To perform its function, the tensor fascia lata pulls on a wide layer of fibrous tissue that covers the outer side of the thigh. The fascia lata and its central tendon transmit the force of this and the gluteus maximus muscles to the hip and knee. The tensor fascia lata helps flex the knee and hip. The same muscle is involved in lifting the hip forward and to the side and in turning the leg inward. It takes part in stabilizing the pelvis and knees during walking and running. In runners and track and field athletes, these muscles are very developed. Changing the sitting position also requires the participation of these muscles.
Symptoms
Trigger points in the tensor fascia lata cause pain in the hip joint just anterior to the greater trochanter (Figure 9.1). There are two places where trigger points may be present - one in front, directly under the pelvic bone, the second two to three centimeters behind the first. In some cases, pain may extend along the outer thigh to the knee (not shown). There is also a deep, dull pain behind the hip area, between the ischium on that side and the greater trochanter (not shown). The muscle shortened under the influence of trigger points makes it difficult to straighten the hip and makes a person walk more slowly. You have to stand with your hips and knees slightly bent. When the trigger points in the tensor fasciae lata are at their most active, it is almost impossible to lean back.
The tightened muscle puts pressure on the pelvic bone, the pelvis moves forward, and an unnatural curve appears in the lower back. This same impact can create the impression of a shortened leg. The thigh becomes very sensitive and it is difficult to lie on it. Pain from trigger points in the tensor fasciae lata is mistaken for hip bursitis or a sign of thinning hip cartilage.
Causes
Excessive walking, running, or climbing puts excess stress on the tensor fasciae lata. Overload leads to the fact that subsequent sitting ends in the formation of trigger points due to the fact that the muscles remain in a shortened state. The same thing happens if you sleep with your knees raised. These muscles become even more tense when walking or running on uneven ground. They have to work harder to compensate for gait in worn-out shoes or foot instability caused by Morton's foot, which is discussed in Chapter 10. The tensor fascia lata muscles are engaged whenever you stand on your feet. They experience unnecessary stress if you carry a heavy load while walking and if you are overweight. Try to avoid prolonged sitting if these muscles bother you. If you have signs of limited mobility in your hips, take care not to sit in a hunched position or sleep in a fetal position. Keep in mind that walking, running and other physical exercises will be too harmful for muscles that lack elasticity and flexibility. Monitor the condition of your hip joints. Restricted mobility is a clear sign of the presence of trigger points. Overloading any muscle that has trigger points quickly activates them, and pain cannot be avoided.
Treatment 
To locate the belly of the tensor fasciae lata by contracting the muscle separately, first locate the greater trochanter, a bony protrusion on your hip. Figure 8.22 will help you. Place your finger in front of the greater trochanter and shift the weight of your body from foot to foot (Fig. 9.2). The muscle will swell and fall in turn. If you simply rotate your knee or foot inward or lift your leg to the side, the muscle will also contract. The tensor fascia lata is a muscle that works very intensely. It will not be possible to perform a deep massage of this muscle with your fingers; they will not create the necessary leverage, but the Tera Keynes device will cope with this (Fig. 9.3), like a tennis or lacrosse ball pressed against the wall (Fig. 9.4). Trigger points can be located deep within this muscle. If there is a thick layer of fat on the thighs, you can use an even smaller and harder ball. Place the ball in front of the large skewer and press firmly against it. Roll the ball across or along the muscle fibers, whichever is more comfortable for you. Typically, along with the tensor fasciae lata, several other muscles are also affected by trigger points. If you have pain or stiffness in your hips, explore all of the muscles listed in the Trigger Point Index called Outer Thigh and Hip Pain. Make sure that the tension in the iliotibial band on the outside of the thigh is caused by the tensor fascia lata and gluteus maximus muscles due to trigger points in them. Tenderness in this area is more likely due to trigger points in the underlying vastus lateralis muscle, which is part of the quadriceps femoris muscle.
