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| Tensor fascia lata (TFL) muscle (Ref: https://learnmuscles.com/glossary/tensor-fasciae-latae-tfl/) |
I have taken care of many patients with ITB syndrome (IT band syndrome) for many years who were soccer players, tennis players, runners, cyclists, triathletes, the most. One of my routine treatments was ITB stretching as Ober’s maneuver that I have felt does not satisfy the outcome.
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| Ober's stretch (Ref: https://www.aafp.org/pubs/afp/issues/2005/0415/p1545.html) |
Then, I changed stretching to be another TFL (Tensor fascia lata) stretching because I found some factors from TFL related to ITB tightness which was demonstrated in exercise #5. However, I still have not felt stretched enough. Moreover, the TFL muscle stretching in standing position is difficult to apply to subjects who have unstable knee joints or have leg pain with the weight bearing.
Exercise #5: Stand TFL stretching: Step target leg backward, then put it behind the fore - leg. Then rotate the hip external rotation as the toe out. Final, shift pelvic forward like over - pressure hip extension.
Finally, I would like to present one normal stretching that may stretch TFL directly. Due to, TFL is one joint muscle that passes only the hip joint; additionally, IT band stretching is not the way to release IT band tension. Therefore, I focus on stretching only the TFL at the hip joint by reversing all its muscle action.
“To perform TFL stretch, the main direction consists of hip extension, hip external rotation and hip adduction.”
4 options to stretch Tensor fascia lata (TFL) muscle
Exercise #1: Single leg stand TFL stretch
Exercise #2: Half kneeling TFL stretch
Exercise #3: Prone TFL stretch
Exercise #4: Supine TFL stretch
Anatomically, TFL muscle is located on the lateral portion of the femur. TFL merged into the IT band, So do gluteus maximus. The fasciae of these two muscles join the iliotibial band just distal to the greater trochanter forming a triangular ‘‘pelvic deltoid”.
TFL originates from the outer lip of the iliac crest, the anterolateral iliac fossa just below the iliac crest, the deep surface of the fascia lata, the iliac tubercle, the lateral aspect of the anterior superior iliac spine and a notch below the anterior superior iliac spine. TFL attaches to two layers of the IT band of the fascia lata and ends usually around the greater trochanter.
The major muscle action of TFL includes three directions that are hip abduction, hip internal rotation, and hip flexion. By mechanical, the gluteus medius and minimus are at a major disadvantage to act as the primary hip abductors, whereas the tensor fasciae latae is at a major advantage to exert the necessary force to counterbalance the force of weight during the full stance phase of the gait cycle. TFL function depends on the position of the hip. It helps the gluteal abductors prevent the Trendelenburg gait and stance so that we can conclude that it is one of the posture muscles. The anterior fibers flex the hip and the posterior fibers abduct and internally rotate the hip.
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| Trendelenburg sign (Ref: https://www.pinterest.com/) |
Mechanism of TFL shortening happened after hip abductor fatigue. The TFL muscle was in spasm, it is pulling hard on ITB and developing pain at the insertion point on the outside of the knee. Shortening of the TFL and ITB can pose problems in the behavior of walking and running. Additionally, they often develop clinical symptoms such as the iliotibial band syndrome or the patellofemoral syndrome.
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| Patellofemoral pain syndrome (Ref: https://www.enzopierromassagetherapy.it/) |
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| IT band syndrome (Ref: https://www.kaizo-health.com/) |
The principle to stretch this muscle is the same as the others: stretch to the point where “tightness with pain” or “noticeable tension without pain” will hold at the point for 30 seconds of 3 - 5 reputations following demonstrated VIDEO.
"However, I would like to recommend strengthening exercise for gluteus maximus and gluteus medius. It is very crucial part of treatment and be able to release IT band tension, afterward".
Reference:
https://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.908.4975&rep=rep1&type=pdf
https://www.ijsr.net/archive/v7i10/ART20191686.pdf
https://www.koreascience.or.kr/article/JAKO202018436566234.pdf
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