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'Stripping' the ITB


DC SM
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Morning all,

I have recently had a number of clients refer to past treatments (with other Therapists of various titles) that had the dreaded "stripping" of the Iliotibial band. I'm wondering what everyones opinions on this technique are?

I have to admit that its something that I am not a huge fan of, and not something that I consider even if I am working around that area. I have found (and stand to be corrected) that localised work in specific areas (TP's, MFR), and STR around the ITB and the VL are much more beneficial, alongside glute work - IMHO of course. The reports I have had - and from being on the recieving end recently of said technique, it seems to me to be extremely painful (in my case for a number of days post treatment) and doesnt carry a long term effect.....so.....

I'm very open to changing my mind on the technique - so shoot!

Cheers all

D

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sportstherapy
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Stripping and stretching ITB are both useless IMO. I usually give it a good warm up with some vigorous effleurage, then get to work on MFR and soft tissue mobilisations to free up any restrictions that it will more than likely have. Of course, without working TFL it's pretty pointless.

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biggazfromlincoln
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we were trialling a new technique on wednesday and will post something on STO website or youtube, it goes against what has been taught for years but were conducting some clinic trials to see how effective the new treatment modality is, we will report thereafter but agree trying to stretch ITB is pointless and as ST says concentrating on TFL is the key IMO
BGFL

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stephen jeffrey
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There are huge benifits to working the ITB and its main attachments with TFL gluet max, and at the Tibia. Stripping should help remove adhesions between ITB and VL. (this is probably what is happening with foam rolling)
It takes time to prepare the tissue, the pressure applied should be comfortable, and the strip should be performed SLOOOOOOWLY !

I have had great success with chronic SIJ disfunction/inflamation by focusing on adhesions around the greater tronchanter.within the ITB..

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biggazfromlincoln
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There are huge benifits to working the ITB and its main attachments with TFL gluet max, and at the Tibia. Stripping should help remove adhesions between ITB and VL. (this is probably what is happening with foam rolling)
It takes time to prepare the tissue, the pressure applied should be comfortable, and the strip should be performed SLOOOOOOWLY !

I have had great success with chronic SIJ disfunction/inflamation by focusing on adhesions around the greater tronchanter.within the ITB..

the technique we are looking at seperates ITB and VL, but instead of compressing it, it seperates it by decompressing, , i question the benefit of foam rollering, fascia needs heat to become more pliant, unless your foam roller is warm, it wont have the same benefit, but i do understand it may have some trigger point benefit

BGFL

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sportstherapy
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There are huge benifits to working the ITB and its main attachments with TFL gluet max, and at the Tibia. Stripping should help remove adhesions between ITB and VL. (this is probably what is happening with foam rolling)
It takes time to prepare the tissue, the pressure applied should be comfortable, and the strip should be performed SLOOOOOOWLY !

I have had great success with chronic SIJ disfunction/inflamation by focusing on adhesions around the greater tronchanter.within the ITB..

But are you exactly stripping ITB?

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stephen jeffrey
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But are you exactly stripping ITB?

Exactly no, mostly yes.

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stephen jeffrey
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the technique we are looking at seperates ITB and VL, but instead of compressing it, it seperates it by decompressing, , i question the benefit of foam rollering, fascia needs heat to become more pliant, unless your foam roller is warm, it wont have the same benefit, but i do understand it may have some trigger point benefit

BGFL

Interesting, are you warming the tissue before decompressing, in isolation to any other technique.

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sportstherapy
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Exactly no, mostly yes.

Each to their own, stripping fascia is painful and I can't see the reasoning behind it, stripping muscle yes but fascia and connective tissue no.

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stephen jeffrey
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Each to their own, stripping fascia is painful and I can't see the reasoning behind it, stripping muscle yes but fascia and connective tissue no.

Totally agree, stripping the area known as ITB can be incredably painful when performed cold/too fast/inexperienced therapist/more pain =gain/etc,etc. I have already highlighted my method and reason for doing it.

"Stripping muscle yes, fascia and connective tissue no" 😮 they are as one, but I think I understand you.?

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sportstherapy
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Totally agree, stripping the area known as ITB can be incredably painful when performed cold/too fast/inexperienced therapist/more pain =gain/etc,etc. I have already highlighted my method and reason for doing it.

"Stripping muscle yes, fascia and connective tissue no" 😮 they are as one, but I think I understand you.?

I think written down and terminology used, it looks different, but in reality we probably do something similar.

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DFNU
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Stripping and stretching ITB are both useless IMO. I usually give it a good warm up with some vigorous effleurage, then get to work on MFR and soft tissue mobilisations to free up any restrictions that it will more than likely have. Of course, without working TFL it's pretty pointless.

Afterall how can you stretch something which is inelastic?

IMHO the primary aim of "stripping" (and tp) the itb is to release the fascia from vl and biceps fem (much akin to trying to release a zipper which has become stuck)
If tensor fascia latae (clue is in the name) remains active and the itb/fascia adheres to the underlying muscles they remain compressed in a bag (like a compression splint), not ideal when you try to walk or run :o)

An Obers test will show you very clearly if you have been effective too

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nicperrem
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I did a recent course which the tutor was teaching some of Luigi Stecco's techniques. This focused on mobilising / releasing the adhesions between the ITB and surrounding tissues whilst getting the client to actively move into knee flexion / extension if symptoms are distal or rock the pelvis into anterior or posterior tilt if the symptoms are proximal. I find this works quite well. Like most I was probably taught to strip the ITB in basic sports massage terms but by the nature of the treatment you cause the client pain which is just adverse to what you are trying to achieve! In my mind pain nearly always triggers some kind of guarding or spasm to go back on within the local soft tissue!
Most times where there is an issue in the ITB i think you have to look globally i.e is there a medial knee collapse, is there a loss of foot arch etc...
Has anyone completed the rocktape FMT courses? I would be interested to hear if anyone has used the spiral line tape to help correct this?

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biggazfromlincoln
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I did a recent course which the tutor was teaching some of Luigi Stecco's techniques. This focused on mobilising / releasing the adhesions between the ITB and surrounding tissues whilst getting the client to actively move into knee flexion / extension if symptoms are distal or rock the pelvis into anterior or posterior tilt if the symptoms are proximal. I find this works quite well. Like most I was probably taught to strip the ITB in basic sports massage terms but by the nature of the treatment you cause the client pain which is just adverse to what you are trying to achieve! In my mind pain nearly always triggers some kind of guarding or spasm to go back on within the local soft tissue!
Most times where there is an issue in the ITB i think you have to look globally i.e is there a medial knee collapse, is there a loss of foot arch etc...
Has anyone completed the rocktape FMT courses? I would be interested to hear if anyone has used the spiral line tape to help correct this?

Hi Nic,
yes Ive done rocktape course, better than the other course provider by far, and yes I use the spiral line app for both externally rotated hip and medially rotated shoulder, works really well, alos stops foot arch collapsing if done properly
regards
BGFL

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nicperrem
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hey thanks for the reply Gaz

I had been trying to work out a similar method myself then saw it in action with the Rocktape training and got a little excited (Geek i know!)

It showing quite good early results for me

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Mtbw
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Stripping and stretching ITB are both useless IMO. I usually give it a good warm up with some vigorous effleurage, then get to work on MFR and soft tissue mobilisations to free up any restrictions that it will more than likely have. Of course, without working TFL it's pretty pointless.

Absolutely agree.
Such a common condition but some therapists ‘cheating’ clients this way.... ((

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