Fascia Lata: An important structure often overlooked
As we look at how things are connected and how structures in the body influence each other, I can’t help but think that the fascia lata often gets overlooked in the process.
Most people are familiar with the fascia lata from the muscle Tensor Fascia Lata (TFL) – a flexor, internal rotator, and abductor of the hip, who additionally has the role of “tensing” the fascia lata (hence its name). And of course, everyone knows that the TFL connects into the IT-Band along with the gluteus maximus (and depending on what text you read the gluteus medius as well, as it has some connection into the gluteal fascia, which is the more superior thickening of the IT-band).
Fascia Lata and IT-Band
So just what exactly are these structures?
In a nut shell, they are really the same thing! The IT-band, located on the lateral aspect of our thigh, is really the thickest portion of the fascia lata.
The fascia lata is the sheath of fascia that envelopes our entire thigh and hip region. It connects everything together in that area and if you can wrap your head around this concept (no pun intended!) you would come to realize that muscles which are antagonistic to each other actually share a connection! Extensors are connected to flexors, abductors are connected to adductors, and external rotators are connected to internal rotators. This is a drastically different way of thinking from the way in which most anatomy courses are taught, where muscles have these specific origins and insertions and there is no connection between muscles which are antagonistic to each other save for the fact that contraction of one inhibits the other.
Attachments of the fascia lata
To get an appreciation for how large the fascia lata is, lets explore its connections:
- Coccyx
- Sacrum
- Crest of the ilium
- Inguinal ligament
- Pubic bone
- Ramus and tuberosity of the ischium
- Sacrospinous ligament
- Passes over the knee and becomes continuous with the fascia of the lower leg
Practical Application
Understanding the vast connection that the fascia lata has through the lower extremity, we can see that treating it in one region will have influence over other regions/muscles as well. In addition, this fascial structure is continuous with another important fascial sheath, the iliac fascia, which continues the fascial webbing from the thigh, up through the pelvis, covering the entire iliacus and psoas regions and up to the thoracic area.
Mabel Todd in The Thinking Body writes:
“The iliac fascia is near the diaphragm at its upper end, and in the pelvis is closely associated with the pelvic fascia and with the formation of the femoral canal and the femoral ring, while below it becomes continuous with the fascia lata of the leg.”
Todd continues, offering these words about one of the functions of the tensor fascia lata:
“The tensor fascia lata, the so-called “posture muscle,” aids in this controlling function by drawing the fascia lata tighter upon need, thus pulling the individual muscle groups closer together within their intermuscular septa. This action aids the femur to steer the body-weight back to center from its outward position.”
The fascia lata can affect many structures, both locally in the thigh and hip region and globally via its connection into other fascial systems. When attempting to enhance movement with various soft tissue therapy techniques, understanding all of the potential connections that whatever you are working on (muscle, fascia, skin, tendon, etc) has on other structures is important. Remembering that the fascia lata is not just located on the lateral portion of our thigh (IT-band), but rather offers a means of communication/connection for all muscles of the thigh, including antagonistic muscles, can help aid the treatment approach.
Patrick
patrick@optimumsportsperformance.com
References:
Gray H. Gray’s Anatomy. Running Press. Philadelphia, PA. 1974.
Todd ME. The Thinking Body: A study of the balancing forces of dynamic man. Princeton Book Company. Hightstown, NJ. 1937
Ober FR. The Role of the Iliotibial Band and Fascia Lata as a Factor in the Causation of Low-Back Disabilities and Sciatica. J Bone Joint Surg [Am]; 18:105-110. 1936.
11 comments
Excellent work. It is certainly difficult to conceptualize antagonists being connected based on traditional muscular anatomy, but there is always room for understanding things better.
Regards,
Carson Boddicker
Speaking of antagonists effecting each other, quite often when I foam roll, I get real high onto the rectus femoris regio and even by the TFL. When I get there, particularly the day after a leg session, I hold and actually feel a release by the glute max, med and piriformis area. I always found that interesting, and reading this just reinforces that. Good insight!
Patrick,
Your post reflects some of the topics a friend and I were talking about on Sunday. One thing to remember is the muscles also have a push effect on the fascia not just a pull, which is important with both the thoracolumbar fascia and fascia lata since they enclose muscles. I think it should cause a red flag in your head when you have a period of detraining (some slight atrophy) and a loss of stability and pain that were not present during the highest and most intense levels of training.
Thanks for the comments gentlemen.
Craig,
Good call! There is always a push and a pull and everything is a two-way street. I didn’t mean for this post to come of as “this is the only way to look at things”. It is just one way to look at things and one possibility. There are many more! Just like the two-way street model, I state in the article that we can affect other parts of the body, globally and locally, by treating the IT-band fascia, however, we can also treat something like the diaphragm or the iliac fascia and affect the IT-band fascia.
Thinking like this opens up an enormous canvas of treatment options. As our good friend Carson Boddicker states, “there is always room for understanding things better.”
Patrick
Patrick, have you been fortunate enough to attend a cadaver workshop for massage therapy? I hear once you actually get your eyes on all the layers of fascia/connective tissue you see the body in a very different way.
Colin, yes, I have been to cadaver lab. It is a great time!
Patrick
Good post, an great for bringing up Mabel Todd as source material. Another great source from the same era is Else Gindler and her Gymnastik.
I would only add that the list of connections goes on: down into the intermuscular septa to the femur, especially 1) the large wall that separates (and joins – see Huijing 2008 for the important concept of lateral intermuscular transfer through areolar tissues) the hamstrings from the quadriceps, starting from /with the distal attachment of gluteus (this connecting it vis=a the lat to the contralateral shoulder).
Also the connection of the ITB to the south: the fibularis longus – tib ant sling under the arch on the lateral side, and via the other ‘tensor fascia lata’ – the sartorius – into the pes anserinus (and thus indirectly reinforcing the MCL) on the inside. Recent research (on the road without the reference) also shows the criss-crossing fascia profundis just superficial to the upper tib ant works through the fascia lata to improve lateral stability at the hip. Actually, that’s my inference – the research actually showed that cutting this fascia in front of the tib ant (but not into the muscle) reduced lateral hip stability (in animals, of course – not the kind of thing we do with our clients).
Cheers.
Thanks for the reply, Tom! Great stuff as usual.
Keep up the good work and safe travels.
Patrick
There are a whole mees of great comments before mine but I will just add that I think most ITB problems are purely postural. If the pelvis is the correct position the ITB has a chance of aligning correctly. It is just that with everyone’s tucked pelvis there is no way for the IT or the TFL to find a good home.
Great post sir! Your perspective and experience are really helping me a better understanding of the martial art I train. This post is in perfect harmony with out conceptual view of the body, which we divide into yin muscles and yang muscles, but the western scientific specificty here helps me weaknesses in my knowledge of the anatomy.
On a related note, Colin brought up cadaver labs. There a great YouTube channel that has HD uploads of real human dissections. Not as good as the real thing of course, but it’s still a handy resource. Here’s the link – http://www.youtube.com/user/jono03#g/u
“I hear once you actually get your eyes on all the layers of fascia/connective tissue you see the body in a very different way.”
Boy is this an accurate statement!
Leave a Comment