In today's video we're going to go through three steps to addressing tensor
fasciae latae pain and I'm going to give you five exercises that you can start
using right now
Yo what's up it's Coach E here from Precision Movement and
today we're going to go through three steps to addressing tensor fasciae latae
pain so the tensor fasciae latae is a muscle right at the top and outside of
your hip right here it's not very big it's maybe about that big and it inserts
into your iliotibial band okay so that's the taut band of fascia that runs on the
outside of your thigh okay this muscle is often very problematic people have a
lot of pain here it tends to flare up in people and they don't know what to do
often times they'll massage foam roll the IT band trigger point strap a static
stretch but the thing is with the tensor fasciae latae none of these approaches
are going to give you lasting relief because for the majority of people the
tensor fasciae latae is sore as a compensatory mechanism okay the tensor
fasciae latae is compensating for muscles other muscles in the hip that
aren't functioning correctly okay now I'm gonna go into this very briefly but
if you want the full background the anatomy of the biomechanics and the
references definitely check out the article I'm gonna like that in this
video here you'll see a little icon on YouTube and I'm also going to link it at
the end of this video because if you have tensor fasciae latae pain you're
going to want to understand everything fully so you can take the right steps to
be rid of it for good okay so the tensor fasciae latae in terms of biomechanics
it performs four movements okay hip flexion it contributes to hip flexion
hip internal rotation so that way internal rotation okay and hip abduction
so bringing the leg out to the side now it also assists in when the knee is
flexed only tibial external rotation like that okay so rotating the tibia
externally okay that doesn't happen when the knee is straight because all the
rotation occurs at the hip in that case so only when the knee is flexed
tibial external rotation because the tensor fasciae latae inserts into the IT
band and the IT band inserts into lateral aspect of the tibia the lateral
condyle it rotates it out okay and that's very important to understand when
you perform the techniques that we're gonna show you I'm gonna show you here
today so the three steps to addressing tensor fasciae latae pain
these three steps are part of the precision movement process for
eliminating pain and improving mobility so in all the courses that we offer hip
control spine control everything these three steps are followed because if you
don't follow these three steps you're not going to resolve pain long
term and you're not going to improve mobility long term okay you might get
some instantaneous acute effects but then you'll regress back to what you
started at okay so step one is address some structural limitations
step two is activation and dissociation and step three is functional integration
and I'm gonna go through all these steps and give you exercises for each one okay
so let's start with step one structural limitations structural
limitations can be muscle length itself could be fascial length or it could be
joint capsule mobility the joint mobility if you don't address these
things first if you do any dynamic mobility exercises activation exercises
you're not going to get the results that you're after because these structural
blockages you can just think of it as imagine bone on bone if that's happening
no amount of stretching is going to go through that you've got to fix what's
causing that bone on bone okay same thing happens with the limitations that
I mentioned so one technique that you can use that will help with tensor
fasciae latae pain is the four point hip joint mobilization okay this hits the
joint capsule and I've got a video I'll link to it as well but we'll go through
a really quick demonstration of this technique so you want to get a band you
don't have to do this with the band but it does help yeah and what we're going
to do is we're gonna mobilize into internal rotation because the tensor
fasciae latae like I said it's a hit internal rotator so if our joint capsule
is limited into internal rotation the TfL is gonna have to fight that much
harder and to no avail it's gonna work harder but it's not gonna be able to do
anything cuz bumping up against this joint capsule so it easily becomes
overworked and that's how the pain develops okay so this is going to
mobilize into internal rotation to remove that blockage if it exists for
you okay so you're in a four-point stance here set up nice spinal alignment
hips shoulder width apart or hips or knees hip width apart hands shoulder
width apart and you're going to internally rotate the hip where the band
is the hip that you're working on okay so I internally rotate now you can block
it if you want you can get throw a dumbbell or a kettlebell down there but
you don't have to you okay and from here what I'm gonna do is I'm gonna sit back
and once I start to feel that restriction is sit back and I'm starting
to feel restricted here what I'm gonna do is I'm going to scour so I'm going to
circle my hips around your significant other might appreciate this one as well
but you'll circle your hips around five to ten circles in one direction under
control nice and slow and then five to ten circles in the other direction okay
