Table 1.

Overview of included studies investigating effects of stretching and other release methods as treatment approach for ITBS.

Author (Year)	Population	Purpose	Intervention	Findings
Pepper et al., 2021 [27]	Healthy adults (18–50 years) with no ITBS history	To compare the immediate effects of stretching and foam rolling on ITB stiffness.	Stretching: Three bouts of a 7 s submaximal contraction in hip abduction followed by a 15 s stretch. FR: Five 3 min repetitions	No effects of either intervention on ITB stiffness, despite increases in hip RoM.
McKay et al., 2020 [24]	Female distance runners (19–45 years) with unilateral ITBS for at least 3 months	To assess the effectiveness of three different exercise regimens (stretching, conventional hip rehabilitation, and experimental exercises, which involve progressive increase in complexity) in female runners with ITBS.	Stretching (progressive stretching program included four ITB stretches that were held for 30–40 s and repeated 2–4 times, three times per week). Group B: Conventional exercise (focusing on hip muscles) Experimental hip strengthening exercise. The intervention lasted for eight weeks.	There were no statistical differences between the three groups. Nonsignificant improvement in pain was observed after stretching intervention. ITB stretching was reported to improve Y-balance test performance and movement quality in the single-leg mini-squat.
Afshari et al., 2023 [29]	Semi-elite athletes (20–40 years) with ITB shortness confirmed by the modified Ober’s test	To investigate the effect of active stretching techniques and self-myofascial release on improving the ITB flexibility and functional performance of athletes.	FR: foam rolling took about 3 min. PNF active stretching: contraction–relaxation technique for 3–5 min. Combination of FR/PNF	The mean of the active hip adduction RoM, single-leg hop test, lateral hop test, and vertical jump in all three groups increased significantly after the intervention compared to before. All three studied groups had similar changes over time, and no group was superior to the others.
Kasunich, 2003 [30]	Case report: long-distance runner (38 years) with low-back pain and sacroiliac pain and proposes ITB tightness as a possible causative factor	To investigate the effects of a multimodal therapy based on stretching and release methods on a single patient.	Chiropractic manipulative therapy, trigger point therapy and stretching of the ITB (once per day during first two weeks and twice per day during second two weeks, in side-lying position). The intervention lasted for 4 weeks.	The patient did not demonstrate much improvement until extensive stretching was included in the treatment plan. It is important to consider ITB tightness as a possible cause of low back and sacroiliac pain.
Friede et al., 2020 [32]	Recreational runners with ITBS and healthy controls (18–45 years)	To test ITB stiffness and isometric hip muscle strength in a sample of subjects clinically diagnosed with ITBS for comparison with a healthy control group, and to assess the effectiveness of a multimodal training program in strengthening the hip abductor and external rotator muscles and modulating ITB tone.	The intervention lasted for 6 weeks and consisted of: myofascial techniques addressing trigger points, strengthening exercises (for gluteal muscles and hip external rotators), stretching (twice a day, two sets of 60 s duration, 30 s inter-set break), foam rolling (three times for 60 s, 30 s break between sets). Intervention also consisted of measures aiming to improve neuromuscular control and lower extremity alignment during gait and running.	ITB tension is not increased in the affected legs of runners with ITBS compared to the healthy leg or a physical active control group, respectively. Following six weeks of physiotherapy, hip muscle strength (all directions but abduction), pain and lower extremity function were significantly improved. ITB stiffness was found to be increased compared to baseline measurements.
Sharp et al., 2012 [36]	Asymptomatic male non-professional rugby players (19–30 years)	To compare the relative effectiveness of two myofascial release techniques for the ITB: self-myofascial release (foam rolling), and Emmett technique.	Emmet technique used on the “ITB site” and the “sartorius and ITB site” (lasted for 5 min). FR: focused on TFL and ITB area, left and right side were treated (there was a maximum time of 60–90 s allocated for each region). Control: no intervention.	No significant improvements in active hip adduction RoM were observed after foam rolling. Emmet technique appeared to be more effective in hip RoM increase (2% increase in hip RoM after FR, 70% increase after Emmet technique). No significant effect of FR and Emmett technique on vertical jump height during countermovement jump was observed.
Park et al., 2022 [39]	Men cycling club members (20–45 years) with ITBS	To investigate the effect of one-time self-myofascial release using a foam roller via special tests, visual analog scale (VAS), and exercise performance on adult male cycling club members diagnosed with ITBS.	After the first 10 km cycling course, the control group had a static rest for 120 min. The FR group conducted the intervention using a foam roller for 20 min after a static rest of 100 min, and then both groups underwent a post-cycling special test after the second cycling on the same course.	Significant differences were observed in the FR group in VAS through Nobel’s compression test, ITB flexibility through Ober’s test, and VAS and power while cycling. No significant difference was observed in HR, cadence, and record time.
Pedowitz, 2005 [40]	Case report: 30-year-old distance runner with ITBS	To investigate the potential of osteopathic manipulative technique (OMT) called counterstrain on a single-case basis.	The intervention lasted for 2 weeks with OMT applied every 2 to 3 days.	One week after intervention the patient reported that he had been feeling well and had returned to his normal, full running activity by day. He also stated that he had been free of pain and feeling happier overall. His ability to perform the regular activities of daily life had improved.
Else and Moodley, 2010 [38]	Active runners or cyclists with ITBS and active or latent trigger points in the ITB (18–60 years)	To determine whether foam roller treatment of the ITB can be used as an effective treatment for ITBS in cyclists and runners and whether it is better to be used alone or in conjunction with spinal manipulation.	Intervention lasted for 3 weeks (6 treatment consultations). Group one: combination of both treatments. Group two: foam rolling (they held their weight over the foam roller on painful area for minimum of 120 s). Group three: lumbar spinal manipulation to the restricted segments.	Combination group showed the best improvement consistently across all forms of measurement. Group three had the smallest increase in overall improvement subjectively and objectively. All three treatment protocols were equally effective in treating ITBS as demonstrated by the statistically significant results.
Vaughan et al., 2014 [37]	Student asymptomatic population (both genders, mean age of 26.1 ± 6.7 years)	To investigate the effects of the application of a foam roller for three minutes to the right iliotibial band (ITB) of asymptomatic participants.	A three-minute session on the foam roller.	Results demonstrate a statistically significant increase in the pain pressure threshold at the lower thighimmediately post-bout; however, the difference was ameliorated five minutes later.
Mayer et al., 2020 [65]	Experienced (regarding FR) and nonexperienced athletes (healthy; both genders; 18–65 years)	To investigate muscle-specific and connective tissue-specific responses after FR in recreational athletes with different foam rolling experience.	FR: 5 trials per 45 s of foam rolling with 20 s of rest between each trial.	In experienced athletes, tissue stiffness of the ITB revealed a significant decrease of 13.2% at post-intervention (t1 = after 0 min) and 12.1% 6 h after intervention (=t3). In nonexperienced athletes, a 6.2% increase in stiffness was found at t1, which was not significantly different to baseline. For both groups, no significant ITB stiffness changes were found at further time points (30 min, 6 h or 24 h after intervention).