Anatomy of the Tensor Fascia Lata Muscle - Everything You Need To Know - Dr. Nabil Ebraheim

Educational video describing the anatomy of the tensor fasciae latae muscle.
It is a small muscle that lies between the gluteus maximus and tensor fascia lata at the middle and upper area of the thigh. The tensor fascia lata muscle arises from the anterior part of the outer lip of the iliac crest. It is inserted along the iliotibial tract at the middle third of the thigh. The iliotibial band is a thick band of fascia that extends along the lateral thigh from the iliac crest to the knee. The iliotibial band is inserted into the lateral condyle of the tibia (gerdy’s tubercle).
Function: assists in flexion and abduction of the thigh. It counteracts the posterior pull from the gluteus Maximus muscle on the iliotibial tract.
Innervation: it is innervated by the superior gluteal nerve. The superior gluteal nerve exits the pelvis at the greater sciatic foramen above the piriformis muscle.
Snapping hip syndrome
•The iliotibial band slides over the greater trochanter causing a snapping noise and motion. It may be painful especially with activity. The patient can reproduce the snapping.
•Diagnosis of iliotibial syndrome
•Direct palpation of the greater trochanter
•Put the patient on the side
•The hip is placed in extension and when the hip is rotated a “pop” or “ snap” may be felt.
•Ober’s test: the Ober’s test is a clinical examination test used to access the tightness of the iliotibial band.
•The patient should lay on the side with the unaffected leg on the bottom.
•The examiner will then slowly abduct the leg with the knee in flexion and the hip in extension.
Trochanteric bursitis
•It occurs due to repeated trauma, inflammation or irritation of the iliotibial band over the greater trochanter. The bursa will be irritated and inflamed and the patient will point to the area of pain over the greater trochanter of the femur.
Runner’s injury (iliotibial band syndrome)
•The condition usually occurs in distant runners.
•It is friction injury due to rubbing between the iliotibial band and the lateral femoral condyle.
•MRI will show the iliotibial band thickened and inflamed.
•Treatment: physical therapy, injection, rarely surgery.
•The injection can be done at either spot depending on the area of maximum tenderness.
Thigh compartment syndrome
Fasciotomy by opening the tensor fascia lata.
Common approaches
1-Watson-Jones approach
•Between the tensor fascia lata and the gluteus medius muscles.
•Both muscles are supplied by the superior gluteal nerve.
2-Smith Peterson approach
•Approach between the tensor fascia lata (superior gluteal) and the Sartorius (femoral nerve).
•Be aware of the lateral femoral cutaneous nerve of the thigh.

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