Target the glutes to reduce TFL muscle activation
The TFL muscle (Tensor Fascia Latae) is basically a drama magnet — an easily-worked-up, overactive muscle that leads to the development of both hip and knee pain. The TFL muscle has been clinically misdiagnosed as trochanteric bursitis, patellofemoral pain syndrome and Iliotibial band syndrome (ITBS or IT band syndrome), just to name a few. These common diagnoses are a result of compensatory patterns that develop from a combination of joint dysfunction and muscle weakness. But strengthening the glutes can minimize the activity of the TFL muscle (tensor fascia latae), and giving this particularly sensitive muscle less to do minimizes the likelihood of pain.
Research shows that a combination of gluteal muscle dysfunction and hip joint dysfunction causes the TFL to be overused. Thus, impacting the entire kinetic chain from the foot to the low back. The frequently experienced patellofemoral pain commonly seen with runners occurs due to abnormal loading of the knee joint. The hip muscles control dynamic medial knee tracking which is commonly seen when this type of knee pain.
The TFL muscle starts at the top of the hip and runs down the outside of the thigh into the knee. It functions as a secondary flexor, abductor and internal rotator of the hip. Its job is to control the IT band and prevent overpronation, but that’s a pretty hefty ask of a muscle that’s not nearly as big in size as it is in attitude. Dysfunctional glutes often lead to poor movement patterns that causes the TFL to be overactive. And when the TFL gets fed up, you’ll feel it!
The best way to eliminate knee pain is to minimize the activation of the TFL muscle in the first place. Here are 6 exercises that are great for isolating and strengthening the gluteal muscles to do exactly that:
Clamshell
o Starting by lying on one side.
o The hips are flexed to 45 degrees and the knees to 90 degrees.
o Raise the top knee up slow and controlled while keeping both heels in contact with each other.
o Hold for 10 secs.
o Slowly return to starting position.
o 10 reps.
o Repeat on the opposite side.
Single Leg Bridge
o Start by lying on your back with the leg raised in the air.
o Then push the other foot into the table to raise the pelvis until a position of 90 degrees of knee flexion is achieved.
o Try to keep the pelvis in neutral with the motion smooth and controlled.
o Hold for 5 sec.
o Slowly and controlled return to the starting position.
o 10 reps.
o Repeat on the opposite side.
Quadruped hip extension with knee bent
o Start by being on your hands and knees.
o Then lift one leg up and backward, extending the hip and knee to 90 degrees.
o Making sure to keep the pelvis in neutral and the motion controlled.
o Hold for 5 sec.
o Slowly and controlled return to the starting position.
o 10 reps.
o Repeat on the opposite side.
Forward lunge
o Starting position with the feet/toes pointed straight ahead.
o Then step forward so the front knee and hip are flexed to 90 degrees as well as the back leg without contacting the floor.
o Make sure the movement is smooth and controlled.
o Return to starting position.
o 10 reps.
o Repeat on the opposite side.
Side stepping with band
o Start in a squatted position with a band tied just above the knees.
o Then step to one side with one foot, followed in the same direction by the other.
o The step lengths should be about 50% of the starting-position distance between the feet in the squat position.
o Take 10 steps to one direction and go in the opposite direction.
Forward Step Up
o Start with one foot on a step.
o Then pushed that foot down on the step to raise the other foot off the floor to the level of the step, without resting it on the step.
o Make sure to keep control and balanced.
o Then return to the starting position.
o 10 reps.
o Repeat on the opposite side.
To sum up, because of multiple planes of motion at the hip joint and the number of muscles involved, a dysfunction can occur that leads to pain in the hip or knee. But awareness of compensatory movement patterns and being able to control them decreases the likelihood of developing pain. Reducing the overactivity of the TFL muscle by correcting those motions and strengthening the glutes will decrease the strain on it.
These exercises should help reduce discomfort and knee pain. But if issues persist, we recommend a thorough evaluation to pinpoint the underlying causes of your pain.
The TFL is also the primary culprit in IT Band Syndrome (ITBS). Symptoms of ITBS include sharp, stabbing or burning pain in the hip, groin or outer knee. Check out our stretching and strengthening protocol to help eliminate ITBS by getting the TFL to chill out here.
Have more questions or want to come in for a full movement analysis? Give us a call or shoot us an email. We’d love to help.
Happy training!
Raymond Delacruz, PT, MSPT, CSCS, CMTPT, FAAOMPT
Team Clutch PT