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  • Writer's pictureRobin R Varghese, PT.

Tensed about TFL??? Are you wondering about what is causing you your pain


Let us understand about TFL.

  • Tensor Faciae Latae (TFL) is a skeletal muscle.

  • It is continuous with the iliotibial tract, which attaches to the tibia. The muscle assists in keeping the balance of the pelvis while standing, walking, or running.

  • The tensor fasciae latae tautens the iliotibial tract and braces the knee, especially when the opposite foot is lifted.

  • Though often used interchangeably with TFL and ITB, the tensor fascia is, in fact, a separate anatomical structure.

  • TFL often serves as a landmark for surgical procedures, including anterior/anterolateral hip and femur procedures. It functions as a lateral stabilizer to the knee and an abductor of the hip/thig.

  • After the origin, The TFL descends on the anterolateral aspect over the thigh, running superficially to the greater trochanter of the femur. It inserts distally to the IT track/band, which is comprised of the fascial aponeurosis of the gluteus maximus and the tensor fascia latae. The IT band then runs along the lateral aspect of the thigh, where it attaches to the lateral condyle of the tibia, specifically the Gerdy tubercle.

  • The FL extends medially where it invests the adductor muscles and again is strengthened at the knee. At the knee, the fascia lata receives a fibrous continuation from the biceps femoris tendon, from the sartorius and the quadriceps femoris.


What does the name mean?


Tensor" is an agent noun that comes from the past participle stem "tens-" of the Latin verb "tendere", meaning "to stretch". "Fasciae" is the Latin term for "of the band" or a sheet of connective tissue and is in the singular genitive case. "Latae" is the respective singular, genitive, feminine form of the Latin adjective "latus" meaning "side"

Thus, "Tensor fasciae latae" translates from Latin to English as "stretcher of the side band".

The tension in the iliotibial band is really a function of the tension in the muscles that it originates from, the tensor fascia latae and the gluteus maximus.


Functions of TFL

  • It acts, via the iliotibial (IT) band's attachment to the tibia, to assist with knee flexion and lateral rotation.

  • assisting in pelvis stability while standing and walking.

  • TFL is to assist in walking. The TFL does this by pulling the ilium inferiorly on the weight-bearing side, causing the contralateral hip to rise. The rise in the non-weight-bearing hip allows the leg to swing through without hitting the ground during the swing phase of the gait.

Difference Between TFL and ITB

  • TFL represents the band on the Lateral Side

Tensor-To stretch

Fasciae- Broad Band

Latae- On the side or lateral


TFL medially rotate and abduct the femur and assists in flexion at the hip joint. It also stabilizes the knee when it is extended, as well as when we walk and run.

  • ITB represents Ilium to Tibia

I-Ilium

T-Tibia

B-Band


ITB functions to stabilize the knee, especially in walking and running.

  • The ITB is an extension of the tensor fascia, and it is redundant tissue in the lateral thigh compartment partially composed of the TFL.

  • At the distal end of the gluteus maximus, the two layers of the fascia lata become united, forming a thick band of fibrous tissue that is contiguous with the iliotibial band.


Did you know that TFL can aid Venous Return???

  • The fascia latae wraps the large muscles of the thigh and forms the outer limit of the fascial compartments. In doing so, it limits the outward expansion of contracting muscles, making muscular contraction more efficient in compressing veins to push blood towards the heart.

What is the Clinical significance.

  • Because it is used for so many movements and is in a shortened position when seated, the TFL becomes tight easily. TFL stretches lengthen this important muscle.

  • The TFL can become clinically significant in cases of tightening, friction between over bony prominences, or through its attachment to the IT band

  • A shortened TFL can lead to an anterior tilt of the pelvis and/or medial rotation of the femur.

  • Geriatric patients may often suffer from weakened TFL actions due to Vitamin B12 deficiency and thereby compromises hip flexion.

  • Trigger points on TFL can be another trouble, and lies in the belly of the muscle.

  • Referred pain from this trigger point is generally concentrated in the anterolateral thigh over the greater trochanter and can also extend all the way down the thigh towards the knee.

  • TFL tear or strain has been experienced by many runners, this is because the TFL is used to bring the leg forward and also, as it provides pelvic stability with the dominant one-sided bearing of weight.


Symptoms of TFL:

  • Pain down and in the outer hip

  • Pain when lying on the affected hip

Treatment

discontinue any activities that worsen the tenderness.

Stretching exercises

Strengthening exercises


Stretching

  • Before beginning your tensor fasciae latae stretching routine, warm up with a few minutes of light aerobic exercise, including some dynamic movements for your hips and legs.

  • The American College of Sports Medicine recommends stretching at least two to three days per week, but it advises that more frequent stretching will yield greater gains in flexibility.

  • Stretch only to the point of tightness or mild discomfort.

  • Do not stretch to the point of pain.


Some of the stretches are as below. But we recommend that you take the guidance of your Physical Therapist before you can try on your own. This will prevent any injury that could happen by adopting wrong or misunderstood techniques. Get in touch with your physical therapist ASAP to learn these stretches in order to perform them effectively.













At Valley Healing Hands, we provide the best physical therapy treatment for Tensor Fasciae Latae or TFL tightness/ injury/ syndromes/ trigger point release or TPR. We have excellent Physical therapists who will be happy to serve you with customized plans. Our patients are very satisfied with our services. You may learn about it here and get connected to us here.


If you wish to read more about ITB or Ilio Tibial Band, kindly check our previous post on ITB here

If you wish to get connected to some products which might be of help to you, kindly check out the link https://backmusclesolutions.com/blogs/the-ql-blawg/tensor-fasciae-latae-pain



References:

1. Pubmed, Ganderton C, Pizzari T, Harle T, Cook J, Semciw A. A comparison of gluteus medius, gluteus minimus and tensor facia latae muscle activation during gait in post-menopausal women with and without greater trochanteric pain syndrome. J Electromyogr Kinesiol. 2017 Apr;33:39-47.

2.Saladin, Kenneth. Anatomy and Physiology. 6th ed. Mc-Graw Hill. 2010.

3. National Library Of medicine, Anatomy, Bony Pelvis and Lower Limb: Fascia Lata

Tucker Peabody; Bruno Bordoni, https://www.ncbi.nlm.nih.gov/books/NBK557497.

4. National Library of Medicine, Anatomy, Bony Pelvis and Lower Limb: Tensor Fasciae Latae Muscle, Amy P. Trammell; Ahmed Nahian; Holly Pilson, https://www.ncbi.nlm.nih.gov/books/NBK499870.

5.Joe Miller (2015-05-13). "Tensor Fasciae Latae Muscle Stretches". Livestrong.com. Retrieved 2015-05-31.)

6. Joe Miller (2015-05-13). g/wiki/Tensor_fasciae_latae_muscle#cite_note-4



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