Tensor fascia lata- Tensor fascia lata, m. tensor fasciae latae, a flat, slightly elongated muscle, lies on the anterolateral surface of the pelvis; its distal end is woven into the fascia lata of the thigh. The muscle begins on the outer lip of the iliacus... ... Atlas of Human Anatomy
tensor fasciae lata- (m. tensor fasciae latae) a muscle located on the lateral surface of the thigh in the split of the fascia lata. It starts from the superior anterior iliac spine and inserts into the iliotibial tract. The function pulls... ... Glossary of terms and concepts on human anatomy
Muscles and fascia of the thigh, right- Front view. anterior superior iliac spine; inguinal ligament; spermatic cord; great saphenous vein of the leg; adductor muscles; sartorius; rectus femoris muscle; fascia lata (hips); vastus medialis; patella and subcutaneous... Atlas of Human Anatomy
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The tensor fascia lata is a relatively small muscle located on the anterolateral surface of the pelvis. Being paired with the sartorius muscle, it has an inverted v-shape on the front of the thigh. These two muscles are separated by the rectus femoris, also located on the front of the thigh. All three muscles are involved in hip flexion, but the tensor fascia lata and sartorius muscles are also involved in rotation of the lower extremities in different directions. When the hip is fixed, it participates in the rotation of the pelvis.
The iliotibial tract, the large, thick tensor fascia lata tendon, is the primary stabilizer of the hips and lateral knee. The muscle bundles of the gluteus maximus muscle and the tensor fascia lata are directed vertically downward, passing into the iliotibial tract of the fascia lata. This structure connects the front and back of the pelvis to the lateral thigh and knee. Its distal fibers help the lateral part of the collateral ligament separate the lateral condyle of the femur and tibia and stabilize the tibiofemoral joint.
Excessive tension in the gluteus maximus muscle and tensor fascia lata can lead to various diseases. With atrophy or decreased tone of the tensor fascia lata, proximal friction occurs in the greater trochanter or lateral condyle of the femur, which can lead to injury and inflammation of either the tendons or bursae.
Increasing iliotibial band flexibility, tensor fasciae lata tone, and surrounding muscle tone can prevent injury and inflammation. Together with the thoracolumbar fascia, the iliotibial tract forms a stabilizing “horseshoe” located in the lumbosacral spine and directed vertically down to the popliteal fossa. Atrophy or decreased tone in this area can cause excessive tension in the lower back and pain when raising the leg forward. The pain may occur when walking, running, cycling, going up or down stairs, or when sitting.
Restricted hip mobility (namely, difficulty in adducting the hip), coupled with increased tension, which is easy to notice upon palpation, signals the presence of inflammation or damage to the ligaments.
PALPATION OF THE TENSOR FASCIA LATEUS AND ILIOTITIBIAL TRACT
The client is in the side decubitus position with the hip and knee slightly flexed. For convenience, you can hold your leg.
1. Stand facing the client's thigh. Use your palm to locate the lateral femoral condyle.
2. Move your palm proximally toward the greater trochanter.
3. Palpate the iliotibial band along the lateral aspect of the thigh.
4. Palpate the proximal and anterior portion of the tendon, reaching the tensor fasciae lata.
5. Ask the client to abduct the hip several times to feel the movement of the tensor fascia lata.
ILIOTIGIAL TRACT STRETCH AT HOME
1. Stand up straight, straighten your shoulders.
2. With one hand, grab something stable.
3. Cross your legs, placing one leg behind the other.
4. With your knees slightly bent, gently move your hips in the opposite direction of the hand you are holding onto until you feel a stretch.
5. Tilt your head slightly and stretch upward with each exhalation. As you inhale, relax.
lies on the anterolateral surface of the pelvis
Start: external lip of the iliac crest, closer to the superior anterior iliac spine
Attachment: Passes into the fascia lata of the thigh (iliotibial tract)
Function: Stretches the fascia lata and the iliotibial band. Through it it acts on the knee joint and flexes the hip. Due to their connection to the tensor fascia lata, the gluteus maximus and gluteus medius muscles contribute to movement of the knee joint
Comb
The shape is close to a quadrangle.
