Function
The Tensor Fascia Latae (TFL) muscle can be found on the outside of your thigh, commonly known as the Iliotibial Band or IT Band muscle. Its primary role is to maintain ITB tension while aiding hip and knee movement by acting as a weak abductor and medial rotator on hip movement and helping flex legs at knee.
Anatomically, its relationship with the ITB is crucial to its functioning. The iliotibial tract is a dense layer of deep fascia running from iliac bone down to outside of femur; the TFL inserts at Gerdy’s tubercle on anteromedial aspect of proximal femur.
The location of TFL insertion is critical as it determines its function. Anterolateral fibers blend with an ITB component that attaches onto the lateral patella retinaculum. From there, the TFL extends downwards and forwards towards both lateral sides of patella while backwards along tibia for maximum mobility.
At one legged stance, TFL and ITB work in concert to limit the unique bending forces generated by bodyweight and ground reaction force. These bending forces may cause high tensional stress on the femur which requires tensioning through ITB through TFL in order to keep it taut.
Additionally, the TFL acts to flex a leg at the knee joint and assist with external tibial rotation (turning of foot outward). More generally speaking, the TFL helps maintain alignment of body in frontal plane while standing on one leg.
If the TFL is not functioning optimally, it can cause pain in both hip and knee joints, often described as being achy or tender to touch – symptoms which may also resemble lower back discomfort. It may be difficult to differentiate these from each other and should always be treated separately.
Good news is that you can take control of TFL pain and prevent its return in the future. The first step should be identifying what factors contribute to it.
Anatomy
The Tensor Fascia Latae muscle is an important hip muscle that plays an integral part in how we walk, run and stand. Part of the Iliotibial Band (IT band), this muscle works alongside others to allow our legs and feet to move effectively. While most are familiar with IT band, tensor fascia latae is less often talked about or discussed; yet this muscle may play a critical role in hip, knee and lower leg pain and dysfunction.
The TFL begins at the anterior aspect of the iliac crest and runs superficially over the hip until reaching the greater trochanter of the femur, where it inserts. Next it joins up with IT band structures which run along lateral aspects of tibia to the Gerdy tubercle on lateral condyle of femur; furthermore iliotibial tract extends to upper patella (superior patellar retinaculum) on anterolateral tibia as part of anterolateral tract extension.
Due to its multiple insertions and connections, the TFL can often be miscategorized as both an abductor of hips and knee flexor. However, its primary function is actually not directly abducting hips – instead it influences tension levels on IT band, ultimately impacting knee stability.
TFL (the Thigh Flexor Muscle) is a fusiform-shaped muscle and forms the broad lateral portion of the IT band. Surrounded by other deep hip and gluteal muscles such as the adductor magnus and gluteus medius, which all work in concert with TFL to control hip flexion and abduction respectively.
Early studies suggested that the TFL was composed of one muscle with indistinct attachments to both the iliotibial tract and lateral patella, although more recent research indicates otherwise. Recent evidence indicates that an early iliotibial tract may have combined with quadriceps tendon to form fascia lata muscle structure; TFL appears to integrate itself into this deep fascia as it descends. Such complex arrangements of insertions help explain its multiple functions while making it hard for researchers and clinicians to pinpoint specific parts.
Trigger Points
The Tensor Fascia Latae muscle, running from the pelvis to the knee and innervated by the Nevus Gluteus Superior, can develop trigger points due to both active and passive overload. Engaging in activities that involve constant hip flexion, such as prolonged running or sitting on inclined surfaces, can lead to active overload. Similarly, passive overload may occur from walking on inclined surfaces or participating in sports like soccer or rugby. Both scenarios can contribute to trigger point formation in this muscle.
Once a tensor fascia latae trigger point develops, pain may be felt in the front of your hip or around the hip joint and may radiate down into the inner thigh. Over time if left untreated, this may become chronic pain that’s felt constantly or can be triggered by specific movements; this condition is commonly known as myofascial Pain Syndrome (MPS).
Trigger point pain in the tensor fascia latae muscles usually begins with achiness or stiffness in the hip and gradually intensifies over time, eventually becoming constant ache that interferes with walking or running and may tilt forward the pelvis, leading to severe backache. Left untreated, trigger point pain can become chronic aching pain that keeps occurring throughout life causing further disruption. If left untreated it can even tilt forward causing pain in other parts of the body like shoulders.
Acupuncture works to release trigger points in the tensor fascia latae to alleviate pain in the hip, knee and thigh area. Furthermore, this releases mobility within hip mobility which allows your leg to extend further behind your body which may help with running stride length.
At our clinic, we combine manual pressure release and acupuncture twitch response therapy to effectively relieve tensor fascia latae trigger points to alleviate hip, knee and thigh pain. With this therapy method we inserted small needles that stimulate nerves within muscles to produce twitches to break down trigger points and ease associated tension and pain.
Stretches
TFL stretches are essential in maintaining healthy TFL muscles. A tight TFL can lead to imbalances in hips, lower back, and lateral knee areas which lead to pain in these areas and reduce performance at both gym and physical activities outside of it. Therefore, including TFL stretches into your routine – particularly if you engage in frequent running and walking activities – is highly recommended.
The Tensor Fascia Latae muscle can be found at the front and outer part of your thigh, lying just underneath the deep fascia that wraps around the Iliotibial Band (ITB). This band thickens lateral to where TFL rests. Furthermore, TFL runs along lateral condyle of femur supporting extension while working synergistically with other gluteal area muscles (such as Gluteus Maximus and Gluteus medius ) to abduct and medially rotate it femur abduction and medially rotation of extension.
TFL pain can often be felt around the hip or buttock area when sitting for prolonged periods, often when sitting for too long at once. It may be caused by not stretching enough, or by certain exercises which cause muscle tightening such as running and cycling, which cause muscle tension to tighten further.
To properly stretch the TFL muscle, it requires incorporating movements that target both hip flexor and tibialis anterior muscles. One effective approach is to stand upright with a shoulder-wide stance and cross one leg behind another (you can use a wall as support if this exercise is new to you); push forward into this position while keeping hips to one side to create an excellent TFL stretch, holding this for 30-60 seconds before switching sides and repeating on other side.
When performing these stretches, always listen to what your body tells you and do not push past your comfort zone – forcing yourself beyond this will likely not yield desired results. Along with performing this stretch routinely, make sure to include other hamstring stretches and gluteal stretches into your workouts to protect against injury.
