This Brent of the Brookbush Institute,
and in this video we're going to go over
tensor fascia lata or TFL
self-administered release technique. I'm
going to have my friend Melissa come out,
she's going to help me demonstrate this
technique. Before we get into the
technique itself that, it does help to
know a little bit about the anatomy of
the tensor fascia lata, where it's
located. Alright so if you guys know
where your ASIS is, it's just posterior
to your ASIS, your anterior superior
iliac spine. But let me take it a step
back. If you don't know where your
anterior superior iliac spine is, find the
top of your pelvis, which a lot of people
call their hips, which is weird because
your hip joints down here. This is your
pelvis so if you find the top of your
pelvis, your iliac crest as it's called,
and you follow it anteriorly all right
towards the front, eventually you'll find
this bony notch before it all becomes
soft tissue. Well firm tissue in
Melissa's case because you've got a
six-pack going here, right it must be
nice. But this bone right before this
softer tissue being her rectus abdominis
and her obliques, is her anterior superior
iliac spine. So right behind that, this
soft tissue in here, which I can actually
feel some some pretty pretty dense
fascicles that are probably going to
give her a little tenderness already,
that's the tensor fascia lata. Now the next
question we have to answer is how broad
and how long is this muscle. So if we
follow the ASIS and go back up the iliac
crest, and then we find the greater
trochanter just a few inches below it. So
the greater trochanter is another bone,
another notch that you can feel right
here, that's more related to where
your hip joint actually is. So one of the
tricks you can do is if you lift your
leg and then put it down, lift your leg
put it down, you guys might be able to
feel the greater trochanter moving
underneath the skin, that might help you
palpate. So if we go from iliac crest to
greater trochanter, that's approximately
the length of my TFL. And then if I know
where my greater trochanter is, I
actually know the breadth as well because
it goes from ASIS
to just posterior a vertical line from
the greater trochanter. Right so we got
this about this width and the
length from iliac crest to greater
trochanter, in kind of a triangle shape.
That's what you're going to search with
one of our release tools, you got that.
Now we're going to add pressure by
having her laid down on top of one of
these release tools, and we have a few
ways to go. We can go cheap and just grab
any any ball will work. We use softballs
a lot for home exercise programs. This is
one of those sand-bell type weighted
weighted balls they tend to work really
good, if you happen to be in a gym that
has them. If you want to take it a step
up from there we do love our trigger
point materials, and we got a little
partnership going with them -only because
I was already using their product, I
do happen to like it. One thing I like
about their products is its PVC pipe
rolled with foam, so as the foam breaks
down, as you get more advanced it
actually gets harder as opposed to a lot
of our foam roll products that tend to
get softer as you use them, which is not
going to be good for your progression.
And then if you really really want to
take it up a notch, it is at a little
different price point, but for the
technology it is it's pretty it's really
affordable for the technology. It is this
is a new product we have fallen in love with
called the Hypersphere from Hyperice.
And what this does is it vibrates, it
vibrates that at a very high frequency.
Yeah so by adding vibration what I would
assume is happening is on top of
stimulating Golgi tendon organs and
Ruffini endings to help us get autogenic
inhibition, we're going to go ahead and
also stimulate our Merkels and Pacinian
corpuscles which are vibratory
receptors, which may also help us with
inhibition at least based on the
clinical outcomes;
and what we've seen in practice you get
really great and effective release from
this, and maybe even release was a little
bit faster than you do with something
like a foam roll or a ball. So I'm going
to turn this thing back on, and I'm just
going to start it on the low setting
here for Melissa. She's going to go
right into that area that we were just
talking about right, so just behind ASIS.
We want to stay off of bones, so you're
not going to foam roll a bone away.
I want her to roll from ASIS back towards
her glutes, but not on her glutes right,
and she can roll in between her iliac
spine and greater trochanter. And what
she's going to look for is the most
tender spot, that most tender spot we're
going to assume is our our tender
pointer or trigger point. Everything else
could potentially be a satellite site,
which is essentially a referral pain
pattern that comes from the original
trigger point itself. So you don't want
to just chase down every spot guys, you
do want to find the most tender spot, and
once you find that you want to hold from
there. We can kind of mess with with her
posture here a little bit, we probably
could make some improvements. I'm going to have
you bring this leg up actually right, and
then you can kind of use this leg to
help take off some pressure, and then I
want her to straighten this leg out so
that the TFL is in a somewhat lengthened
position right, but I do want this leg
relaxed. So I'm going to ask her to go ahead and
lay her knee soft, because what I don't
want to do is use this leg, go ahead and
lock your knee again. I can tell she's
pushing down into the ground here right,
and now if we think about what the TFL
does it is an abductor. She's probably
using a stiff leg and pushing down in
the ground to contract her TFL, and do
something called guarding. We want no
guarding, we want that muscle totally
relaxed so that we get the best release
possible. Now who's going to need a
tensor fasciae latae release, that's a
that's a very important question. This
isn't something that you just throw
anybody for any reason, this should be
something that is targeted and aids in
improving the quality of human movement
based on your assessment. So if we were
going to talk about something like the
overhead squat assessment, the tensor
fascia lata is an internal rotator,
flexor an abductor of the hip, which
means knees bow in, knees bow out,
anterior pelvic tilt, excessive forward
lean are all signs that may potentially
indicate over activity of the tensor
fascia lata. If you're using goniometry,
a lack of external rotation right
since this muscle is an internal rotator,
would indicate a potential need to
release the TFL, and then in a somewhat
paradoxical fashion if somebody lacks
internal rotation that also might
indicate TFL over activity, especially if
you're measuring internal rotation at 90
degrees of hip flexion. That has to do
with our arthrokinematic dysfunction and
the fact that the TFL will also
anteriorly and superiorly glide the
femoral head in the acetabulum. So knees
bow in and knees bow out, anterior pelvic tilt
excessive forward lean, internal or
external rotation during goniometry,
are all potentially good reasons to do
your tensor fascia lata release. You want
to try the other side, all right here's how
you set up one more time. You will notice
that we have a mat down, this can get
quite uncomfortable to hold for a couple
minutes as our release techniques take
time. I do see a lot of people rush
through their foam roll techniques, rush
through their mobility techniques in
general which includes stretching, and
even our self-administered joint
mobilizations we want to make sure that
once we do a technique, we do it right so
that we get the result we're looking for.
I used to hate when my mother told me
to the fastest way to get something done,
was to do it the right way the first
time, and your like arggh right, you're like
because it just takes long and I just want
to get it done, but it's going to take a
lot longer if you
a half ass it over and over and over and
over again to get the result that you're
looking for. How does that hypersphere
feel, fast yeah, a little it's a little
intense the first couple times you did
it. Now of course if she was in so much
pain in this position with this hard
small object right, because if something
is small and something is very firm we
end up having a lot of pressure because
the surface area is very small, what I
could do is go hey it looks like you
can't relax into this position; and if
you can't relax and you're going to
guard, we're not going to get a release.
So what I could go back to do is let me
have this, let's go ahead and try this with
a foam roll, see how that feels. Don't
automatically assume that more pain is
better, more pain is not better, a better
release is better. So she feels more
comfortable on a foam roll and she can
actually relax and get a release. This is
where we can start, over time we can
decrease the surface area or increase
pressure by maybe using a harder object.
And of course with all of these
techniques we want to make sure that we
assess, address and reassess. I hope you
guys have enjoyed this video, take some
time to practice this before you give it
to your patients and clients. I think
you'll find that there's little little
form cues and stuff that you'll pick up
just by trying to figure the technique
out yourself. If you have any questions
please leave a comment below.
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