TFL TLC - Why Your Hip Pain May be Trending Down the Leg

This muscle is surprisingly the least sought after nemesis - in fact it’s one that gets away with almost everything. Psoas major and minor take major heat when it comes to tightness and stress in the hip area. But what if those primary movers are not the primary cause of your discomfort? 

Let’s break it down. The TFL is the Tensor Fascia Latae which attaches at the Illiotibial or IT Band. It helps with movement from the hip to the knee, specifically playing a role in internally rotating, abducting and flexing the hip. But did you know that if the TFL is tight, more than likely other muscles surrounding it need to be strengthened while the TFL itself needs to be lengthened? Not surprisingly, it’s a tricky muscle to pin down, so please bear with me as I breakdown an in-depth read from Precision Movement by Eric Wong.

In this article, Wong makes great points on what the FTL does and how we can solve for its tension. After giving each movement a try, I found one called the  Active Four Point TFL Stretch to be quite helpful. To begin, you start on your hands and knees and simply bring the leg to the side and to a 45° angle (activating the gluteus muscles while lengthening the TFL). I know all too well what it’s like to be doing an exercise and have your TFL tighten almost to the point of a cramp, and personally, this one seemed to be the best for my body. 

When other antagonistic muscles have become less active and the TFL turns into super mom, it’s time to start looking into strengthening the compensatory muscles. While there are many, the most common are the hamstrings and gluteus minimus and medius specifically. Dr. Boynton absolutely nails it when he says,

“once you feel tightness in the TFL it’s time to ask why”

Unfortunately, there may not be a quick fix or a simple solution for the TFL. Likely, the body mechanics you employ need to be understood and addressed. In some cases, the compensations we have can lead to the TFL being 2.5 times its usual size and perhaps a reason for our body developing unilateral hip osteoarthritis. The difficult part is maintaining the routine to consistently build the muscles around the TFL to turn on and develop appropriately. What I’ve found is that spending 45 minutes a week or 5 to 10 minutes a day on specific exercises is very beneficial. 

To give context, I noticed tightness in my hip for some time and assumed the worst (i.e. a lack of cartilage). And after much rest from a particular activity (dance) and consistent weekly physical therapy, I was in a much better position. Not only could I stand up and walk without discomfort, but I could hop on one foot again without any pain and workout as intended. That isn’t to say that I haven’t had my work cut out for me. Rather, I have needed to slow down and simplify my movements, making sure my foot-to-knee-to-hip alignment was correct, my glutes activating as the exercise was designed, and my unilateral stability consistent and on an upward trend. 

Whether you have a regular stretching routine or get massages frequently, functional movements are going to be your best option for solving this imbalance. Your body is in your hands, and you deserve to understand what is or isn’t working properly. To learn more, I encourage you to take a look at the tests found in this article and see a specialist to fine tune your movement patterns.