0:04 This Brent of the Brookbush Institute, 0:06 and in this video we're going to go over 0:07 tensor fascia lata or TFL 0:09 self-administered release technique. I'm 0:11 going to have my friend Melissa come out, 0:13 she's going to help me demonstrate this 0:14 technique. Before we get into the 0:16 technique itself that, it does help to 0:18 know a little bit about the anatomy of 0:20 the tensor fascia lata, where it's 0:21 located. Alright so if you guys know 0:24 where your ASIS is, it's just posterior 0:27 to your ASIS, your anterior superior 0:29 iliac spine. But let me take it a step 0:31 back. If you don't know where your 0:33 anterior superior iliac spine is, find the 0:36 top of your pelvis, which a lot of people 0:37 call their hips, which is weird because 0:39 your hip joints down here. This is your 0:41 pelvis so if you find the top of your 0:43 pelvis, your iliac crest as it's called, 0:45 and you follow it anteriorly all right 0:49 towards the front, eventually you'll find 0:51 this bony notch before it all becomes 0:53 soft tissue. Well firm tissue in 0:57 Melissa's case because you've got a 0:58 six-pack going here, right it must be 1:00 nice. But this bone right before this 1:04 softer tissue being her rectus abdominis 1:07 and her obliques, is her anterior superior 1:10 iliac spine. So right behind that, this 1:13 soft tissue in here, which I can actually 1:15 feel some some pretty pretty dense 1:18 fascicles that are probably going to 1:19 give her a little tenderness already, 1:21 that's the tensor fascia lata. Now the next 1:23 question we have to answer is how broad 1:25 and how long is this muscle. So if we 1:29 follow the ASIS and go back up the iliac 1:33 crest, and then we find the greater 1:35 trochanter just a few inches below it. So 1:38 the greater trochanter is another bone, 1:39 another notch that you can feel right 1:42 here, that's more related to where 1:44 your hip joint actually is. So one of the 1:47 tricks you can do is if you lift your 1:49 leg and then put it down, lift your leg 1:53 put it down, you guys might be able to 1:54 feel the greater trochanter moving 1:56 underneath the skin, that might help you 1:57 palpate. So if we go from iliac crest to 2:00 greater trochanter, that's approximately 2:02 the length of my TFL. And then if I know 2:05 where my greater trochanter is, I 2:07 actually know the breadth as well because 2:09 it goes from ASIS 2:11 to just posterior a vertical line from 2:15 the greater trochanter. Right so we got 2:17 this about this width and the 2:20 length from iliac crest to greater 2:23 trochanter, in kind of a triangle shape. 2:25 That's what you're going to search with 2:29 one of our release tools, you got that. 2:31 Now we're going to add pressure by 2:35 having her laid down on top of one of 2:37 these release tools, and we have a few 2:39 ways to go. We can go cheap and just grab 2:41 any any ball will work. We use softballs 2:45 a lot for home exercise programs. This is 2:48 one of those sand-bell type weighted 2:51 weighted balls they tend to work really 2:53 good, if you happen to be in a gym that 2:54 has them. If you want to take it a step 2:56 up from there we do love our trigger 2:58 point materials, and we got a little 3:01 partnership going with them -only because 3:03 I was already using their product, I 3:05 do happen to like it. One thing I like 3:07 about their products is its PVC pipe 3:09 rolled with foam, so as the foam breaks 3:13 down, as you get more advanced it 3:15 actually gets harder as opposed to a lot 3:19 of our foam roll products that tend to 3:21 get softer as you use them, which is not 3:24 going to be good for your progression. 3:25 And then if you really really want to 3:28 take it up a notch, it is at a little 3:30 different price point, but for the 3:32 technology it is it's pretty it's really 3:35 affordable for the technology. It is this 3:38 is a new product we have fallen in love with 3:39 called the Hypersphere from Hyperice. 3:41 And what this does is it vibrates, it 3:45 vibrates that at a very high frequency. 3:48 Yeah so by adding vibration what I would 3:54 assume is happening is on top of 3:56 stimulating Golgi tendon organs and 3:58 Ruffini endings to help us get autogenic 4:00 inhibition, we're going to go ahead and 4:03 also stimulate our Merkels and Pacinian 4:09 corpuscles which are vibratory 4:11 receptors, which may also help us with 4:15 inhibition at least based on the 4:17 clinical outcomes; 4:18 and what we've seen in practice you get 4:21 really great and effective release from 4:24 this, and maybe even release was a little 4:26 bit faster than you do with something 4:28 like a foam roll or a ball. So I'm going 4:32 to turn this thing back on, and I'm just 4:33 going to start it on the low setting 4:34 here for Melissa. She's going to go 4:39 right into that area that we were just 4:41 talking about right, so just behind ASIS. 4:44 We want to stay off of bones, so you're 4:46 not going to foam roll a bone away. 4:47 I want her to roll from ASIS back towards 4:53 her glutes, but not on her glutes right, 4:56 and she can roll in between her iliac 4:58 spine and greater trochanter. And what 5:01 she's going to look for is the most 5:03 tender spot, that most tender spot we're 5:06 going to assume is our our tender 5:11 