TFL Tendinopathy

A tensor fascia lata (TFL) tendinopathy is an overuse injury of the muscle and tendon at the front/side of the hip. The TFL tendon attaches to the front of the pelvic crest and extends to the outside of the knee. Overuse can lead to pain at the front and side of the upper leg, sometimes radiating to the outside of the knee.

The TFL plays an important role in hip flexion and stabilising the upper leg during movement.

How does TFL tendinopathy develop?

Tensor fascia latae (TFL) tendinopathy usually develops gradually and is typically the result of an imbalance between the load and the load-bearing capacity of the tendon. When the load exceeds the tendon's capacity, the risk of overuse and injury increases.

With repeated loading of the TFL, pressure accumulates. The tendon tries to adapt to this, but this only succeeds if the tissue is strong enough and has sufficient time to recover. If one of these conditions is lacking, the body reacts with an inflammatory response in the tendon. This reaction is a warning that the tendon is overloaded.

The recovery process requires an approach that involves:

• temporarily reducing the load
• implementing targeted exercises to strengthen the tendon
• gradually increasing the load-bearing capacity

This approach can help the tendon recover and significantly reduce the chance of recurrent complaints. It is important to take the body's signals seriously and support the recovery process step by step.

When the tendon becomes overloaded, it usually goes through two phases:

• Reactive phase

With a sudden and heavy load, the tendon reacts by thickening and becoming painful. In this phase, it is important to temporarily reduce the load so that the tendon can recover.

• Phase of structural change

If the load persists, the structure of the tendon changes. It remains thickened and may feel stiff. Specific exercise therapy combined with a reduced load is essential in this phase to make the tendon stronger and more functional.

Correct diagnosis and a targeted approach for each phase are crucial to effectively treat the complaints and prevent further damage.

Overuse of the TFL can lead to symptoms such as:

• Discomfort during activities such as walking, running, or prolonged standing
• Pain at the front and side of the upper leg
• Radiating pain to the outside of the knee

One usually also experiences discomfort when flexing the hip, lifting the leg, driving, getting in/out of a car, getting up from a sitting position, walking, etc.

Treatment for TFL tendinopathy may include the following elements:

• Adapting load and lifestyle
• Specific exercise therapy
• Injections

We will discuss with you which treatment option is most suitable based on your specific situation and needs.