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Tuesday, June 6, 2023

IASTM: Fascia Lata (Thigh)

Brent Brookbush

Brent Brookbush

DPT, PT, MS, CPT, HMS, IMT

IASTM: Fascia Lata (Thigh)

By Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

Course 2

Lateral Fascia Lata (17:50)

Anterior and Medial Fascia Lata (18:58)

Iliotibial Band

Based on the implications of new research suggesting that fascia may be a medium of communication, the iliotibial band (ITB) may aid in the explaning relationships between the various muscles, ligaments and bones it attaches too. Based on studies by Faircough et al. and Stecco et al. the ITB invests in the following (168, 169):

This research is what inspired consideration of the TFL , vastus lateralis , biceps femoris and ITB as a synergy of particular practical importance. The over-activity/increased-tension of this synergy seems to be a primary contributor to the excessive tibial rotation noted in feet turn out (and knees bow in ), and the inadequate anterior glide of the fibular head discussed later in arthrokinematics. Although the TFL and biceps femoris are commonly considered to be external rotators of the tibia, the synergy establishes a rationale for why release of vastus lateralis trigger points (often mistakenly referred to as "foam rolling the iliotibial band") may be effective in alleviating knee pain. The puzzling relationship related to the ITB is the one with the Gluteus Maximus . Unlike the other structures listed, this muscle is prone to under-activity. Hence, despite its potential to produce force, it cannot be a contributor to dysfunction/diagnoses that seem to be related to increased stress.

The ITB, like the other fascial structures discussed is often considered as a source of dysfunction and pain. Further, we can note that many of the structures of the knee with investments into the ITB are often involved in diagnoses related to knee pain (patellar tendon and lateral retinaculum). Regardless of whether the diagnosis is "runner's knee (patellar tendonitis, jumper's knee (iliotibial band syndrome), or patellofemoral malalignment (patellofemoral pain syndrmoe), the same histochemical markers and increased thickness of connective tissue seem to be present (169 - 172). It would be interesting to determine whether the same decreases in tissue strength noted in plantar fascia research (157, 158), and whether fascial dysfunction alone may result in changes in activity of the muscles invested.

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