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66 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 3 66 m a s s a g e & b o d y wo r k m a rc h /a p r i l 2 0 2 3 critical thinking | ANATOMY FOR TOUCH Anatomical drawings and dissection images often depict the iliotibial (IT) band as a two-dimensional "strap" on the lateral thigh, leaving us with an incomplete picture that doesn't exactly match what we feel beneath our hands. Broadening our understanding of this tissue to include a three-dimensional view of the deep fascia of the entire thigh, the fascia lata, can help us refine our touch and inspire different possibilities of how to approach it in our sessions. WHERE DOES IT LIVE? The IT band can be found within the deep fascia of the thigh, superficial to the vastus lateralis, spanning the entire distance between the iliac crest and the lateral condyle of the tibia, crossing both the hip and knee joints. Before we go into more detail about the IT band specifically, let's look at how deep fascia is organized as a whole. Beneath the skin and soft subcutis, a strong, thin membrane, rich in dense collagen fibers, fully envelops the limbs, covering all the muscles like a single sleeve or stocking. Generally called deep fascia, specific names are used based on region. On the lower limb, the deep fascia of the leg (below the knee) is named crural fascia, and the deep fascia of the thigh (above the knee) is named fascia lata (Image 1). The inner surface of this membrane forms walls or septa that dive to the bone, dividing groups of muscles into compartments. In the thigh, there are three septa, which separate the quadriceps, hamstrings, and adductors into three distinct compartments (Image 2). Fascia Lata: Home of the IT Band Broaden Your Understanding to Help Refine Your Touch By Rachelle Clauson and Nicole Trombley Fascia lata. Though the IT band is a well-known area of thickened fascia on the lateral thigh, the larger deep fascia membrane (of which it is a part) is less often represented in images. This image of the left anterior thigh with skin and subcutaneous tissue removed shows a rare view of the fully enveloping fascia lata covering the muscles like a single stocking. Image courtesy of AnatomySCAPES. com. 1 So where is the actual IT band in all this? This is where things get interesting. While all mammals have fasciae latae, only humans have IT bands. WHERE DOES IT COME FROM? Deep fascia in both humans and mammals remodels itself in response to load. However, the fascia lata is loaded differently in humans because of bipedalism. 1 Walking upright on two legs generates powerful forces directly into the fascia lata by the gluteus maximus, gluteus medius, and tensor fascia lata (TFL). 2 Regular and repetitive strain on the fascia lata initiates a remodeling response, slowly causing thicker, denser collagen fibers to be laid down, eventually leading to the development of your IT bands. Since your first steps, every stride, jog, hop, jump, and running leap has been loading your fascia lata, with

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