Start: Superior ramus and crest of the pubis
Attachment: pectineal line of the femur
Function: Adducts and flexes the hip, slightly externally rotating it
Gluteus maximus muscle
wide and thick fleshy mass of diamond shape; It determines how much the buttocks will protrude. Holds a person's torso in an upright position.
Start:. Dorsal surfaces of the sacrum and coccyx
Attachment: Gluteal tuberosity of the femur, iliotibial tract
Function: Extends the thigh in the hip joint, with strengthened lower extremities, extends the torso, maintains the balance of the pelvis and torso. Abducts the hip.
Biceps femoris
Located along the lateral edge of the posterior thigh. There are two heads in the muscle - long and short.
Start:
Long head– Ischial tuberosity
Short head– Lateral lip of the linea aspera, lateral epicondyle of the femur, lateral intermuscular septum of the femur
Attachment: Head of the fibula, lateral condyle of the tibia, fascia of the leg
Function: The long head extends the thigh, bends the lower leg, and when the lower leg is bent, turns it outward
Semitendinosus muscle
In the middle, the muscle is often interrupted by an oblique tendon bridge.
Start: Ischial tuberosity
Attachment: Medial surface of the tibial tuberosity, fascia of the leg
Function: Extends the thigh, flexes the lower leg. When the shin is bent, the shin turns inwards
Semimembranosus muscle
The outer edge of the muscle is covered by the semitendinosus muscle.
Start: Ischial tuberosity
Attachment: Medial condyle of the tibia
Function: Extends the thigh, bends the shin, rotates it medially (with the shin bent)
Since the muscles of the posterior group of thigh muscles spread over two joints, with a fixed pelvis they, acting together, bend the lower leg at the knee joint, extend the thigh, and with a strengthened lower leg, they extend the torso together with the gluteus maximus muscle. When the knee is bent, the same muscles rotate the lower leg, contracting separately on one side or the other. The semimembranosus muscle internally rotates the tibia
Gluteus medius
The muscle is thick, there are two layers of bundles - superficial and deep. 
Start: Gluteal surface of the ilium
Attachment: Apex and outer surface of the greater trochanter
Function:
Gluteus minimus
The shape resembles the gluteus medius muscle, but is much thinner in diameter. Covered throughout.
Start: Gluteal surface of the ilium
Attachment: Anterolateral surface of the greater trochanter
Function: the anterior bundles rotate the thigh inward, the posterior bundles rotate the thigh outward
Pear-shaped
Passing through the greater sciatic foramen, the muscle does not completely fill it, leaving small gaps along the upper and lower edges through which blood vessels and nerves pass.
Start: Pelvic surface of the sacrum lateral to the sacral foramina
Attachment: tip of the greater trochanter
Function: Rotates the hip outward
Thin muscle
Long, slightly flattened, lies subcutaneously, located most medially.
Start: from the anterior surface of the pubic bone downwards, passes into a long tendon, which bends around the medial epicondyle of the femur from behind.
Attachment: attaches to the tibial tuberosity.
Even before its insertion, the gracilis tendon fuses with the tendons of the sartorius and semitendinosus muscles, as well as with the fascia of the leg, forming the superficial pes anserine.
Function: Adducts the thigh and also takes part in flexing the tibia, turning the leg outward
Long adductor
located on the anteromedial surface of the thigh.
Start: The superior ramus of the pubis is below the pubic tubercle, lateral to the gracilis muscle.
Attachment:
Function: Adducts the hip, flexes, and rotates it outward
Short adductor
a small muscle of the medial thigh muscle group.
