Tensor Fasciae Latae Pain

The tensor fasciae latae muscle (TFL) is a small muscle located in the lower thigh region of the body. It is one of the hip muscles and plays an essential role in various movements of the hip joint and the leg, including assisting hip flexion, internal rotation of the hip and abduction of the hip along with gluteus medius and gluteus minimus.

The TFL originates from the outer surface of the iliac crest, which is the uppermost part of the hip bone (pelvis). From its origin, the muscle runs downward and slightly forward, attaching to the iliotibial (IT) band, a thick band of connective tissue extending along the thigh’s outer side.

What does TFL pain feel like?

Typically with TFL pain there is general aching around the upper thigh just slightly on the lateral side, but sometimes this can come and go, it can also refer to the lower leg into the outside quadriceps, iliotibial band or around your glutes and into your lower back. Remember normally there’s been dysfunction elsewhere to cause tfl pain as we will discuss soon.

The 9 Causes of Tensor Fasciae Latae Pain are

1. Overuse or repetitive activities

   Activities involving frequent hip flexion and abduction, such as running, cycling, or climbing stairs, can strain the TFL muscle and lead to pain.

2. Muscle imbalances

   Weakness or tightness in other hip or leg muscles can place excessive stress on the TFL, leading to pain and discomfort.

3. Iliotibial band syndrome

   The iliotibial (IT) band is a thick band of connective tissue that runs along the outer side of the thigh and is connected to the TFL. Overuse or tightness of the IT band can cause inflammation and pain in the TFL area.

4. Hip joint problems

   Issues with the hip joint, such as bursitis or hip osteoarthritis, can refer pain to the TFL region.

5. Direct trauma

   An injury to the Tensor Fascia Lata or the hip area, such as a fall or impact, can cause localised pain.

6. Poor posture or mechanics

   Incorrect movement patterns or poor posture during physical activities can strain the Tensor fasciae lata muscle and contribute to nagging hip pain.

7. Training errors

   Rapidly increasing physical activity intensity, duration, or frequency without adequate conditioning can contribute to TFL pain.

8. Hip muscle tightness

   Tightness in other hip muscles, such as the hip flexors or gluteal minimus issues, can affect the function of the Tensor fasciae lata muscle and contribute to pain.

9. Nerve impingement

   Compression or irritation of nerves near the Tensor fascia lata muscle can cause referred pain in the muscle.

What is the Function of Tensor Fasciae Latae?

1. Hip flexion: It assists in lifting the thigh toward the abdomen, as seen in movements like marching or bringing the knee up when walking.

2. Hip abduction: It helps move the thigh away from the body's midline, such as when moving the leg sideways.

3. Hip internal rotation: It contributes to the inward rotation of the thigh, which is essential for various activities like crossing the legs.

The TFL works in conjunction with other hip muscles, such as the gluteus medius and minimus, to provide stability and support during standing, walking, running, and other weight-bearing activities.

The iliotibial (IT) band, which connects to the TFL, extends further down the thigh and attaches to the outer side of the tibia (shinbone). The IT band helps stabilise the knee during movements and plays a role in maintaining proper leg alignment.

How do you treat inflamed TFL muscle?

To manage TFL pain, identifying and addressing the underlying cause is essential, as noted earlier. Rest, ice, stretching, and strengthening exercises from physiotherapy can often help alleviate discomfort. In most cases, consulting with a physiotherapist may be necessary to develop an appropriate treatment plan and to ensure a proper diagnosis. They can also guide on preventing further TFL pain in the future.

Now, how do we go about relieving these symptoms? One of the most effective ways to easing pain is to use a massage ball to massage TFL in between sets of squats.

Using a massage ball through the glute medius will also help to reduce pain and increase glute activation. The ball helps to reorientate the muscular filaments to allow for better muscular contraction.

Releasing the tensor fasciae latae (TFL) can be helpful in reducing tightness and discomfort in the hip and outer thigh region. There are several methods to remove the TFL, and here are some effective techniques:

The Five ways to release Tensor Fasciae Latae

Self-myofascial release with a foam roller:

• Lie on your side with the foam roller placed horizontally just below your hip on the outer thigh and close to gluteus maximus and lateral side.

• Use your forearm to support your upper body and your other leg to stabilize.

• Roll slowly along the outer thigh through the TFL trigger points, from just below the hip to just above the knee.

• When you find a tender spot (trigger point), pause and apply gentle pressure for about 20-30 seconds to allow the muscle to relax.

