The Tensor Fasciae Latae (TFL) Can Cause Hip and Back Pain: Here are Some Ways to Help

WTFL???? What is the Tensor Fasciae Latae (TFL)

The Tensor Fasciae Latae, or TFL to its friends, is a small muscle in the outside front of the hips that works very, very hard. The TFL is a multi-tasker. It does hip flexion, hip abduction, internal rotation, and it even internally rotates the lower leg through its attachment to the IT band.

The TFL is an important hip flexor muscle

Moving the leg out to the side in parallel inspires the TFL to work in hip abduction with the gluteal muscles

The TFL is also one of the primary muscles working in internal rotation

Because the TFL has so many abilities, it is often overworked. It’s just so easy for other muscles to lay back and let the TFL take over. The TFL is also not one of those sexy muscles that we pay a lot of attention to when we go to work out, so it may not be strong enough to do everything we need it to do.

As a result it is not uncommon for the TFL to get sore and/or tight, contributing to problems in the lower back, hips, and knees. The TFL is also one of the common culprits in what is often interpreted to be a tight IT band. Because the IT band is fascia, and doesn’t stretch, it can’t be tight. For more on “tight” IT bands and my rant about the futility of foam rolling check out this blog post (link).

How do I Find my TFL?

Sitting on the floor with both knees bent and the feet more than hip width apart, let both knees fall to one side. If your hips are very tight you may want to sit on a block to start. Focus on the leg that is internally rotated (the back leg). Place your thumb on your hip bone then move it around to the outside of your hip about 2 inches, then down about 2 inches. Poke around for a lumpy muscle.

As you are poking, begin to sink your right hip back down towards the floor, rotating towards your back leg. You will be able to feel the TFL contracting and shortening under your thumb. If this is unpleasant, then you probably have a cranky TFL.

Poke around the front outside of your hip feeling for the TFL. You should feel it compress and shorten as you sit your butt down and rotate towards the back leg

How do I Release a Tight TFL?

When a muscle is very tight and angry, its usually because it is stressed out. It feels overworked and unappreciated. Sometimes when you start with rolling out or stretching a muscle like this it just gets more stressed out and, while there may be momentary relief, it will just get tighter again when you start to move.

Beginning with a very gentle TFL contraction will help the muscle feel more confident, loved, and appreciated. Here are three very kind TFL exercises to get you started.

Strengthening a Weak TFL

TFL Internal Rotation Exercise

Laying on your back, bend both knees with both feet more than hip width apart. The wider the feet the more difficult the exercise. Put your hands on your hip bones to remind you that the hips will not move at all. One leg at a time, gently internally rotate your femur, dropping the knee in towards the floor. Feel that little TFL gently contract at the end range of motion to push your knee down towards the floor. Remember, keep this gentle or you will start to feel other muscles (glutes, inner thighs, back) and you want just the TFL. Do 10-15 soft, sweet pulses in this position on each leg.

TFL Flexion Exercise

Still lying on your back move both legs to parallel, just at hip width apart. Pick up both legs to table top (knee at a 90 degree angle), internally rotate the leg slightly keeping the knee still and moving the foot out, then begin to pulse the knee in towards your chest. It is very important not to let the pelvis move. You may notice that the pelvis wants to tuck under as you pulse. Don’t do it. You are in charge. Do 5-10 pulses on each side.

TFL Abduction Exercise

Lay on your back with your legs together. Your abdominal muscles will be working a bit here to keep your body still so only your legs will be moving. Externally rotate both legs, turning the feet out but keeping the knees straight. Without bending the knees, start to slide the legs apart as far as you can go without twisting the hips or arching your back. You will feel your TFL work as a team with your side butt. Teamwork! Do 10-20 pulses apart in this position. Don’t arch your back, even though that feels very tempting.

External rotation biases the TFL when doing hip abduction (moving the legs away from the center of the body). Don’t worry if you don’t go as far as Natalie when you first start, she’s a pro.

How to Stretch your TFL

Its really easy to miss the TFL when you are stretching your hips. Its in a weird spot on the front outside of the hips and its often so tight and grumpy that your body would just rather skip it. Hopefully giving it a little strength will help it feel more relaxed, but the form on your lunge will still have to be impeccable to get into the right spot.

1. Start in an upright lunge, back knee down and hips perfectly square and slightly tucked under.

2. Slightly externally rotate the back leg. It doesn’t have to be much for most people to feel it. Just move that back foot across the body a few inches and that should be enough.

3. Make sure that when you rotate the back leg you don’t rotate the pelvis, those two hip bones are still in one line.

4. Gently push the hips forward and slightly out to the side, extending the hip of the back leg. If you don’t start to feel a stretch in that TFL keep checking on your form. Hips must be tucked, square, and the back leg externally rotated to get the right stretch.

5. Lift the arm up over your head and lean sideways away from the back leg, sticking your hip out to the side a little bit. That’s just a bonus bit of juicy goodness to get a little deeper into the stretch.

6. Be sure to do both sides and if one side feels tighter, do it again. It’s best to hold the stretch about 30 seconds or so but less if it is very painful. You can do some gentle, soft pulses into the stretch if the muscle needs some movement to help it relax. No momentum.

This delicious TFL stretch is a variation on the square lunge. Be sure to keep your hips square!

What Else Can I do to Relax my TFL?

As mentioned above, the TFL can become overworked because it is compensating for sleepy muscles in other places. Two of the most common muscle groups that could be slacking off are the illiopsoas, and the gluteal muscles.

Check your Psoas

The illiopsoas is also a hip flexor and an internal rotator so a sleepy psoas can heavily overburden that TFL. To test out your psoas strength do the hip flexion movement listed above but with the leg slightly turned out. This should move the work in the inner hip. If that feels difficult, work to strengthen that psoas.

Are the Gluteus Medius and Gluteus Minimus Working?

The gluteal muscles are right up next to the TFL and also attach to the IT band. If you have a sleepy butt then your TFL has to work very hard as a hip stabilizer, and that might make it resentful. To find your glutes do the leg sliding apart exercise mentioned above but with the legs internally rotated. See if you can find that side-butt work. If that feels week the more side butt strengthening should help support your pelvis without so much contribution from the TFL.

Doing the same leg slides into abduction with the legs internally rotated will bias the glute muscles. If this feels weaker than the TFL exercise you may need to strengthen your side butt!

Remember that our muscles are tight for a reason. They are tight because they are trying their best to hold our bodies together and do the work we ask of them. Treating them with kindness and figuring out how to support them is the best way to get them to relax and stop screaming at us so we can be stronger, more flexible, and have less pain.

Happy Bendings!