Start: Body and inferior rami of the pubis
Attachment: Medial lip of the linea aspera of the femur
Function: Adducts and flexes the hip
Adductor magnus
It is the widest and largest compared to other muscles of the medial group. It lies somewhat deeper than the adductor longus and brevis muscles, outside the gracilis muscle.
It begins with a powerful short tendon from the lower branch of the pubis and the branch of the ischium. The muscle bundles, diverging fan-shaped downwards and outwards, are attached by a wide tendon along the entire length of the medial lip of the linea aspera of the femur. Part of the distal muscle bundles passes into a thin tendon that attaches to the medial epicondyle of the femur
Start: Branch of the ischium, ischial tuberosity
Attachment: Medial lip of the linea aspera of the femur
Function: Adducts the hip and rotates it outward
Quadriceps femur
occupies the entire anterior and partly lateral surface of the thigh. Consists of four parts:
Start:
2. Vastus lateralis muscle – Intertrochanteric line, greater trochanter, lateral lip of the linea aspera of the femur, lateral intermuscular septum of the femur
3. Vastus medialis – Medial lip of the linea aspera of the femur. Medial intermuscular septum of the thigh
4. Vastus intermedius - Anterior and lateral surfaces of the body of the femur, lateral intermuscular septum of the thigh
Attachment: Base and lateral edges of the patella. Tibial tuberosity
Function: Extends the tibia at the knee joint, the rectus muscle flexes the thigh at the hip joint
Triceps tibia
It consists of two muscles - the gastrocnemius (superficial) and the soleus (deep). Each of the three heads of the muscle (2 from the gastrocnemius and one from the soleus) has its own origin.
Start:
Calf muscle:
Lateral head - Femur above the lateral condyle
Medial head - Femur above the medial condyle
Soleus muscle - attaches to the head and upper third of the body of the fibula along its posterior surface, as well as to the line of the soleus muscle of the tibia.
Attachment: Common tendon (Achilles) - the tubercle of the calcaneus, a tendon arch stretched between the tibia and fibula.
Function: Gastrocnemius - Flexes the lower leg and foot
Soleus - Flexes the foot
Anterior tibial
located on the outer side of the front part of the leg and occupies 2/3 of the space between the tibia and fibula.
Start: Lateral condyle, lateral surface of the tibia, interosseous excavation of the tibia
Attachment: Medial cuneiform bone, base of metatarsal bone
Function: Extends and supinates the foot, and with a fixed foot, tilts the lower leg forward
Upper posterior serratus
the muscle of the third layer of the superficial back muscles, located under the rhomboid muscle.
Start: Spinous processes of VI-VII cervical and I-II thoracic vertebrae, nuchal ligament
Attachment: II-V ribs, outward from the corners
Function: Raises the II-V ribs, participates in the act of inhalation
Lower posterior serratus
accessory respiratory muscle. Located at the junction of the thoracic and lumbar spine.
Start: Spinous processes of 9-12 thoracic and 1-2 lumbar vertebrae
Attachment: four bundles to the lower edge of the outer surface of 9-12 ribs.
Function: Lowers 9-12 ribs, participates in the act of exhalation
Spinal erector
It is the most powerful and longest muscle of the back. Along its entire length, it fills the depression on the sides from the spinous processes to the corners of the ribs. Heading upward, the muscle is divided into three parts: the iliocostal muscle (1) is located laterally, the spinalis muscle (2) is located medially, and the longissimus muscle (3) is located between them.
Start:
Iliocostal muscle from the posterior part of the lateral sacral crest; near the corners of the lower five or six ribs; near the corners of the lower five or six ribs.
Spinalis muscle begins from the spinous processes of two or three upper lumbar and two or three lower thoracic vertebrae; from the spinous processes of the upper thoracic and lower cervical vertebrae.
Longissimus muscle starts from the posterior surface of the sacrum, the transverse processes of the lumbar and lower six to seven thoracic vertebrae; from the transverse processes of four to five upper thoracic and lower cervical vertebrae.