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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1 comment:
I recently have found that I have the same problem that you have. I had acl reconstructive surgery back in 1996 and have been fine for most of my athletic ventures until the past year or 2. My chiropractor informed me that I have issue with my tfl and the tightness is what's hurting and impairing me and not my acl. I was relieved to hear this and I'm looking forward to hearing what your treatment consists of. Since I'm not a message therapist and can't really afford to get massages a few times a week...would there be a it band massager that you would recommend or some sort of stretches I can manage on my own to help my elasticity?
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