Muscle Monday: Tensor Fasciae Latae or TFL
What is the TFL?
The Tensor Fasciae Latae is a muscle in your hip (not a specialty drink at Starbucks) and is most well-known for its long fascial attachment (the IT Band) that runs down the side of your thigh and is notorious for causing hip pain or knee pain in runners.
The Tensor Fasciae Latae is an overlooked muscle that is actually considered to be a part of the gluteal (butt) group, even though it’s oriented closer to the front of your body. It’s job is mainly to help lift your leg out to the side but because it’s so small compared to the leg it has to move, it’s considered a synergist that works with other muscles to make movements happen.
The TFL attaches at the pelvis and then fades into its lower attachment: the famous IT band. The IT band then connects to the outside part of your tibia bone just below your knee. Pain from running or even just existing in daily life can be for many reasons, but issues with the TFL should not go without consideration!
The TFL helps to stabilize the pelvis and knee when walking or running as the opposite leg lifts to step forward. Injuries and poor body mechanics can throw off the delicate balance of all the muscles around the hip that support your pelvis and control how your knee is oriented, so knowing more about all the little muscles that can easily get ignored during your workouts can be the difference-maker in exercising pain-free and increasing your athletic performance just enough to get you that progress you’ve been struggling to find.
What type of person do we typically see having problems with this muscle?
The TFL/IT Band tends to be a runner’s nemesis. The reason for this is because the TFL and IT Band help with stabilizing the pelvis and the outside of the knee, and in sports with repetitive activities (think: running or cycling), if there is an imbalance of these key muscles, things will not function as they are supposed to and pain will develop. Some runners experience tightness along their IT Band which can lead to pressure and pain at the outside of the hip and/or the outside of the knee. Many runners quickly become frustrated with this condition because they believe their IT Band is “tight” so they begin a ton of stretching and foam rolling only to find that nothing is helping!
What a lot of athletes fail to realize is that often times a “tight” IT Band is not the true cause of the problem, but rather the result of some other problem. For instance, the IT Band can have excess strain being placed on it because other muscles around the hip may be weak and therefore lead to overcompensation of the TFL or even place an exaggerated stretch/strain to the IT Band while running. One example of this is a weak gluteus medius and maximus. Weakness in these muscles can lead to an over-stretch/strain of the TFL and IT Band, and all the foam rolling in the world will never actually fix it. Another example is having weak hip flexors (like the iliopsoas), which can cause the TFL to work harder to compensate and consequently get strained, causing pain in areas such as the low back, IT band, knee, or gluteal region.
How will you know the best way to fix your IT Band issue?
To identify the true cause of your IT Band issue, you really need a full assessment of all of the muscles of your lower extremity and trunk and someone to analyze your movement patterns. At Nashville Physical Therapy we have specialists who can perform a Total Body Wellness Assessment and/or Running Analysis in which we can identify any weak muscles, tight muscles, joint restrictions and movement pattern issues and then provide the specific exercises needed to address the true cause of your pain. For more information on running analysis and IT Band issues, check out one of our other blog posts: https://www.nashvillephysicaltherapy.com/post/it-band-issues-in-runners-an-often-chronic-issue
Here are some other facts about the TFL:
· The TFL takes part in lifting your leg to the side (like side-lying leg lifts), along with the gluteus medius. It is important to understand how to isolate different muscles and know that you are truly working the one that needs to be worked. Working the wrong muscle group may not solve your problem and might even make your condition worse!
· The TFL helps to also stabilize a straight knee when standing and assists in internally rotating your leg (rotating your whole leg to point your toes towards the center of your body). If your gluteus medius and maximus are weak and your TFL takes over, it can lead to excessive internal rotation and result in knee pain.
· Using a foam roller on your IT band can be helpful to some, but can also get you nowhere if the cause of your IT Band issues are due to a strength issue and not a length issue.
· The TFL is innervated by the superior gluteal nerve at the spinal level of L5-S1 (the same nerve that supplies the gluteus medius and gluteus minimus). Spinal issues in the L5-S1 region can lead to weakness of these muscles.
If you feel you've been having trouble with your TFL or IT Band and want an expert to take a look, we'd love to help you! You can reach us by call/text 615-428-9213 or email firstname.lastname@example.org to set up an appointment with a PT today! You can also book online here https://pteverywhere.com/PtE/nashville/bookingonline
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