The tensor fasciae latae (TFL) is a relatively small muscle on the lateral edge of the anterior hip. Originating on the iliac crest at the anterior superior iliac spine (ASIS), the tensor fasciae latae forms the other half of the inverted “V” with the sartorius on the front of the thigh. While the sartorius follows a medial pathway down the thigh to the pes anserine tendon, the TFL extends posteriorly along the iliac crest anchoring into the bony structure of the ilium as well as the gluteal fascia. The TFL is enveloped by, and thus strongly associated with, the multifaceted and interconnected layers of the fascia lata of the thigh.

The middle longitudinal layer of the fascia lata, commonly referred to as the iliotibial band, is a primary stabilizer for the hip and lateral knee. Both the TFL (anterior) and gluteus maximus (posterior) descend laterally into the iliotibial band. This thick band transcends the lateral thigh and attaches to the lateral tibial condyle. Its distal fibers assist the lateral collateral ligament in preventing separation between the lateral femoral and tibial condyles. To a lesser extent, the TFL may influence patellar positioning within the femoral groove due to its attachment to the lateral retinaculum.

The greatest clue to the functional role of the TFL is that the iliotibial band is defined only in humans, indicating its importance in bipedal ambulation. Specifically, the TFL works with the gluteal muscles to stabilize the pelvis during single leg stance and maintains fascial tension during knee extension. The size and complexity of fascia in this area serves to reduce and distribute tensile force on the lateral femur, a function unique and essential to bipedal ambulation. Additionally, both the sartorius and TFL flex the hip while rotating in opposite directions and are active when the lower extremity pivots over a planted foot. Both assist the psoas, iliacus, and rectus femoris during hip flexion when the foot is not planted, as occurs during the swing phase of gait.

Tightness in the TFL, gluteus maximus, and associated iliotibial band can create friction proximally on the greater trochanter or distally on the lateral condyle of the femur. This excessive friction often results in injury to the bursa or tendon. Maintaining optimal flexibility in the iliotibial band and strength balance between the adductors, abductors, and rotators of the hip helps prevent this problem. Poor fascial mobility and excessive tension may also play an indirect role in dysfunctional patellar tracking and the associated chronic knee pathologies.

Palpating Tensor Fasciae Latae

Positioning: client supine with hip internally rotated.

Standing at the client’s side facing the thigh, locate the anterior superior iliac spine with your fingertips.

Slide your fingertips laterally and inferiorly toward the outside of the thigh.

Palpate along the fibers of the tensor fasciae latae as it becomes thicker and smoother at the iliotibial band.

Instruct the client to gently resist abduction and flexion of the hip to ensure proper location.

Passive Stretching for Tensor Fasciae Latae

Positioning: client prone.

Standing at the client’s side, grasp the lower leg with one hand and stabilize the center of the pelvis with the other.

Maintain 90 degrees of knee flexion as you passively rotate the hip laterally (pivot foot inward, toward the midline).

Instruct the client to remain relaxed as you locate the end range of movement and stretch the tensor fasciae latae muscle.

Add passive hip extension to the maneuver to increase intensity of stretch if required.

Tensor Fasciae Latae

Attachments

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Origin: Anterolateral lip of iliac crest

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Insertion: Lateral condyle of tibia via the iliotibial band

Actions

• Flexes the hip

• Abducts the hip

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Internally rotates the hip

Innervation

• Superior gluteal nerve

• L4–S1

Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (New York: Jones & Bartlett Learning, 2010; jblearning.com). Contact her at christy_cael@hotmail.com.