tight and it is usually because it is compensating for another muscle that isn’t doing its job. In this case, it is the gluteus medius.
There are two fairly broad categories of muscles, movers and stabilizers.
The TFL muscle/IT band is meant to be a mover and the gluteus medius (GMed) is meant to be a stabilizer of the hip. When the GMed is not functioning properly, the TFL muscle/IT band will take over. The problem is, the TFL muscle/IT band is not meant to be a stabilizer and that is why it ends up causing issues down the road. When it is tighter than normal because it is trying to stabilize the hip, it can cause multiple issues. The tightness can lead to pain on the outside of the knee, hip pain, hip bursitis, and/or pain on the outside of the thigh.
So now, what do we do about it? We could easily release the IT band with any muscular/fascia release technique (ART, Graston, etc.) and provide fairly immediate relief. But, until that GMed is retrained to do its job, the TFL muscle/IT band will continue to tighten up fairly quickly after treatment and the pain will return. The GMed needs to be retrained in a stabilizing function, not as a mover. Once that GMed starts to take over, the TFL muscle/IT band will start to relax on its own because it doesn’t have to do the stabilizing job anymore. In my opinion, the best
combination is to do those muscular/fascia release techniques and combine it with stabilizing exercises so you can address both issues at once. It allows for quicker recovery and ideally fixing the true problem instead of just giving temporary relief.