IT band syndrome after knee replacement

Posted by Faith M @collielady, Jul 26, 2018

I had both knees replaces last month. Right on 6/4 and left on 6/13. The right knee has done great. But the left has had issues. This week both PT and the surgeon's nurse said I have IT band syndrome. PT put a strip of K-tape down the side of my leg and suggests ice massage to the area. And the nurse showed me a stretching exercise to do. I am wondering if others have had this problem and how it was handled and how long it took to get better. The pain behind my knee prevents me from raising my leg while walking.

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JK | @contentandwell | Nov 5, 2019

In reply to @ilovedaisies "I’ve only just found this board, happening upon it, while doing a google search. I’ll need..." + (show)

@ilovedaisies

I’ve only just found this board, happening upon it, while doing a google search. I’ll need to take the time to read everything, but thought it might be helpful to share what, so far, I’ve learned. I’ve had an IT band + issue.

I had knee replacement surgery in late July, and while the bend of my knee and mobilization was incredible — they’d never seen anything like it, there was awful pain while lying in bed, attempting the knee ‘slide’ exercise... Something would feel like it was catching — which could be detected by hand — and the pain would drive you through the roof.

Moving on to outpatient PT, however, thankfully, it was suggested not to aggravate it, so slides and some squats — basically any exercise that exacerbated it — were stopped. So, my movement really progressed forward. Soon, I could go up the stairs, too, as well as walk outside with hills, etc.. (Initially, coming down hills would aggravate things...)

While the PT thought it had to be my shortened IT band — I’d been knock-kneed for about three years — I’d learned thru research that the fibula bone in the lower knee, too, was involved. With manipulations by a D.O., whom I’d happened to be seeing, fortunately, for an hip “upslipped innominate” which, also, interfered with walking — everything that happens to be seems to be rare — he noticed that my fibula (we’ve two bones in our lower leg bone) which usually should slip freely back and forth, had resistance moving posteriorly. He mentioned a procedure I could share with PT which might help with that.

More research, however, revealed there was a strapping procedure which could be done — that I shared with both the PT and the D.O — that would help hold the fibula into that posterior pocket. The video had shown that, over time with disuse, the pocket could have filled up with scar tissue, keeping the fibula from being able to slide back-and-forth freely.

It worked! No longer would I feel the pain the the outside, lower knee pocket, when going downhill. Taped, instantly, I had no pain. Without it, I’d struggle, frequently. With repeated tapings, over time, the fibula would move ever more freely. On last exam, it was found that the pocket seems to be open, allowing full freedom of movement. And I have nary any pings of pain in that outer knee area, with normal walking. However, if I try to do a slide, Strangely, as originally, or descend stairs, the pain returns. And here I’d thought, mechanically, the pain might have been due to the tight IT band trying to slip over the fibula, when it had been held, unnaturally, always forward.

Which is what has me researching patellar tendon knee straps, today, so I can apply them myself. Researching those, though, I’ve learned about the IT band syndrome which can follow knee replacement surgery, in addition to being a runner’s knee. My new goal, now, will be to learn more about this syndrome. But I thought it might be helpful to those who might be happening the same front side, outer lower pain that I did, to become aware of the fibula, the taping and how it might help. Three months on, now, it’s time for me to be focusing on descending stairs...

I’d be nowhere near where I am in totally natural movement — with the exception of that slide and descending stairs — if I hadn’t discovered this technique. Hoping some may find it helpful...

Linda

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Hi @ilovedaisies and welcome back to Connect.
Your research really proved fruitful. That's great that you are able to do more now than you could as long as you tape it. I am unclear if you now continue to have the improvements without taping or if you still have to tape. If you do still have to tape, is there any possibility that in time the taping will result in a permanent improvement or do your physical therapist and DO think you will always need to do it for relief?
I have had two TKRs but have been very fortunate in not having any of the problems that many have. I am sure many will be very interested in trying this out themselves. I felt my biggest accomplishment after my TKRs was the stairs -- not having to hold on! I had an injury this past summer though and am now back to holding the rail.
JK

kayjd | @kayjd | Dec 26, 2019

Has anyone on here with IT Band Syndrome following a knee replacement found long-term relief or recovery? My husband had his 2nd FKR on 10/31/2019 and is getting worse each day. (First FKR was great experience.) Eight weeks out and he's gone from 115% bend to almost unable to bend. Not because of the joint, per se, but because of the severe lateral pain starting just above his knee and the even worse pain behind his knee. It wakes him every 15-30 minutes at night, and last night he woke up yelling. A cyclist and former runner, he is diligent with his therapy. His DR and the PTs are all scratching their heads, but we live in a rural area so I'm not surprised that they might not have seen such a reaction to the FKR... yet. So success stories? Suggestions? I'd like to point his heath team in new direction(s).
Thanks for any input!

