Most of us are only familiar with the Iliotibial Band (IT Band) if it has felt tight and sore. It was probably at that time you may have heard that you have an unruly and tight tensor fascia latae, more commonly know as the TFL.
While the name does sounds like latin for “a lot of tense fascia”, with the ability to flex, abduct, and internally rotate the hip, it’s not surprising that this muscle is famous for taking on more than it can chew.
The TFL, however, is only one of several muscles that attach to the IT Band. The others include the gluteus maximus and medius, the tibialis anterior, and the peroneus longus (remember this one for later). Any or all of these muscles (and possibly a bunch of others) might be implicated with IT Band pain or tightness. How do we figure out which might need release and which might need strength?
Wanting to be a more precise teacher has always driven my course of study and last year, I attended the Level 1 training of movement assessment protocol, called NeuroKinetic Therapy®. I can now no longer assume that if a muscle feels “tight” that it is in fact, “facilitated” (or neurologically connected) and needs to be released. When we learned the test for the tensor fascia latae, I was shocked to learn that my right, chronically “tight” TFL couldn’t hold up to the assessment. In other words, it was “inhibited” (neurologically disconnected), which meant, even though it was sore, trying to roll out that soreness might inhibit it even more. This was surprising because I always thought my sore IT bands were due to an overactive TFL and an underactive gluteus medius. This is a common pairing (and to be fair, probably still true for me), but was not the whole pattern.
One of the basic assessments in the NKT® protocol is a Single-Leg Stance (SLS) test. It was this assessment that gave me a clue into where to look to rebalance the muscles that support the IT Band for pain relief.
Here’s a video of David Weinstock, founder NKT® demonstrating this test on his daughter:
The SLS assessment is exactly like it sounds – you stand on one leg and you get a sense of which direction you tend to fall. Very often you’ll fall toward the same direction no matter which foot you are standing on. Say for example that you fall to the left when you are standing on your right foot. Maybe you feel your right arch collapsing, your hip jutting out to the right, and maybe even a little pain somewhere along your IT band.
As I mentioned above, another muscle that affects the tension balance of the IT band is the peroneus longus. The dead give away in the above example is the tendency for the right foot to roll inward or pronate. The peroneals are some of the few muscles that actively create pronation in the foot (gravity does the rest).
If the peroneals are facilitated and the TFL is inhibited, it is possible that the TFL is not able to hold up its end of the line is because the peroneals are doing too much work. One way to self-assess this is to plantar flex and evert (the main two actions of the peroneus longus) the suspect foot a few times to fire up the peroneals and then re-do the balance test. If your balance gets worse, you can start to assume there’s a relationship between the two.
I bet you are wondering what to do now that you realized some overly active ankle muscles might be throwing off your balance. This is where Yoga Tune Up® and NKT blend wonderfully, allowing you to be precise and on-target with your Yoga Tune Up® releases and exercises. Check back on Friday for some great YTU® tips and tricks to rebalance your IT Band.
References
- Kendall, F.P. ; McCreary, E.K; Provance, P.G.; Rodgers, M.M.; Romani, W.A. (2005). Muscles Testing and Function with Posture and Pain, 5th Edition. Baltimore: Lippincott William & Wilkins.
- Lavine, R. (2010). Iliotibial band friction syndrome. Current Reviews in Musculoskeletal Medicine, 3(1-4), 18–22. doi:10.1007/s12178-010-9061-8
- Miller, J. (2014). The roll model: A step-by-step guide to erase pain, improve mobility, and live better in your body. Las Vegas: Victory Belt.
This is so helpful when trying to help my patient improve their static balance. I know that pronation is a common habit/ deficit for people but connecting it to the TFL and ITB is something I may have learned at some point but never applied. Thanks for that tip and I appreciate the link to NKT.
Thanks for the article and I really appreciate your understanding and emphasis on the facilitated verses inhibited muscles and how our sensation does not always indelicate what we might think and that sometimes a tight muscles can be tight and weak or tight and strong.. being able to recognize this difference and work from there allows us to come to a more muscularity balanced state of being..