• Continue rolling and pausing on other tender spots.

Self-myofascial release with a massage ball:

• Alternatively, you can use a massage or tennis ball for more targeted pressure on specific areas.

• Place the ball between your hip and a firm surface (e.g., the floor or a wall).

• Apply pressure to the ball and roll it over the TFL area to find trigger points.

• When you locate a tender spot, hold the pressure on it for about 20-30 seconds, allowing the muscle to release.

Stretching the TFL

• Stand with feet shoulder-width apart.

• Cross one leg behind the other and lean slightly to the opposite side.

• Keep the crossed leg straight and the foot flat on the ground.

• You should feel a stretch on the outer side of the hip.

• Hold the stretch for about 20-30 seconds, then switch to the other side.

  
  

Hip flexor stretch

• As the hip flexors and TFL are interconnected, stretching the hip flexors can indirectly release tension in the TFL prior to exercise.

• Kneel on one knee and step the other foot forward into a lunge position.

• Tuck your pelvis under and gently push your hips forward.

• You should feel a stretch in the front of your hip on the side of the kneeling leg.

• Hold the stretch for about 20-30 seconds, then switch to the other side.

TFL Massage or Dry Needling

• Seeking help from a Sports Physio who can specifically target the TFL and surrounding areas can provide more targeted and comprehensive release.
  
  

It's essential to perform these techniques gently and avoid applying excessive pressure. If you have any underlying injuries or medical conditions, it's advisable to consult with a healthcare professional or a Melbourne Physiotherapist before attempting these self-release techniques. They can provide personalised guidance and ensure the exercises are safe and appropriate for your needs.

4 for Tensor Fasciae Latae Pain with Squatting

1. Poor Technique Due to Pain or Ongoing Hip Pain

Squatting with incorrect form can place unnecessary stress on the TFL muscle, leading to pain. If the athlete is not squatting properly, the TFL muscle can be hyperactive, providing stability to the hip joint. Furthermore, pain is one of the major inhibitors of our glutes (in particular, gluteus maximus). This is primarily a survival mechanism to help prevent further injury, as our glutes are major propulsion muscles. 

If you’ve had a previous injury on one side of your body, your body will subconsciously move to unload that area of the body. Unless you physically focus on strengthening the issue.

2. Inactivity or Muscle Weakness

Regarding muscle, the saying “if you don’t use it, you lose it” applies. If we don’t create a demand on or stimulate the power, it will become smaller and harder to engage. If you’re sitting on your glutes now, squeeze them together. If you can’t get strong, even activation on both sides, good luck getting activation in the gym. Therefore weakness in other muscles around the hip can place more strain on the TFL muscle during squatting. For example, weak gluteal medial muscles can cause the TFL muscle to work harder to stabilise, leading to pain.

3. Tightness in the TFL Muscle

Tightness in the TFL muscle: Tightness in the TFL muscle can cause pain during squatting. The TFL muscle is responsible for hip flexion and abduction, and tightness can lead to difficulty in performing these movements.

4. Overuse and Asymmetry

Overuse of the TFL muscle can also lead to pain during squatting. This can occur if an athlete is squatting too frequently or performing too many repetitions. Furthermore, though we are biologically symmetrical, our demands on our bodies are rarely so. Our body’s response to these demands is to make specific adaptions increasing our ability to survive future stressors, thereby making the body asymmetrical. Asymmetry can be a massive issue regarding the demands of training. Whether it be Sports, CrossFit, Powerlifting or Olympic Weightlifting, 90% of chronic and acute injuries happen on an athlete’s non-dominant side. If you’re right-handed, the issues will mostly occur on your left side. This is because we put the same load and weight during training through both sides, with one side typically lacking stability, muscle bulk and overall neuro-muscular development.

If we cannot activate our glutes, specifically the gluteus medius, the TFL can begin to take over as a primary hip stabiliser. This manifests as pain in the front region of the hip and leads to slow movement throughout the squat or an inability to reach the bottom of the squat

How to Prevent TFL Pain from Coming Back

Once we have improved mobility in our hips and released the tensor fasciae lata, we need to look at how we maintain this new pain-free range and prevent this muscle from tightening up again. Strengthening the glute medius is going to be one of your priorities. Single-leg glute bridges, band walks and band hip extensions will all help with this. Adding two sets of 15 – 20 reps of each exercise into your warm-ups will improve your performance immensely, mainly if done before deadlifts, cleans, snatches and especially squats.