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.

@dickiedo

Have seen PA on two occasions. She stated it and takes time. PT etc. pain when trying to lay on left side sleeping. TKR was Right knee. Difficulty driving. Tried all positions. Painful applying brakes. Range of motion 0 and 115. swimming 3 times a week.
Nice to have someone with similar issue.
Tx

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Well WOW @dickiedo – for 3 months your ROM is great. And it sounds like you are doing everything you can do. Swimming is fabulous exercise. So so sorry that it is affecting your driving. None of us wants to have problems with that. Have you tried any of the alternative remedies – like for example, myofascial release, CBD Oil, etc? You know I'm not a doctor… and I can't recommend any of it, but I've read some good reports. I'm going to tag a few people who might be able to share their experience or give you some encouragement. @ChrisTrout, @mrhappy, @doodles418, @jenniferhunter @babette – Meantime, your TKR was right knee – when you are driving and have pain applying brakes, is it the extension that bothers you? And when you are sleeping on your left side, how does that trouble your right knee?

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@dickiedo, Greetings and good evening. It sure does sound like you are experiencing some pretty unwanted issues with your TKR. I had the very same thing happen. Everything was going along nicely….I was walking my 3 miles a day….and climbing up and down the river bank. All of a sudden kaboom! Unbelievable pain and limited mobility. I went back to my orthopedic surgeon. He was very concerned and jumped up and took me to X-ray. Everything looked very healthy. The implant was just like a fluid sculpture. He then told me in a very sad voice…"Chris, it's the fascia. I am so sorry."

I now know why he was so concerned. Chronic myofascial pain syndrome….is the official name. Pain city is my nickname for it. All of a sudden I was dead in the water…..and then I stumbled upon MFR, Myofascial Release massage treatment. It is only because of MFR that I am able to drive, to walk, to go out with friends, to attended play and concerts, to plays with my grandchildren and any other activity that healthy 77-year-olds with a new knee ought to be able to do.

To review the discussion on Connect follow this link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I think I would run, not walk, to the nearest MFR therapist to get an evaluation. Other contact information is on the discussion page. If you are unable to find such a person, please let us know and I will help you. My very best to you. May you be healthy and whole very soon. Chris

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@artscaping

@dickiedo, Greetings and good evening. It sure does sound like you are experiencing some pretty unwanted issues with your TKR. I had the very same thing happen. Everything was going along nicely….I was walking my 3 miles a day….and climbing up and down the river bank. All of a sudden kaboom! Unbelievable pain and limited mobility. I went back to my orthopedic surgeon. He was very concerned and jumped up and took me to X-ray. Everything looked very healthy. The implant was just like a fluid sculpture. He then told me in a very sad voice…"Chris, it's the fascia. I am so sorry."

I now know why he was so concerned. Chronic myofascial pain syndrome….is the official name. Pain city is my nickname for it. All of a sudden I was dead in the water…..and then I stumbled upon MFR, Myofascial Release massage treatment. It is only because of MFR that I am able to drive, to walk, to go out with friends, to attended play and concerts, to plays with my grandchildren and any other activity that healthy 77-year-olds with a new knee ought to be able to do.

To review the discussion on Connect follow this link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I think I would run, not walk, to the nearest MFR therapist to get an evaluation. Other contact information is on the discussion page. If you are unable to find such a person, please let us know and I will help you. My very best to you. May you be healthy and whole very soon. Chris

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@artscaping I have been posting here for 6 months about a post TKR problem I have had that I call tight band feeling below my knee. It makes my calf “feel” contracted all the time too. I am almost 2 years post TKR and at one year my surgeon told me I would just have to live with this. I asked many questions, and got no explanation or answers. So I turned to this forum looking for fellow sufferers and answers. This is the first time I have heard of MFR. I have good rom and my knee works great, it is just my below my knee and lower leg that hurts all the time and makes my leg feel leaden when I walk a lot. No over the counter meds touch the pain. I refuse to take more opioid based meds. I had concluded on my own that this had to be some sort of nerve damage. Could MFR help this sort of thing? Thank you in advance for any information. Desperate in Oklahoma.

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@artscaping

@dickiedo, Greetings and good evening. It sure does sound like you are experiencing some pretty unwanted issues with your TKR. I had the very same thing happen. Everything was going along nicely….I was walking my 3 miles a day….and climbing up and down the river bank. All of a sudden kaboom! Unbelievable pain and limited mobility. I went back to my orthopedic surgeon. He was very concerned and jumped up and took me to X-ray. Everything looked very healthy. The implant was just like a fluid sculpture. He then told me in a very sad voice…"Chris, it's the fascia. I am so sorry."

