Getting in Touch with Your TFL

Your Tensor Fasciae Latae (pronounced Tensor Fah-sha Lotta), or TFL, is a small, upside-down teardrop-shaped muscle in your hip. While the muscle isn’t large, it certainly has a large role in how your hips function. You can see a picture here from Gray’s Anatomy and some interactive anatomy here. The TFL helps to abduct, flex, and medially rotate your hip as well as extend your knee (or prevent it from collapsing while walking). Of course it helps to regulate the opposite of those actions too. In short, TFL is involved in every motion of the hip and the major actions of the knee! The insertion for this important little muscle is on the Iliotibial Band (ITB), that taut strip of connective tissue going down the outside of your thigh. TFL can be responsible for some considerable tenderness and tightness on the outside of the thigh.

My Connection

I think it’s funny that I teach this stuff, and I pass it along to my client’s all the time about what is good for them, and yet I have problems with my own TFLs. I had reconstructive surgery on my ACL 12 years ago and I have to say that my hips and legs haven’t been the same since. Over time, I have slowly realized that it’s not so much the surgery as how my body responded to the surgery – and the protective mechanisms I developed. Don’t ask me why it took me so long to realize this; I guess it’s easier to look objectively at somebody else’s body.

How it manifests for me is a massive trigger point in my left TFL. It’s bothered me on and off over the years – some little stress sets it off and it will make my entire leg ache. Over the past few years however, I’ve found a new pattern of periodically tweaking my hip when I carry something awkward (like a massage table) on one shoulder. Invariably it causes my left piriformis to go into spasm so that I can hardly walk – limping for several days. Only just recently have I realized a direct connection between the two pains. I have the same problems mirrored on my right side, just not as severely.

Lifting something awkwardly for a Memorial Day picnic, my piriformis went into spasm again. In working on the area myself, I probed around the rest of my hip to try to see what else was contributing. When I pressed on the latent trigger point in my TFL, my piriformis began pulsating for as long as I help the pressure. When I dug in a little further, I felt a sharp pain in the middle of my anterior shin (Tibialis Anterior) – another common site of pain for me. AHA! Paradigm shift!

Bodywork

IN my next post, I’ll go into a little more detail over the treatment protocols I intend to use to get rid of these things. I’m a massage teacher, and I can receive bodywork on a fairly regular basis. Still, I’ve been receiving bodywork regularly for years and it hasn’t done much for these trigger points. Nothing short of direct, focused efforts will do it. So here’s my plan.

First, I will make sure that I get at least one massage per week with at least some special emphasis specifically on my hips and these trigger points. Good, but that won’t be enough. Clair Davies recommends that you work on them with 6-12 good strokes multiple times per day and that you’ll see improvement in less than 2 weeks, even for the really bad ones. Well it’s proving time! I’m going to work them at least three times per day for at least two weeks and gauge the results.

I’ll keep you posted!

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Your Perception Is Your Reality

“Your perception is your reality”

I recently heard someone say this and I thought it would make a great critical thinking question, especially when applied in context to massage and our client relationships. This is a pretty deep statement and has implications that affect all aspects of our lives. Many times people perceive what they want to perceive. In class, we identified five areas of impact – personally, professionally, communication, your clients, and your work.

Personal Perceptions

Your personal perceptions dramatically affect your own self-esteem and relationships. In essence, your own self-perception is actually the basis of self-esteem. Relationships also have a large element of perception. I know that I have seen people that when they state “I’m not happy in my relationship” it is less of an observation and more of a decision. They have decided that they are not happy and that nothing about it ever will. Others seem to be able to make it through hard times by having the faith that it is only a temporary struggle and that brighter times are ahead. We call these kinds of perceptions a person’s character and we describe it in terms of being optimistic or pessimistic or cheerful or sarcastic. These personal perceptions can really color a person’s world. Stereotypes are an example of this too.

Professional Perceptions

Let’s talk about ethics first. When it comes to ethics, there are times when perceptions can matter almost more than the substance. Were you to socialize with a client, another client or professional could easily perceive the relationship as being improper. Really any interaction is open to interpretation about motives and you only have any kind of control over the impression that you present (I call it impression management). While you can’t control the thoughts of another person, you want to avoid anything that could give the “appearance of impropriety”.

Professional perceptions are also exemplified in job interviews. Your performance in that interview is dependent on how that interviewer perceives you. In this case the perception can quite literally create the reality in that you will never really be that employee unless they perceive you to be.

Communication

Since communication takes two, and the two can never completely know each other’s mind, there is an aspect of interpretation. How many times have we discovered a miscommunication because one person perceived a meaning the other never intended? Sometimes perceptions can also relate to selectivity – only seeing or hearing what one wants to see or hear. Different perspectives will also place different priorities on different things. You may intend emphasis on one thing, but someone else prioritizes another.

Your Clients

I know I’ve seen many clients who say that they are stressed. Sometimes I have to wonder how much of that is a symptom and how much is a self-fulfilling prophecy. Are they stressed, or does believing that they are stressed just allow them to accept it and not find a way to get rid of it? If a client resigns themself to a life of chronic pain, does the perception create or contribute to that reality? There is a connection.

Another aspect is the “I can’t” mentality. You know what I’m talking about. A child is working on their math homework and is saying “I can’t do it” and then after a lot of frustration and agony they do in 30 seconds what they’ve been “unable” to do for half an hour. They’re just trapped in a mindset and convinced their self that it is too hard. They can’t do it as long as they believe that they can’t. Other examples can be clients stating that they can’t function without a steady stream of caffeine, that they don’t have time to take care of their self, or eating right is impossible.

In Your Work

Perceptions here can create some conflict when you perceive something to be beneficial to a client and others may disagree. A huge example of this is I have heard of some spas prohibiting their MTs from working on clients’ gluteal areas because of the perception that it is sexual. These clients miss out on an important integrative region of their body because of a perception (I’d say misconception, but that is my perception! :D). You may perceive that a client needs more pressure to achieve the results they seek, but they perceive that the pressure is already too hard. You perceive that trigger points are to blame for the agonizing pain they are in, but they perceive that trigger point work is simply increasing the pain they are experiencing.

So What To Do About Perceptions?

The good news is that you do have control over your perceptions and, to a lesser degree, others’ perceptions as well. Even a phrase like “look on the bright side” indicates that there is a choice about how you choose to perceive something. An important thing is to do some periodic self-evaluation and see (pun intended) if there are any perceptions that hold you back. Do you have any self-fulfilling prophecies? “I think, therefore I am” could be changed to “I think ______, therefore I am _______.” To a degree, when you think certain thoughts, you start behaving in a way to start to bring those thoughts into reality. Affirmations work this way. You choose something you want to be (a perception), and through repetition you change your thought processes to make it a reality.

Another simple strategy is to just do it. How many times have you thought something was hard or impossible only to realize it wasn’t all that bad? When an event occurs that dramatically changes our entire world view, we call it a paradigm shift. We can cause these to happen intentionally by opening ourselves up to new experience.

I certainly hope that you’ve perceived this to be helpful!

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