Thank you! After years of hearing various suggestions about why I cannot do balance poses, this makes sense. I can balance if I’m moving on skates. Standing still, not so much. The specifics empowers me much more than a vague thought that “maybe your life is not in balance.”
This is awesome. One of my huge takeaways from YTU is the power of PNF. Not only does it do wonders for proprioception, it strengthens and activates while also allowing better release. Will definitely look into NeuroKinetics!
Wow ! I am impressed by the video ! I did not know about the NKT and I will like to learn more when it will be possible for me ! As a runner and having lots of friends running, I often ear about the IT band and I will be happy to come and that a look again at your article.
SLS is super useful to help figure out what’s going on with the gait patterns in people with neurological disorders. All kinds of interesting patterns come up. My weird little yoga pet peeve is when teachers bust out navasana as an abdominal exercise. Poor TFL, no respect even though it’s carrying more than its share of heavy lifting!
Thank you so much! This clarified a lot of information for me!!
Thank you for sharing this information. I am going to try the TFL assessment that you recommend.
Thank you for your insightful article. I have pain and tightness in the TFL and I will do the assessment you recommend.
Thanks Melinda! You helped us to think about TFL and the muscles which are in relationship with it super clear and simple but still interesting. I did the SLS test and figured out I tend to fall to my left side a little bit. It explains a lot because whenever I am in hurry and need to be there quickly, I walk fast and after couple of minutes I feel a small amount of muscle fatigue on my right leg’s peroneus longus and peroneus brevis. (Both of them evert the foot and plantar flex the ankle) It also cause a sensitivity on my left hip’s ITB and TFL. I will focus on finding my balance and relaxing those overused muscles. I definitely search more about the Neurokinetic Therapy 🙂
Well this explains a lot! In the past year I was told that I had weak ITB, never really understood it until now. I see where the the Tensor Fascia Latae plays a role. I will need to revisit this blog later. Thank you for making it easy to understand.
So very interesting and informative. Thank you. Where we think we are tight, may usually be where is uninhibited. I tried this test and it help to shed light that my perperoneus longus are possibly doing more than they should.
Melinda, thanks so much for providing some tips on understanding the complex origins of tension and soreness in the body. This is super helpful!
An excellent and precise article that allows me to understand more. Thank you Melinda
This makes me see IT band tension in a whole new way, I didn’t consider the
TFL’s role in things nor did I consider that rolling may not always be the best route for “tension” as there may be something else happening other than the perceived “tension”. This Leg Stance assessment and information was eye opening in terms of how we might be imbalanced in opposite ways from one side to the other of the body.
LOVE THIS!
Great! The link and integration of all the inferior member is great!
I am going to test my TFL right now!
Thank you!
This totally explains why i always fall to the left side when I try to balance on one foot. I have recently been experiencing pain in my right peroneus longus which I had attributed to running but now that may not be the case. I will definitely have to get it checked out. I will be rolling this out out and trying the corrective exercises.
Had some undefined hip, leg, calf pain a few months ago. I figured it was from overuse, I teach a lot of classes including step aerobics. i went to a Physiotherapeut in my little town and he checked me out and said: Why in the world are you not rolling with your balls, since I heard about you from my clients. he said that my gastrocnemius was under shock. i started rolling the gastrocnemius and the TFL, after 2 weeks I was painfree.
Thanks again Melinda for deepening my understanding IT band issues!
For whatever reason I have never made the correlation between the IT band the Peroneus. I will definitely have to try this! thanks for the article.
Interesting article! I learned two things: one is the connection between the peroneus longus being overworked to compensate for a weak TFL and how to counteract that. But I think I have also become very interested in the assessment tools learned in NeuroKinetic Therapy and want to explore this more. Amazing. Thank you.
This is a very informative an interesting article blending NeuroKinetic Therapy and YTU. I am anxious to find out about the YTU piece of this in the next article. Thanks for the information and great video.