pointer or trigger point. Everything else 5:13 could potentially be a satellite site, 5:16 which is essentially a referral pain 5:18 pattern that comes from the original 5:22 trigger point itself. So you don't want 5:24 to just chase down every spot guys, you 5:26 do want to find the most tender spot, and 5:28 once you find that you want to hold from 5:31 there. We can kind of mess with with her 5:33 posture here a little bit, we probably 5:35 could make some improvements. I'm going to have 5:36 you bring this leg up actually right, and 5:39 then you can kind of use this leg to 5:41 help take off some pressure, and then I 5:42 want her to straighten this leg out so 5:44 that the TFL is in a somewhat lengthened 5:46 position right, but I do want this leg 5:49 relaxed. So I'm going to ask her to go ahead and 5:51 lay her knee soft, because what I don't 5:53 want to do is use this leg, go ahead and 5:56 lock your knee again. I can tell she's 5:58 pushing down into the ground here right, 6:01 and now if we think about what the TFL 6:03 does it is an abductor. She's probably 6:05 using a stiff leg and pushing down in 6:09 the ground to contract her TFL, and do 6:11 something called guarding. We want no 6:16 guarding, we want that muscle totally 6:18 relaxed so that we get the best release 6:21 possible. Now who's going to need a 6:25 tensor fasciae latae release, that's a 6:26 that's a very important question. This 6:30 isn't something that you just throw 6:32 anybody for any reason, this should be 6:35 something that is targeted and aids in 6:38 improving the quality of human movement 6:40 based on your assessment. So if we were 6:43 going to talk about something like the 6:44 overhead squat assessment, the tensor 6:46 fascia lata is an internal rotator, 6:48 flexor an abductor of the hip, which 6:52 means knees bow in, knees bow out, 6:55 anterior pelvic tilt, excessive forward 6:58 lean are all signs that may potentially 7:01 indicate over activity of the tensor 7:04 fascia lata. If you're using goniometry, 7:06 a lack of external rotation right 7:10 since this muscle is an internal rotator, 7:12 would indicate a potential need to 7:15 release the TFL, and then in a somewhat 7:18 paradoxical fashion if somebody lacks 7:20 internal rotation that also might 7:23 indicate TFL over activity, especially if 7:27 you're measuring internal rotation at 90 7:29 degrees of hip flexion. That has to do 7:31 with our arthrokinematic dysfunction and 7:34 the fact that the TFL will also 7:37 anteriorly and superiorly glide the 7:40 femoral head in the acetabulum. So knees 7:45 bow in and knees bow out, anterior pelvic tilt 7:47 excessive forward lean, internal or 7:49 external rotation during goniometry, 7:51 are all potentially good reasons to do 7:53 your tensor fascia lata release. You want 7:56 to try the other side, all right here's how 7:59 you set up one more time. You will notice 8:02 that we have a mat down, this can get 8:04 quite uncomfortable to hold for a couple 8:07 minutes as our release techniques take 8:10 time. I do see a lot of people rush 8:13 through their foam roll techniques, rush 8:15 through their mobility techniques in 8:17 general which includes stretching, and 8:19 even our self-administered joint 8:20 mobilizations we want to make sure that 8:23 once we do a technique, we do it right so 8:26 that we get the result we're looking for. 8:28 I used to hate when my mother told me 8:31 to the fastest way to get something done, 8:34 was to do it the right way the first 8:35 time, and your like arggh right, you're like 8:38 because it just takes long and I just want 8:40 to get it done, but it's going to take a 8:42 lot longer if you 8:43 a half ass it over and over and over and 8:45 over again to get the result that you're 8:48 looking for. How does that hypersphere 8:49 feel, fast yeah, a little it's a little 8:54 intense the first couple times you did 8:56 it. Now of course if she was in so much 8:57 pain in this position with this hard 8:59 small object right, because if something 9:04 is small and something is very firm we 9:06 end up having a lot of pressure because 9:08 the surface area is very small, what I 9:11 could do is go hey it looks like you 9:12 can't relax into this position; and if 9:14 you can't relax and you're going to 9:15 guard, we're not going to get a release. 9:17 So what I could go back to do is let me 9:19 have this, let's go ahead and try this with 9:21 a foam roll, see how that feels. Don't 9:29 automatically assume that more pain is 9:32 better, more pain is not better, a better 9:35 release is better. So she feels more 9:38 comfortable on a foam roll and she can 9:42 actually relax and get a release. This is 9:44 where we can start, over time we can 9:47 decrease the surface area or increase 9:50 pressure by maybe using a harder object. 9:55 And of course with all of these 9:59 techniques we want to make sure that we 10:01 assess, address and reassess. I hope you 10:06 guys have enjoyed this video, take some 10:08 time to practice this before you give it 10:10 to your patients and clients. I think 10:12 you'll find that there's little little 10:14 form cues and stuff that you'll pick up 10:17 just by trying to figure the technique 10:19 out yourself. If you have any questions 10:21 please leave a comment below. 10:31
