Comparison of the Immediate Effect of Active Stretching Techniques and Self-myofascial Release on the Flexibility of the Iliotibial Band and Functional Activities in Semi-Elite Athletes: A Randomized Clinical Trial

Abstract

Background: The iliotibial band (ITB) is prone to shortening in sports activities. Correcting the lack of flexibility can be a factor in improving the overall biomechanics of the body and preventing future injuries. Methods: A total of 51 semi-elite athletes (age range: 20 - 40 years) with ITB shortness confirmed by the modified Ober’s test participated in this study. The participants were randomly divided into three groups, including foam roller, proprioceptive neuromuscular facilitation (PNF) active stretching, and a combination of foam roller and PNF stretching. Results: The mean of the active hip adduction range of motion (ROM), single-leg hop test, lateral hop test, and vertical jump in all three groups increased significantly after the intervention compared to before (P < 0.05). All three studied groups had similar changes over time, and no group was superior to the others. Conclusions: Using a foam roller, PNF active stretching technique, and a combination of both can improve hip ROM in patients with ITB shortness. As a result, the functional activities of athletes, including vertical jump, lateral hop, and single-leg hop, can be improved. Flexibility and ROM increased significantly in all three treatment groups. There is no priority between different interventions.

Stretching and Releasing of Iliotibial Band Complex in Patients with Iliotibial Band Syndrome: A Narrative Review

“…They found an increase in passive hip adduction RoM after the intervention; however, this change was small (0.8°) and also occurred in the control group, which could be due to measurement error and is probably not clinically relevant [ 27 ]. On the other hand, a study by Afshari et al [ 29 ] measured active hip adduction RoM in semi-elite athletes with ITB shortness (confirmed with modified Ober’s test), with similar improvements observed over time immediately following ITB foam rolling, active PNF stretching, and the combination of both treatments. In a study conducted on healthy rugby players by Sharp [ 36 ], no significant improvements in active hip adduction (RoM) were observed after foam rolling.…”

“…For the treatment of ITB tissue, the roller should be moved from the greater trochanter to the lateral knee joint line [ 32 , 36 , 37 ]. Foam rolling study interventions for ITBS or ITB shortness management usually involve rolling over the ITB tissue only [ 29 , 32 , 38 ]. However, Park et al [ 39 ] created a program of independent myofascial release using a foam roller for adult male cyclists with ITBS, treating the following tissues: Triceps surae, Tibialis anterior, Quadriceps femoris, Tensor fasciae latae, and Gluteus maximus.…”

“…While in some studies [ 27 ] participants performed a more dynamic foam rolling, moving the body back and forth over the roller, in other studies [ 36 , 38 ] participants had to find the painful area or abnormally tender point and hold a static position for a period of time. Most studies that examined the effects of ITB–TFL complex release used the duration of a foam rolling session of one to five min [ 27 , 29 , 32 , 36 , 37 ], with the exception of Park et al [ 39 ], whose foam rolling session lasted 20 min. A longer duration of their intervention is to be expected, since they treated five different muscles in one session.…”

“…The additional external rotation of the hip may contribute to greater stretch, as it has been found that the stiffness of the ITB also increases with this motion [28]. Stretching the ITB-TFL complex in side-lying position has also been used in intervention studies [29,30]. Afshari et al [29] studied the effects of the PNF (contractionrelaxation) stretching technique with the subject lying on his or her side, so that the side to be treated was facing upward and the knees were bent to 90 degrees.…”

“…On the other hand, studies conducted on an asymptomatic population have inconsistent findings. While Sharp [ 36 ] observed no significant effect of foam rolling and the Emmett technique on vertical jump height during countermovement jumping, Afshari et al [ 29 ] found a significant increase in the mean of single-leg hop test, lateral hop test and vertical jump after foam rolling, PNF active stretching technique and the combination of both interventions. Furthermore, they emphasized that all of the interventions studied showed similar changes over time, and no one group was superior to the others.…”