I now know why he was so concerned. Chronic myofascial pain syndrome….is the official name. Pain city is my nickname for it. All of a sudden I was dead in the water…..and then I stumbled upon MFR, Myofascial Release massage treatment. It is only because of MFR that I am able to drive, to walk, to go out with friends, to attended play and concerts, to plays with my grandchildren and any other activity that healthy 77-year-olds with a new knee ought to be able to do.

To review the discussion on Connect follow this link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I think I would run, not walk, to the nearest MFR therapist to get an evaluation. Other contact information is on the discussion page. If you are unable to find such a person, please let us know and I will help you. My very best to you. May you be healthy and whole very soon. Chris

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@dickiedo @scgraham My physical therapist told me it's common to have tight illiotibial bands in your legs and I can imagine that after knee surgery, that may get even tighter. All surgeries create scar tissue in the fascia and because fascia is a body wide web of interconnected tissue, it gets tighter. That also happens when you stop moving and you loose your flexibility. Then we sit too much and our hips get tight because of not standing and walking around, and all of that pulls on your lumbar spine. The psoas muscles connect from the spine to the pelvis and get tight. That does happen to me, and my physical therapist works on them. All of this body tightness can cause nerve compression because nerves pass through some very small spaces and between bones and ligaments. I have not had knee surgery, but I have had spine surgery and I need to stretch out the incision area when it gets tight. I have been doing myofascial release for several years before and after spine surgery and it helps me a lot. It is something to try, and you need to be patient while you work through layers that took years to form. @ scgraham I think MFR can help you. I have been able to recover from my surgery without pain drugs, and having done MFR extensively before surgery helped me recover better. I was doing MFR for thoracic outlet syndrome which is a compression of nerves and blood vessels under the collar bone which is close to the area of my surgery. There are also some syndromes that happen when the pelvis is out of alignment that cause sciatic pain. Here is a link. https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/ This link shows the muscles of the hips and pelvis and how it attaches to the legs. https://trainingandrehabilitation.com/causes-hip-pain-how-to-fix/ This link shows physical therapy techniques, and you should get clearance from your doctor or physical therapist as to what is right for you. MFR is gentle and similar to stretches done in Yoga by holding a stretch and waiting for the fascia to start to slide. Some doctors don't recognize the benefits of MFR work, but many do recommend it.

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@jenniferhunter

@dickiedo @scgraham My physical therapist told me it's common to have tight illiotibial bands in your legs and I can imagine that after knee surgery, that may get even tighter. All surgeries create scar tissue in the fascia and because fascia is a body wide web of interconnected tissue, it gets tighter. That also happens when you stop moving and you loose your flexibility. Then we sit too much and our hips get tight because of not standing and walking around, and all of that pulls on your lumbar spine. The psoas muscles connect from the spine to the pelvis and get tight. That does happen to me, and my physical therapist works on them. All of this body tightness can cause nerve compression because nerves pass through some very small spaces and between bones and ligaments. I have not had knee surgery, but I have had spine surgery and I need to stretch out the incision area when it gets tight. I have been doing myofascial release for several years before and after spine surgery and it helps me a lot. It is something to try, and you need to be patient while you work through layers that took years to form. @ scgraham I think MFR can help you. I have been able to recover from my surgery without pain drugs, and having done MFR extensively before surgery helped me recover better. I was doing MFR for thoracic outlet syndrome which is a compression of nerves and blood vessels under the collar bone which is close to the area of my surgery. There are also some syndromes that happen when the pelvis is out of alignment that cause sciatic pain. Here is a link. https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/ This link shows the muscles of the hips and pelvis and how it attaches to the legs. https://trainingandrehabilitation.com/causes-hip-pain-how-to-fix/ This link shows physical therapy techniques, and you should get clearance from your doctor or physical therapist as to what is right for you. MFR is gentle and similar to stretches done in Yoga by holding a stretch and waiting for the fascia to start to slide. Some doctors don't recognize the benefits of MFR work, but many do recommend it.

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Thanks for response. That’s first I’ve heard of MFR. Have new appointment with sports therapist next week. Observed him working on student athletes ITband issue so hopefully he’s aware of procedure. Will try messaging myself till then.