I didn’t know that the peroneals are some of the few muscles that actively create pronation in the foot and gravity does the rest.
Thanks, Melinda. I’ve had neurological imbalances in some muscles, which has led to a host of issues. This is a great perspective and encouraging that there are things we can do on our own to help resolve the problem.
Thank you for the informative article. Wonderful video. It is a great example of how YTU and NKT can work together to help people.
Very imformative article and video which helped me understand a few of my muscle imbalances that I have been trying to figure out for months!
This was great. I have always worked upstream or next to when thinking of the IT band. I had never correlated the peroneus longus as being an important player! This will definitely be an addition when working with people-especially my runners!
Very interesting! The way the body compensates never ceases to amaze me! Also loved your simple explanation of facilitated and inhibited, that was helpful!!
So interesting to consider that “trying to roll out a sore spot might inhibit [that muscle] even more.” This goes against my intuition to stretch and roll out tight spots. Interesting also that the gentleman in the video points to sequencing movements in order to perform an exercise correctly. Great info!
Wow thats very interesting!!! Something I have never thought of… the fibularis muscles in the lower leg affects the TFL in the hip? Wow! Mind blowing but this just shows the theory that everything is attached and related. Lets not forget about those fibularis muscles that hold our body up all day and keep us balanced.
I now find NKT fascinating, I am bummed that my first “assessment” with NKT was not done well. I feel I need to look deeper into the work. Thanks for sharing this.
I’ve paid so little attention to the TFL in the past. Not anymore! This makes me completely rethink the IT band and tightness. I’ve also only thought of my flat feet playing a roll in my difficulties with balancing on my right leg. This gives me other areas of exploration as I continue to tackle the issue.
I enjoyed this article, thank you for posting the photo of the IT band and the neuro kinetic therapy video. I’ve been looking for a therapy for inversion and eversion issues for myself.
Such an easy assessment; that can provide pivotal results. Interesting to note that it may not always be the muscles in an area we feel pain or see symptoms that are causing the trouble but an area “uptown or downtown” of that region. I love how David explains that in order to do an exercise properly you have engage the right sequencing of muscles to perform it correctly. It’s great to hear from a health care professional that its not WHAT you do that counts but rather HOW you do it. Thank you for the share, gonna check out more about David & NKT.
This is super helpful to me. I have pain in my TFL and was confused because when I roll it out a lot of times it starts hurting and spasming, your article helps me understand why!
Wow, this is great and really useful — such a simple assessment too. I’ve looked into doing the NKT level 1 training, and it’s something that is definitely still on my radar. I’m currently doing Jill’s level 1 training, so it’s great to hear how well this is integrated with Yoga Tune Up.
Great articles/blogs about the TFL. I especially appreciate you pointing out that “tight” or “sore” doesn’t always equate to facilitated, but could also indicate inhibition in a muscle. And that rolling/releasing is not always the answer. This is why I love YTU work. We are constantly exploring our bodies and combining our tools of self-massage with corrective and strengthening exercises.
I had knee surgery (left side) about 5 months ago, and since then have had incredibly tight, and weak, outter hips. This fall test has been very insightful on where to start looking! In case you are curious – I tend to fall to the right side.
EXCELLENT VIDEO CLIP and information. He described my pattern to a T for the left leg in particular and it was very helpful to see it/hear it articulated. . IMO the peroneals are very difficult to release.
very interesting I previously associate balance problems only with inner ear issues. My own balance some times is way out of wack. The next time I have trouble nailing Vrksanasa I’ll check which way I’m falling. looking forward to reading your next post.
I liked the additional detail regarding how you may experience IT band tightness and pain. Looking more into supanation and pronation could be useful to talk about while teaching because commonly most people will be one way or another. Thanks for this blog and for sharing the video
Thank you for this interesting article about what type of imbalances can contribute to IT band tightness and pain. I appreciate the info about NKT and look forward to your next article featuring YTU releases and exercises to help with this issue!