You can only view 3 videos without an account. Become a Member to access all videos on the website.
Tensor Fasciae Latae (TFL) Static Manual Release
The Tensor Fasciae Latae (TFL) Static Manual Release is a therapeutic treatment that helps to improve flexibility, reduce muscle tension and pain, and restore range of motion in clients with issues in the TFL muscle and area. This treatment involves the application of manual pressure to the tissue surrounding the TFL muscle, either statically or in a repetitive fashion. The release is often combined with a variety of other modalities such as stretching and foam rolling to ensure maximum results. As with
Transcript
00:00:0400:00:07
This is Brent of the Brookbush Institute,
00:00:0400:00:07
and in this video we're going over
00:00:0700:00:11
static manual release of the tensor fasciae latae and gluteus minimus. I'm
00:00:1100:00:14
assuming that if you're watching this video you're watching it for educational
00:00:1400:00:18
purposes, and that you are a licensed manual therapist or student on your way
00:00:1800:00:23
to becoming a licensed manual therapist. Personal trainers this technique
00:00:2300:00:27
probably doesn't fall within your scope, although you could use the palpation
00:00:2700:00:31
portion of this video in an educational setting to help you learn your Anatomy.
00:00:3100:00:35
I'm going to have my friend Melissa come out, she's going to help me demonstrate
00:00:3500:00:39
this technique. Now all of these techniques follow a very similar
00:00:3900:00:45
protocol, over simplified that protocol would look something like palpate and
00:00:4500:00:49
compress. We're going to break it down a little further than that. We want to be
00:00:4900:00:54
able to palpate and differentiate these tissues from other muscles in the area.
00:00:5400:01:00
We do get bonus points for knowing our trigger points, so if you know where the
00:01:0000:01:02
common trigger points in the tensor fasciae latae are, the common trigger
00:01:0200:01:07
points in the gluteus minimus are, you will narrow your search field a bit and
00:01:0700:01:11
you won't have to search around quite so much to find those local points of
00:01:1100:01:16
overactivity. We do have to keep in the back of our head is there any tissues in
00:01:1600:01:22
this area that compression or abrasion might insult. So are there any nerves,
00:01:2200:01:27
lymph nodes, arteries. There are some nerves in this area but usually they're
00:01:2700:01:31
fairly small nerves, and if you happen to give somebody a tingling sensation or a
00:01:3100:01:35
burning sensation, it's pretty easy to get out of the way of those nerves by
00:01:3500:01:41
moving backward or forward. Last we have to figure out what position can we put
00:01:4100:01:46
Melissa in that will add some tension to this muscle. So we've pinned down those
00:01:4600:01:53
nodules, those trigger points, those locally overactive muscle fibers right.
00:01:5300:01:57
We also have to make sure she's comfortable and possibly most
00:01:5700:02:03
importantly, that we're comfortable that we're using our own body mechanics to
00:02:0300:02:07
apply pressure, so that we don't wear ourselves out over the course of one
00:02:0700:02:13
session or one day, one week or even one career. We don't want to be using so much
00:02:1300:02:16
of our hands that we only get a couple of these
00:02:1600:02:21
techniques before we're tired. Now let's start with our palpation and the anatomy
00:02:2100:02:25
involved in the tensor fasciae latae and gluteus minimus here. The first thing
00:02:2500:02:32
you're going to want to find is the top of the iliac crest here right. So the top
00:02:3200:02:38
of her pelvis, because I'm going to want to follow that to her ASIS, I'm going
00:02:3800:02:41
to go ahead and put the top of her pants over the top of her ASIS, so I know where
00:02:4100:02:47
that's located. I'm then going to go ahead and find her greater trochanter.