and what this is do doing is just rotating and mobilizing that joint
capsule in to internal rotation so that if that structural limitation is there
it's going to remove it okay so you do that that's the four pointed hip joint
capsule mobilization that's a technique that you can do daily okay so that's
just one example there many techniques that you can do to remove various
structural limitations okay so if you have that structural limitation one
thing that you might have heard about is femoral acetabular impingement this
technique is great for that because we're getting rid of that impingement by
mobilizing the joint caps okay so that's step one addressing structural
limitations step two is activation and dissociation
okay so I said earlier the tensor fasciae latae is often compensating
for us other muscles that are not working properly okay so some of
these other muscles are the muscles that perform the same actions as the tensor
fasciae latae hip flexion which could be the iliopsoas or the rectus femoris okay
more commonly the iliopsoas could be hip internal rotation okay variety muscles
there but predominantly glute medius and gluten minimus anterior fibers as well
as hip abduction okay see there you have glute all the glutes medius minimus
maximus alright so if any of those muscles are not functioning properly
then something else has to pick up the slack because we still got to move we
still got a lifter flex our hips to walk upstairs and to walk in general so other
muscles kick in to compensate almost like the tensor fasciae lata it'll
jump in and it'll help out but it's so small it quickly and easily gets
overworked which results in soreness so it's just like working the biceps if
you're doing bicep curls all day every day they're gonna get sore they're not
gonna recover and then you're gonna have just chronic pain okay so what we've got
to do is restore activation first of those other muscles okay so let's say
for example it's the glute medius an exercise that I prescribed for this
would be the sideline hip and abduction so there's a lot of studies and I'm
gonna let that are linked to in the article that I'm sending you as well but
that show what are the best exercises to activate various muscles of the hip and
to make sure other muscles aren't working as much and one is the side
lying hip abduction so you've seen if you've seen Buns of
Steel with good old Jane Fonda doing this but what the studies have shown is
maybe internal rotation of the hip activates more glute med relative to
TFL okay so if TFL is working too much and glute med is not working enough
this is what we want to do so internal hip rotation hold that position and then
it's slow controlled lift abduction you can hold it for five seconds and return
under control okay and you can poke in the side here you want to be working a
lot here not so much here TFL is gonna work
because it's an abductor but we want to focus on glutes squeeze those glutes hip
abduction hold it for five squeeze it hard breathe
so we're activating that muscle and down okay so there's a very basic activation
technique to get the glute medius working okay a little tweak that you can
do to get glute max another study has shown how do we get glute max firing
without so much TFL well you do the same kind of technique except you flex your
hip up to at least sixty degrees and then you do abduction and that's going
to get more glute max involvement as opposed to glute median medius
involvement with less TFL okay same protocol do reps hold for five to ten
seconds okay so we're activating the muscles getting them fired up so if
they're sleepy they're atrophied they're weak we need to first activate them and
build up their strength and that neuromuscular connection the mind the
muscle connection so we can use those muscles in other exercises and movements
yeah so there's a couple techniques another technique I want to share with
you here activation wise that one is the monster walk okay it's the monster walk
you've probably heard of it before but there's again a couple little tweaks
when I don't into the research for this so a lot of studies showing how do we
get the best activation okay so in the monster walk traditional monster walk
you put a band around your legs or your feet your ankles and your sidestep okay
but what studies have shown is the best band placement to get glute involvement
is around the feet and the hypothesis is and make sense is that facilitates
external rotation of the hip because you're fighting that force the band
wants to rotate my hip internally so now the external rotators have to work glute
max predominantly okay and then position wise you want to be in an athletic
stance a semi squat position okay so those two tweaks will improve
your activation profile more glutes less TFL all right so you're just stepping
slow steps I like to slide over kind of like a lateral lunge and then bring the
foot back in under control so slide out slide it over bring the foot in under
control step out place down shift your body
weight over bring the foot back under control okay this way we're not using
momentum and we're building strength and control throughout the range of motion
okay not throwing the cable but throwing my feet I'm activating and controlling
all right so that's the monster walk anywhere from ten eight to twelve
repetitions either way okay so that's gonna get glute max, glute med not so
