The Tensor Fascia Lata (TFL) is a muscle with many different functions. It is an abductor, and internal rotator of the hip, and a hip flexor. Having so many functions, the TFL can be involved in many dysfunctional movement patterns throughout the body. We will explore its role in each of the aforementioned functions, assessing the resultant dysfunctions based on whether it is facilitated or inhibited. The TFL is most commonly associated with the IlioTibial Band, which unfortunately has led to its being treated as one unit. The usual treatment for this unit is myofascial release or foam rolling without assessing whether or not it is facilitated or inhibited. This can lead to further biomechanical complications and unnecessary pain and discomfort.
As an abductor, the TFL works in conjunction with the gluteus medius and the gluteus minimus. If one or two of these become inhibited, the other may become facilitated and overburdened. Often times inhibition of the gluteus medius is associated with a valgus knee and foot pronation. I find more often, using the manual muscle testing techniques from NeuroKinetic Therapy, that the TFL is inhibited in this situation. This can lead to ACL tears and other knee problems. http://ow.ly/9FUT2 . Here is an excerpt from an excellent article that references this very topic, “The more accurate description of the anatomy of the glutei and the new biomechanical theory that has been presented describe the abductor mechanism as a system in which the tensor fasciae latae has the primary function of balancing the weight of the body and the non-weight-bearing leg during walking. Gluteus medius with its three parts and phasic functions is responsible for the stabilisation of the hip joint in the initial phase of the gait cycle. It is important also in initiating the major gait determinant of pelvic rotation.Gluteus minimus functions as a primary hip stabiliser during the mid- and late phase of the gait cycle. This proves the importance of the TFL and the resultant dysfunctions when it is inhibited.” http://ow.ly/9FUwH . Inhibition of the TFL can also cause IT band syndrome, where the ITB is compensating for the TFL. In this scenario, rolling out the ITB without strengthening the TFL first, will prove fruitless.
The TFL is also involved in internal rotation of the hip along with the gluteus medius and minimus, adductors, and iliacus. If the TFL becomes inhibited, a greater burden is placed upon these other muscles. I often find facilitation of the adductor magnus and iliacus, which can lead to groin pain. Because internal rotation is opposed by external rotation, inhibition of the TFL can cause facilitation of the external rotators of the hip, especially the piriformis and the obturators. Facilitation of these can lead to an impingement of the hip joint.
The TFL is also a hip flexor working in conjunction with the psoas, iliacus, rectus femoris, adductors, and sartorius. Inhibition of the TFL may result in a facilitation of any of these muscles. Not uncommonly, the psoas is inhibited and the TFL becomes facilitated. Facilitation of the TFL can result in inhibition of the opposing muscles such as the gluteus maximus, lumbar erectors, and hamstrings.
Trendelenburg’s sign is found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius, minimus, and TFL. The Trendelenburg sign is said to be positive if, when standing on one leg, the pelvis drops on the side opposite to the stance leg. The weakness is present on the side of the stance leg. The body is not able to maintain the center of gravity on the side of the stance leg. Normally, the body shifts the weight to the stance leg, allowing the shift of the center of gravity and consequently stabilizing or balancing the body. However, in this scenario, when the patient/person lifts the opposing leg, the shift is not created and the patient/person cannot maintain balance leading to instability. This can cause a shift in the trunk leading to a variety of compensations with the obliques, QLs, and head position.
Inhibition or facilitation of the TFL can cause numerous compensation and dysfunctional movement patterns to occur throughout the body. Please don’t ignore this very important structure!