00:02:4700:02:52
We've actually put a little dot here on Melissa's pants right, so that we can
00:02:5200:02:56
mark the greater trochanter so that you guys can see it, if not in this view in
00:02:5600:03:03
the close-up recap. If I go from ASIS to greater trochanter, and then back up the
00:03:0300:03:13
mid-axillary line to the to the iliac crest here, in that triangle is my TFL,
00:03:1300:03:19
and right in the middle of that triangle is where the TFL trigger point usually
00:03:1900:03:27
is and we have that marked off. Now the gluteus minimus is just behind the TFL
00:03:2700:03:31
right, so the trigger point is also in the middle of that muscle,
00:03:3100:03:38
generally speaking falls just behind the mid-axillary line above the greater
00:03:3800:03:44
trochanter. So we're dealing in this little triangle right here below her
00:03:4400:03:50
pelvis and above her greater trochanter. Now to add some tension to this muscle
00:03:5000:03:55
I'm going to kind of use a modified Obers test right. I'm going to go ahead
00:03:5500:04:00
and bring her leg back, and if you watched the vastus lateralis video I
00:04:0000:04:04
talked about how we should put the vastus medialis on top of the calf,
00:04:0400:04:09
because what you don't want to end up with is kneecap on top of ankle because
00:04:0900:04:13
that hurts. When you start pressing, so we're going to take the meaty part of
00:04:1300:04:20
her of her quad here put it on the meaty part of her lower leg, so that when I
00:04:2000:04:24
start pressing, we're just compressing soft tissues we don't
00:04:2400:04:31
have any problems there. Now I'm going to palpate across these faacicles. This is
00:04:3100:04:36
a fan-shaped muscle right, a fan-shaped muscle whose fascicles run this way. So
00:04:3600:04:44
I'm going to palpate from anterior to posterior to find the tightest fascicles,
00:04:4400:04:50
and then I can start. Once I find some tight fascicles I can start moving a
00:04:5000:04:57
little bit more distal, or a little bit more proximal to find the tightest point
00:04:5700:05:02
within those fascicles, and then of course I'm just going to apply my
00:05:0200:05:07
pressure. I can use a thumb over thumb technique. I can use my pisiform over
00:05:0700:05:13
thumb technique. I can use my inner thenar groove over thumb technique here,
00:05:1300:05:17
and then you'll notice I have the table pretty low here with Melissa, so that I
00:05:1700:05:25
can just lean in until I get a little increase in tissue density here. I
00:05:2500:05:29
don't want to go further than that. I don't want pain. I don't want the tissues
00:05:2900:05:33
to all of a sudden guard on me because I'm pushing in so hard just right
00:05:3300:05:40
up until I hit some tissue resistance, how does that feel Melissa? Yeah that's,
00:05:4000:05:44
that's tender. This muscle definitely tends to get tender. A lot of people talk
00:05:4400:05:50
about IT band tightness and iliotibial band syndrome, and runners knee, guys your
00:05:5000:05:55
IT band is connective tissue it's not muscular tissue. Your IT band doesn't get
00:05:5500:06:03
tight, but your TFL will get over active and short and pull your IT band tight. so
00:06:0300:06:07
on a lot of these individuals what you'll find is they have very sensitive
00:06:0700:06:13
trigger points in their TFL, and releasing them usually does them some
00:06:1300:06:18
good. Sometimes you have to be a little gentler, so sometimes the 30 seconds to
00:06:1800:06:24
120 seconds static hold doesn't work out as well as maybe the five seconds on
00:06:2400:06:29
five seconds off, an increasing pressure a little bit each time.
00:06:2900:06:35
Trying to desensitize that area a little bit. Be gentle with people, you crush
00:06:3500:06:38
somebody right off the bat they might not come back, and if they don't come
00:06:3800:06:42
back you're not going to have a chance to fix their problem. Now after I get a
00:06:4200:06:47
release in the tensor fasciae latae I can just keep moving my thumb back, keep
00:06:4700:06:54
using that same anterior to posterior strum of her fascicles to find other
00:06:5400:06:59
tight fascicles. The gluteus minimus guys is basically the tensor fascia latae's
00:06:5900:07:04
nasty cousin. Both muscles do the same joint actions, both muscles are
00:07:0400:07:08
involved in the same dysfunctions. The only difference is the gluteus minimus,
00:07:0800:07:15
it does not have an attachment to the iliotibial band. Once I find some tight
00:07:1500:07:20
fascicles I'm going to narrow in by going proximal to distal, or distal to
00:07:2000:07:25
proximal to find the the tightest point within those fascicles.
00:07:2500:07:31
And again I'm going to apply my pressure, I could do the five-second holds on and
00:07:3100:07:37
off, increasing pressure each time if she was really sensitive. Or I could go in so
00:07:3700:07:44
I meet tissue resistance, hold for thirty seconds to a hundred and twenty seconds.
00:07:4500:07:48
Alright guys in the next video you'll see or in the next section, you're going
00:07:4800:07:54
to see us do a close up recap so you can see exactly where I'm putting my hands.