dellie | @dellie | Jan 31, 2020

In reply to @kneelady "@collielady @tanner82 I am wondering how you are getting on now and if your problems are..." + (show)

I had a total knee replacement Sept 30, 2019. During my in-hospital therapy & subsequent therapy, I was told I was doing fantastic. I could bend my knee 30+% and that seemed to be the focus. After about a week, I started with severe pain on the outer side of my knee when I bent it. It felt like it caught on something & just took my breath away. My ortho doc & PTs all thought it would go away, but it’s getting worse. I’ve had cortisone injections in the joint outer side of my knee where the IT band is & at the top of the IT band; both with no relief. Is doing stretches, heat, ice, pain gels & roller treatment all with no relief. I just had a nerve block @ L3,4 & 5, with no relief. My ortho doc thought I might get relief if it was an impingement on my sciatic nerve. No help. I am looking for anyone who has experienced this after your knee replacement & what you have done for relief.

perryl | @perryl | Feb 1, 2020

In reply to @dellie "I had a total knee replacement Sept 30, 2019. During my in-hospital therapy & subsequent therapy,..." + (show)

I had a half knee replacement on the medial side in August 2018 . I have full range of movement .But I have pain on the lateral side above knee below and behind ,and struggle to walk far and this is the only activity I can do . Had MRI and was told I have tendonosis in the popliteus tendon . Had a steroid injection for this with no affect ! Also have a tight IT band and found when I was doing all the exercises for this made it worse ,so stopped doing them for a while and it has improved .But when I walk too far get the pain in the back of knee then it tends to start all the other lateral pain . I wear tubigrip on my knee it is not tight just slight support and find this helps more than anything also rub volteral gel on am and pm . My knee is worse now than before I had it done ,except It doesn’t give way !!!

killerbees | @killerbees | Feb 3, 2020

I worked with my Accupunture doc and after five treatments the bands subsided. My surgery was Feb 3, 2019 and knee still is not right. I am suspect that the peronel nerve was not impinged during surgery since its so easy to do. After the knee replacement I started having foot drop on same side as knee replacement. Other ortho's want me to wait another year, but I am seeking three opinions.

willieblack | @willieblack | Feb 4, 2020

In reply to @ptbradshaw "Has anyone had trouble with their IT bands being tight and causing pain after TKR? I..." + (show)

What facility performed the surgery?

ptbradshaw | @ptbradshaw | Feb 4, 2020

In reply to @ptbradshaw "Has anyone had trouble with their IT bands being tight and causing pain after TKR? I..." + (show)

Louisville Orthopedics, Dr Malkani

ptbradshaw | @ptbradshaw | Feb 4, 2020

Has anyone had trouble with their IT bands being tight and causing pain after TKR? I had right TKR in October 2018. Now I’m getting ready to have TKR on my left knee. My right knee continues to hurt but my surgeon says there is absolutely nothing wrong with it. All I can think is that my IL bands need stretching. Any comments?

Justin McClanahan, Moderator | @JustinMcClanahan | Feb 4, 2020

In reply to @ptbradshaw "Has anyone had trouble with their IT bands being tight and causing pain after TKR? I..." + (show)

Hello @ptbradshaw. I moved your discussion and combined it with one titled, "IT band syndrome after knee replacement," and updated your message to say IT rather than IL like you requested. If you are replying by email, you can click on VIEW & REPLY to see the new location of your post and discussion and so you can read through some of the older posts made on the same topic.

JK | @contentandwell | Apr 5, 2020

In reply to @clvclv "Hello, I am new to this group and looking for other's experience with sudden pain on..." + (show)

Hi @clvclv Welcome to Connect. I have had two TKRs but never had what you are experiencing. Actually I also didn't realize that the IT band extended to the knee, I thought it was just in the hip area.
I wish I could give you some advice but as I said my TKRs both had no problems except only getting to about 120 degrees flex, more or less.
Have you spoken to your orthopedic surgeon about it? If so what does he or she say? Most physical therapists are very good but I pretty much rely more on my doctor.
I will be interested in hearing what your orthopedist does have to say.
JK

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