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@artscaping

@dickiedo, Greetings and good evening. It sure does sound like you are experiencing some pretty unwanted issues with your TKR. I had the very same thing happen. Everything was going along nicely….I was walking my 3 miles a day….and climbing up and down the river bank. All of a sudden kaboom! Unbelievable pain and limited mobility. I went back to my orthopedic surgeon. He was very concerned and jumped up and took me to X-ray. Everything looked very healthy. The implant was just like a fluid sculpture. He then told me in a very sad voice…"Chris, it's the fascia. I am so sorry."

I now know why he was so concerned. Chronic myofascial pain syndrome….is the official name. Pain city is my nickname for it. All of a sudden I was dead in the water…..and then I stumbled upon MFR, Myofascial Release massage treatment. It is only because of MFR that I am able to drive, to walk, to go out with friends, to attended play and concerts, to plays with my grandchildren and any other activity that healthy 77-year-olds with a new knee ought to be able to do.

To review the discussion on Connect follow this link.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I think I would run, not walk, to the nearest MFR therapist to get an evaluation. Other contact information is on the discussion page. If you are unable to find such a person, please let us know and I will help you. My very best to you. May you be healthy and whole very soon. Chris

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Will definitely research this process. Happy you found some relief. Will keep you informed as to my results.

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@contentandwell

@dickiedo Like @debbraw, I too have had two TKRs but not had that specific problem. For me 2 months was a huge milestone on my last TKR in October 2017, I was in some extreme pain often before that, pain that even brought tears to my eyes, and that scared me. My orthopedic doctor was on top of it though and seeing me every two weeks until the pain finally subsided, almost overnight! We are all different and all heal at different rates so I hope you will have the same thing happen to you, that suddenly the pain will be greatly diminished.
I was extremely determined that it would be better because my daughter’s wedding was quickly approaching. I don’t know if determination can help, but it can’t hurt!

By the way, have you tried putting a pillow between your legs when sleeping on your side? It really helps. I did it after my TKR and I’m doing it again while my fractured femur heals. The orthopedic doctor suggested it.
JK

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Tried pillows. No change. As soon as I’m on my side with leg bent the pain is there. Hard to get out of that position.

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@dickiedo

Tried pillows. No change. As soon as I’m on my side with leg bent the pain is there. Hard to get out of that position.

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@dickiedo, good morning, yes, the pain and position you describe is a mirror image of what I dealt with many times. The fascia is in layers and becomes restricted. Here is my only recommendation.

Arrange the pillow so that it is between your legs with the knee on top of the pillow. Place a large gel ice bag around your knee……after rubbing in a very good medical cannabis balm like Papa and Barkley’s Releaf Balm 3:1 CBD/THC. A 1:3 ratio is also for acute pain.

Settle in with your nighttime medications or just a half dropper of a 2:1 CBD/THC tincture. That’s it. I have had recurrent-bouts with that fascia and am now back walking again and protecting it with MFR and yoga stretches that you hold for 6 breaths on that leg,

If my day necessitates a lot of standing I use a knee compression wrap from The Mayo Clinic store in Rochester. I will get the brand for you if this is something you want to try. It sounds complicated, yet it is the only multi-faceted approach that works for me. A big plus is that my MFR therapist makes herself available because she knows it is critical to begin work on the knee ASAP.

May you be free of suffering today. Chris

REPLY
@jenniferhunter

@dickiedo @scgraham My physical therapist told me it's common to have tight illiotibial bands in your legs and I can imagine that after knee surgery, that may get even tighter. All surgeries create scar tissue in the fascia and because fascia is a body wide web of interconnected tissue, it gets tighter. That also happens when you stop moving and you loose your flexibility. Then we sit too much and our hips get tight because of not standing and walking around, and all of that pulls on your lumbar spine. The psoas muscles connect from the spine to the pelvis and get tight. That does happen to me, and my physical therapist works on them. All of this body tightness can cause nerve compression because nerves pass through some very small spaces and between bones and ligaments. I have not had knee surgery, but I have had spine surgery and I need to stretch out the incision area when it gets tight. I have been doing myofascial release for several years before and after spine surgery and it helps me a lot. It is something to try, and you need to be patient while you work through layers that took years to form. @ scgraham I think MFR can help you. I have been able to recover from my surgery without pain drugs, and having done MFR extensively before surgery helped me recover better. I was doing MFR for thoracic outlet syndrome which is a compression of nerves and blood vessels under the collar bone which is close to the area of my surgery. There are also some syndromes that happen when the pelvis is out of alignment that cause sciatic pain. Here is a link. https://trainingandrehabilitation.com/identify-treat-lumbar-plexus-compression-syndrome-lpcs/ This link shows the muscles of the hips and pelvis and how it attaches to the legs. https://trainingandrehabilitation.com/causes-hip-pain-how-to-fix/ This link shows physical therapy techniques, and you should get clearance from your doctor or physical therapist as to what is right for you. MFR is gentle and similar to stretches done in Yoga by holding a stretch and waiting for the fascia to start to slide. Some doctors don't recognize the benefits of MFR work, but many do recommend it.