00:07:5400:07:59
Alright guys for the close-up recap let's start with palpation. The top of
00:07:5900:08:03
her iliac crest is right here alright. I'm going to put the front of her
00:08:0300:08:09
pants over the top of her ASIS, and then we'll kind of adjust here. Make sure our
00:08:0900:08:13
little markings there are over her greater trochanter. So we used this
00:08:1300:08:19
little beige button to mark the greater trochanter, ASIS, greater trochanter, up
00:08:1900:08:27
the mid-axillary line. In between this triangle right here is her tensor fasciaE
00:08:2700:08:31
latae, that nice fan-shaped muscle. And you can see we've marked off that trigger
00:08:3100:08:37
point which is basically in the middle of that muscle. You notice just posterior
00:08:3700:08:42
to that trigger point is another trigger point, marking this one representing the
00:08:4200:08:47
gluteus minimus which again falls behind the tensor fasciae latae, but doesn't
00:08:4700:08:53
have an attachment to the iliotibial band. So as far as my palpation I'm going
00:08:5300:08:58
to use those anterior to posterior kind of strumming, with a broad thumb
00:08:5800:09:05
here. Find the the most overactive fascicles there, and then move. In this
00:09:0500:09:09
case since I'm starting so proximal, I'm going to go ahead and keep moving distal
00:09:0900:09:16
until I find the tightest point, maybe even a little nodule within those
00:09:1600:09:20
fascicles that's where I'm going to apply my compression. I'm going to use my dummy
00:09:2000:09:28
thumb and then either my inner thenar groove here, or my pisiform to go ahead
00:09:2800:09:34
and apply pressure. I do find it helpful to add a little bit of a distal to
00:09:3400:09:40
proximal angle to this to help pin down that trigger point. I'm just going to go
00:09:4000:09:45
up to tissue resistance, and then hold it for 30 seconds to 120
00:09:4500:09:50
seconds. I did mention that this area does get very tender on people. You guys
00:09:5000:09:55
have heard of iliotibial band syndrome, runners knee, a lot of that comes from
00:09:5500:09:59
the tensor fasciae latae being overactive in those individuals and pulling on the
00:09:5900:10:04
iliotibial band, and it'll get it'll just get tender to the touch. So that five
00:10:0400:10:09
seconds on, five seconds off, five seconds on a little harder, five seconds off to
00:10:0900:10:14
help desensitize is sometimes a better way to start this technique. Then of
00:10:1400:10:19
course after I finished releasing this trigger point I can just keep going with
00:10:1900:10:27
my anterior to posterior strums, and I'll find my next trigger point in the
00:10:2700:10:34
gluteus minimus, and again just use my my pisiform over thumb grip here, apply
00:10:3400:10:41
pressure until I hit that first tissue resistance, and hold for 30 to
00:10:4100:10:50
120 seconds. So there you guys have it, ASIS, iliac crest, greater trochanter, TFL,
00:10:5000:10:54
gluteus minimus behind it, and trigger points right in the middle of those
00:10:5400:10:58
muscles. So there you guys go that was static manual release of the tensor
00:10:5800:11:03
fasciae latae and gluteus minimus. As I've said in all of our other manual
00:11:0300:11:06
release videos, make sure that by the time you put your hands on somebody you
00:11:0600:11:11
are 80% sure that those are muscles that need to be targeted with manual release
00:11:1100:11:16
techniques, and you should know that from your movement assessments. Manual
00:11:1600:11:23
release techniques by themselves make terrible assessments, be practising these
00:11:2300:11:30
techniques often, and if you can with your fellow professionals. The ability to
00:11:3000:11:35
practice with somebody who also does manual release techniques, to have these
00:11:3500:11:39
techniques done on you is learning that you are not going to get from this video,
00:11:3900:11:47
and no matter how well I speak, or how well we demonstrate this stuff on video,
00:11:4700:11:52
you need to have that practical application before you try this on
00:11:5200:11:57
our patients and clients. I hope you guys enjoyed this video. I hope you learned a
00:11:5700:12:01
lot from our video and this technique. I look forward to hearing about your
00:12:0100:12:03
outcomes.
Related Videos
Quadruped Crawl Sled Pull
Talocalcaneal Manipulation
Talonavicular and Cuneonavicular Joint Manipulations
Proximal Tibiofibular Joint Manipulation
Adductor Magnus (Posterior) SA Static Release
Anterior Thigh SA Active Release
Biceps Femoris Vibration Release
Tensor Fasciae Latae (TFL) Static Manual Release
Vastus Lateralis Self-administered Dynamic Release a.k.a. Pin & Stretch
Splenius Cervicis and Splenius Capitis Static Manual Release (Soft Tissue Mobilization)
Biceps Femoris Manual Static Release
Gastrocnemius and Soleus Manual Static Release
Pectoralis Major and Subclavius Static Manual Release (Soft Tissue Mobilization)
Rope Row
Single Leg Alternating Horizontal Abduction with External Rotation
Wobble Lunge
Wobble Squat
Combined Deep Cervical Flexor and External Rotator Activation