TFL acts primarily through the ITB, allowing it to act simultaneously at the hip and knee. Its pull on the ITB contributes to lateral knee pain in runners.
| Origin | Anterior iliac crest and ASIS |
|---|---|
| Insertion | Iliotibial band — one-third down the thigh, blending with gluteus maximus fibres |
| Nerve Supply | Superior gluteal nerve (L4, L5, S1) |
| Blood Supply | Superior gluteal artery |
| Actions | Flexes and medially rotates the hip; Abducts the hip; Stabilises the knee in extension via ITB; Tenses the ITB during single-leg stance |
|---|
TFL tightness is assessed by the Ober test. TFL is the muscle injected in external snapping hip syndrome. In direct anterior hip arthroplasty, TFL is the lateral border of the rectus femoris-TFL interval.
Palpated just below and posterior to the ASIS during resisted hip abduction and internal rotation.
TFL-ITB contracture producing lateral knee pain at 30 degrees flexion in runners, managed by TFL stretching and progressive running load management.
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