much TFL which is what we're going for okay so those are a couple of exercises
of examples for activation okay and dissociation that's a little more
complex check out the article I'll break it down
more there for you okay finally step three functional integration now that
we've removed structural limitations those are out of the way we've got
muscles activated all the muscles that we need to be working are working and
the moving patterns are broken through dissociation so we've got conditioned
movement patterns just through habit it's like Pavlov's dogs you ring the
bell and they start salivating well whenever we flex our hips we tend to
towards dorsi flex the ankle okay so one example of disassociation is flex the
hip plantar flex yeah that's just a dissociation disassociating that
movement pattern breaking that conditioned movement pattern and that
just opens up new levels of activation it activates muscles differently and it
opens up the variety of the number of movement patterns that we have available
to us it would create new neuromuscular pathways new neural pathways in our
brain all right so step three functional
integration now we want to put all that stuff into movements
that we actually do in real life there's no point just doing activation
exercises then going down and moving doing say a squat for example the same
way that you'd always squat it you want to make sure all the other muscles are
integrated into that movement pattern okay so a couple techniques that I want
to show you the first one is unilateral wall squat and this has been proven in
the research to be a very beneficial exercise for glutes unless TFL so if
you've got one side that's affected and the other side is not affected yeah then
you start with your good side and you see okay where's that range and that's
the range that you want to get to okay so you've got kind of a gauge so this is
my left side is my good side my right TFL is actually a little over overactive
a little facilitated so the unilateral wall squat you just make sure your feet
are pointing straight ahead make sure you've got good hip alignment and then
you're sliding down and then back up okay very simple and this is just going
to start to train that squat movement pattern getting the glutes into it okay
so if I'm going to do it with my bad side what most people will find is when
they do it with their bad side they'll shift over their hip a lot like that to
keep balance ok that's because the abductors are not functioning properly
so you got to make sure the hip doesn't shoot out like that and think about
weight through the ball of the foot and the medial aspect of the heel and then
slide down there and then up okay you can use your other foot for balance this
would be a low level functional integration technique because it's we're
using multiple joints multiple muscle groups and we're doing patterns that are
used in everyday life in sport okay so that's one technique the second
technique is the banded lunge so the banded lunge is a very very
popular exercise now but one thing that I see a lot of people doing mistakenly
is using a band that's way too heavy okay all we want to do is make sure we
use a band that elicits the right activation pattern we're not trying to
build strength in this like max strength in this type of
because it's not a movement that we do in everyday life if we don't have
somebody pushing our knee in as we're doing a lunge which I'm going to show
you okay so use a relatively light band just enough to get a little bit of
activation and to get some kinesthetic awareness of what you're trying to fire
up okay you're gonna do a lunge a banded lunge so step back our banded split
squat make sure both feet are pointing straight ahead
hips are square tall good posture I'm just gonna squat down lunge down making
sure that everything is tracking and good alignment and going all the way up
to full in the extension at the top yep so your focus should be on the medial
aspect of the heel the ball of the foot and just keep that alignment okay under
control so you build that strength through the full range of motion and
this is going to integrate the glutes and the external the glute medius and
the glute maximus for external rotation and hip abduction into a lunge movement
pattern which is a common movement in the gym in sport even in life going up
stairs again okay so that's step three functional
integration so this is these are the three steps that you must go through to
eliminate tensor fasciae latae pain for good okay because if this muscle is
painful that just means it's overworked it could be no other reason it's
overworked it's doing more than it needs to be doing because other muscles are
not pulling their weight okay so we've just gone through a really
quick kind of high-level overview of the three step process and I've shared a few
exercises with you so if this all makes sense to you I highly recommend you
check out the blog post that's going to be linked at the end because this thing
is it's a big one you're going to go through all of the background the
anatomy the biomechanics the scientific studies the research and then I'm going
to give you what you need to do to deal with that TFL pain to get rid of it and
to make sure it's gone and stays away alright so thanks for checking out this
video hope it's been helpful for you see you next time