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The iliotibial
tract is the lateral thicker & stronger portion of the fasciae
latae and originates from the anterior part of the iliac crest and
inserts into the lateral tibial condyle. The gluteus maximus
as well as the tensor fasciae latae muscles insert into the upper
portion of the iliotibial tract. This arrangement allows the
iliotibial tract to act as a tendon for these muscles. The
very important anatomical component of the fascia latae covers the
entire thigh musculature and gives rise to intermuscular septs which
separate all groups of muscles in the anterior and posterior
portions of the thigh. The main function of the tensor fasciae
latae muscle is to stabilize the hip and knee as well as
participating in flexion, abduction, and medial rotation at the hip
joint and the extra extension of the knee.
Tensor fasciae
latae muscle syndrome is clinically expressed in pain in the area of
the iliac crest, greater trochanter and the hip joint area. In
many cases, this kind of myofascial pain can radiate to the lateral
femoral condyle of the knee joint area. Pain increases with
static load and active movement. These symptoms are very
similar to those experienced in other disorders such as cases of hip
disorders, lower back disorders, greater trochanter bursitis,
etc. Therefore, at the time of performing treatment for tensor
fasciae latae muscle syndrome we must palpate to detect possible
combinations of the above mentioned disorders. Given the fact
that the innervation of the tensor fasciae latae muscles originates
from the L4, L5, S1 spinal nerves (which actually converge into the
superior gluteal nerve) the massage therapy procedure for the tensor
fasciae latae muscle syndrome must start from segment reflex
massage. Perform superficial as well as deep fascia release on
all areas of L-S sacroiliac, front and posterior-lateral thigh
area.
1. With 2
thumbs bilateral, under pressure, massage the paravertebral zones
from S1 to L1 area. Continue this procedure 5-6
times.
2. Perform
petrissage #1 followed by petrissage #2 on the lumbo-sacral area,
including the glutes area, and piriformis area and region of the
greater trochanter.
3. Flex
fingers of hand at 90 degree angle and under compression try to
detect trigger points in the areas of the iliac crest, LS segments,
gluts areas, sacroiliac joint region, and greater trochanter
region. If trigger points are discovered apply ischemic
compression on each discovered trigger point.
4. Ask the
client to lay on the unaffected side and place a pillow between
his/her legs. Perform petrissage #1 and 2 in a short circular
pattern in the areas of the iliac crest.
5. Bend
fingers at 90 degrees and use palpation to try to detect trigger
points and tension areas in the iliotibial
tract.
6. Ask patient
to lay face up. Perform massage therapy on the front thigh. It
is best utilize techniques of effleurage, Freccion, petrissage #1,
2, 5, &/or 6. Cross fiber techniques are also highly
recommended.
7. Bend
fingers at 90 degrees and palpate upper portion of thigh including
the region of the iliac spine and iliopsoas muscles. As well as the
lateral and posterior part of the upper thigh and hip area to the
iliac crest (posterior-lateral and anterior parts should be
tested). Upon discovering trigger points perform ischemic
compression trigger point therapy.
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