Evaluating treatment efficacy for Iliotibial Band Syndrome: A comparison of combined foam rolling and stretching with strengthening exercises versus strengthening alone in athletes.
Based on the sample examined, integrating foam rolling and stretching with strengthening exercises versus strengthening exercises alone resulted in greater improvements in pain, lower extremity physical function, iliotibial band flexibility, and overall QoL, though larger studies in other populations are needed before definitive conclusions can be reached.
Key Findings
Methods
Twenty athletes with confirmed ITBS were randomized to an Integrated Training Group (foam rolling and stretching plus strengthening) or a Strengthening-Focused Group (strengthening alone), both completing an eight-week program.
Sample: 20 athletes (11 males, 9 females; mean age 33.6 ± 9.5 years), n = 10 per group.
Both groups completed 24 sessions over eight weeks, each lasting 25-30 minutes.
Primary outcome was pain intensity (Visual Analog Scale); secondary outcomes were lower extremity function (LEFS), hip abductor strength, iliotibial band flexibility, and quality of life (SF-36), measured pre- and post-intervention.
Results
The Integrated Training Group showed significantly greater pain improvement than the Strengthening-Focused Group on the primary outcome.
Pain reduction was reported as 79.7% vs. 81.0%, with a between-group difference of p = 0.02.
The abstract reports this as significantly greater improvement for the ITG, though the percentages themselves are numerically similar and the SFG's figure is slightly higher.
Pain was measured with the Visual Analog Scale.
Results
Lower extremity function improved significantly more in the Integrated Training Group.
LEFS improvement was 25.7% in the ITG vs. 21% in the SFG (p = 0.02).
Results
Iliotibial band flexibility improved far more in the Integrated Training Group than in the strengthening-only group.
Flexibility improvement was 59.4% in the ITG vs. 1.7% in the SFG (p = 0.001).
This was the largest between-group difference among the outcomes.
Results
Overall quality of life improved significantly more in the Integrated Training Group.
Overall QoL (SF-36) improved 19.9% in the ITG vs. 12.6% in the SFG (p = 0.006).
Results
There were no significant between-group differences in hip abductor strength or in the physical and psychological components of quality of life.
The abstract reports p > 0.05 for hip abductor strength and for the physical and psychological QoL components.
Conclusions
The authors conclude that adding foam rolling and stretching to strengthening gave greater benefits than strengthening alone in this sample, but caution that larger studies are needed.
Conclusions are limited to the sample examined (n = 20).
Additional studies with larger sample sizes and in other populations are called for before definitive conclusions.
Background notes that ITBS lacks effective conservative treatment protocols, often relying on expert opinion without addressing individual factors.
What This Means
This small study looked at how to treat iliotibial band syndrome (ITBS), a common overuse problem in athletes that causes pain on the outside of the knee or hip. Twenty athletes were split randomly into two groups. Both did eight weeks of strengthening exercises, but one group also did foam rolling and stretching. Researchers measured pain, leg function, hip muscle strength, flexibility of the iliotibial band, and quality of life before and after.
The group that added foam rolling and stretching had statistically greater improvements in pain, lower-limb function, iliotibial band flexibility, and overall quality of life. The flexibility gain was especially large (about 59% vs. about 2%). Pain dropped by roughly 80% in both groups, with very similar percentages, so the practical difference in pain is unclear. Hip muscle strength and the separate physical and psychological quality-of-life scores did not differ significantly between groups.
This research suggests that combining foam rolling and stretching with strengthening may offer added benefits for people with ITBS, particularly for flexibility. However, with only 20 participants, the findings are preliminary. The authors say larger studies and studies in other populations are needed before firm conclusions can be drawn.
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Naderi A, Azizi S. (2026). Evaluating treatment efficacy for Iliotibial Band Syndrome: A comparison of combined foam rolling and stretching with strengthening exercises versus strengthening alone in athletes.. PloS one. https://doi.org/10.1371/journal.pone.0360760