Tensor Fasciae Latae (TFL) Static Manual Release

Differentiation

1. The tensor fascia lata (TFL) is a superficial muscle located on the anterior portion of the lateral pelvis.
2. The TFL is a fan-shaped muscle; however, most fascicles have a vertical fiber orientation. It is generally possible to strum these vertical fibers but not possible to palpate a defined border as the muscle blends with the fascia lata (fascia of the thigh)
3. The majority of the TFL can be located in a triangle-shaped area. Imagine a triangle with lines from the anterior superior iliac spine (ASIS) to the greater trochanter, from the greater trochanter straight up the mid-axillary line to the iliac crest, and the top of the iliac crest from mid-axillary line to ASIS.
4. In the middle of this triangle is the location of the most common TFL trigger points.
5. The gluteus minimus is located in the area underneath the posterior aspect of the TFL and the area just posterior to that.
6. The most common gluteus minimus trigger points are just superior to the greater trochanter.
7. Like the TFL , the gluteus minimus is a fan-shaped muscle, and most of the fibers have a vertical fiber orientation. However, because the muscle is deep to the TFL , iliotibial band, and gluteus medius , it is unlikely that borders or individual fascicles will be identifiable.

Potentially Sensitive Tissues

• The lateral femoral cutaneous nerve may be compressed or stretched during this technique. Generally, this would result in a burning, tingling or searing pain. The nerve is fairly small and a slight adjustment in hand position either anterior or posterior should be sufficient to avoid continued pressure on the nerve.

Trigger Points

• The common trigger point for the TFL is in the center of the muscle's mass.
• The common trigger point for the gluteus minimus is just superior to the greater trochanter.

Release Technique

1. This technique is likely easiest to perform with the patient/client in side-lying, with hip and knee slightly flexed for comfort and stability.
2. The practitioner should be behind the patient, adjacent to the hips so that extended arms would place the hands over the greater trochanter.
3. Imagine the area of the TFL ; a triangle with lines from the anterior superior iliac spine (ASIS) to the greater trochanter, from the greater trochanter straight up the mid-axillary line to the iliac crest, and the top of the iliac crest from mid-axillary line to ASIS.
4. Use a "thumb over thumb" or "thumb in thenar crease" hand position to palpate the fascicles of the TFL from posterior to anterior to identify taut bands. The TFL is a thick muscle, so several strokes may be required to explore fascicles at various tissue depths.
5. Once a taut band is located, the length of the band is explored for a dense nodule and consistent pressure is applied.
6. Generally, compressive force is sufficient to pin dense nodules; however, a slight posterior to anterior force may be added.
7. Consistent pressure is held until the nodule softens under the practitioner's fingers, or tissue density/sensitivity is significantly reduced (generally 30 - 120 seconds).