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Thank you for answering, will read all these articles. I feel like there might be some hope. Just wondering if one or two releases will do the trick, or if it requires on going treatment.

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@dickiedo

Thanks for response. That’s first I’ve heard of MFR. Have new appointment with sports therapist next week. Observed him working on student athletes ITband issue so hopefully he’s aware of procedure. Will try messaging myself till then.

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@dickiedo As @jenniferhunter knows there are a number of at home MFR treatments you can do. Actually, my MFR therapist invited my partner to a session and taught him how to work on the knee. Most holds are from 3 to 5 minutes and are very gentle. You want to increase the fluidity of the fascia not tighten it up. Call on us…we are here for you. Chris

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@scgraham

Thank you for answering, will read all these articles. I feel like there might be some hope. Just wondering if one or two releases will do the trick, or if it requires on going treatment.

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@scgraham, The MFR treatment may take longer than you might expect. It all depends on the number of layers and the frequency of treatment plus the follow up that you do at home. You may want to go twice a week in the beginning. @jenniferhunter May be able to add her experience with a cranky knee. Be safe and protected today. Chris

Liked by scgraham

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@dickiedo

Tried pillows. No change. As soon as I’m on my side with leg bent the pain is there. Hard to get out of that position.

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@dickiedo When the ortho doctor suggested it after my recent femur fracture I could not even turn to my side due to the pain. The pain is gradually lessening though and I can turn to my side now. I could not stay that way though without a pillow between my legs. I alternate all night between sleeping on my back and grabbing the pillow and turning to my side. I can’t remember what it was like to sleep all night uninterrupted. That’s due to incontinence too, and a current UTI.
JK

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@artscaping

@dickiedo, good morning, yes, the pain and position you describe is a mirror image of what I dealt with many times. The fascia is in layers and becomes restricted. Here is my only recommendation.

Arrange the pillow so that it is between your legs with the knee on top of the pillow. Place a large gel ice bag around your knee……after rubbing in a very good medical cannabis balm like Papa and Barkley’s Releaf Balm 3:1 CBD/THC. A 1:3 ratio is also for acute pain.

Settle in with your nighttime medications or just a half dropper of a 2:1 CBD/THC tincture. That’s it. I have had recurrent-bouts with that fascia and am now back walking again and protecting it with MFR and yoga stretches that you hold for 6 breaths on that leg,

If my day necessitates a lot of standing I use a knee compression wrap from The Mayo Clinic store in Rochester. I will get the brand for you if this is something you want to try. It sounds complicated, yet it is the only multi-faceted approach that works for me. A big plus is that my MFR therapist makes herself available because she knows it is critical to begin work on the knee ASAP.

May you be free of suffering today. Chris

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Wil research MFR further. Maybe your other suggestions at a later time. Thanks

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@scgraham

Thank you for answering, will read all these articles. I feel like there might be some hope. Just wondering if one or two releases will do the trick, or if it requires on going treatment.

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@scgraham usually MFR is ongoing because you work through all the layers of tight tissue that your body built up over the years, and you need to continue doing stretches to maintain what you have achieved. The good news is that you can treat yourself at home after you learn what to do. You can't do everything because your PT can reach places where you can't, but what you do at home will help. Sometimes the first few appointments just scratch the surface.

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@jenniferhunter

@scgraham usually MFR is ongoing because you work through all the layers of tight tissue that your body built up over the years, and you need to continue doing stretches to maintain what you have achieved. The good news is that you can treat yourself at home after you learn what to do. You can't do everything because your PT can reach places where you can't, but what you do at home will help. Sometimes the first few appointments just scratch the surface.

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@jenniferhunter thank you for this explanation. One other question, can a massage therapist do mfr, or does it require a physical therapist? I am brimming with hope. Thank you.

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