Test the TFL
This is a great test for the TFL.
Have the client sit on the edge of the table and pull the knee to the chest before laying back.
When tensor fascia lata is tight, the foot on the untethered leg will deviate laterally.
The FM45 technique is an amazingly simple and quick way to release the TFL. Test the TFL before and after releasing the maxilla. Afterward, any direct work will be more responsive.
Pelvic balancing is the first step. TFL is very active in walking and standing and will not release easily or have lasting results without pelvic balancing.
Each therapist has their own method of pelvic balancing. I prefer craniostructural work with SOT blocking but also use METs, strain-counter-strain, and some NMT techniques.
Balancing pelvic joints is key. Also, the tensor fascia lata is responsive to proprioception from the knee and foot. Evaluate and mobilize the knee first. Look to foot if it indicated through assessment.
At times, the “leg slap” technique for releasing the sacral up-slip is the right choice. When it is, the TFL softens immediately from the mobilization.
Local Neuromuscular Therapy
This post has the TFL routine from The Workbook of Classical Neuromuscular Therapy. Preparing the muscle with craniostructural work and/or pelvic balancing is key for lasting results.
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Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.
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