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.

@scgraham

@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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@scgraham Yes, a lot of medical massage therapists are certified in myofascial release by the John Barnes training methods. That's the important piece, that it is the John Barnes training. you can search for providers at https://myofascialrelease.com/find-a-therapist/
Go for it! I think you'll be glad you did. John Barnes does a lot of self treating every day as part of his life.

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@gobigorgohome

Itbsnaps. Very curious? Did you have a Conformis Custom Knee Replacement?

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Why? Is Conformis known to create this problem?

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I was willing to let Time help with my ITB issue but now have a catch in knee cap walking in and out of the pool and when trying to get up from chairs. Also pain behind knee mostly when sleeping. Still can’t do stairs. Have been icing and no PT for a week. Sleeping and driving still an issue. Seem to be losing a little range of motion. Tkr was May 8th
Thanks for listening.

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Hi @dickiedo – I'm sorry to hear that you've gotten that catch in your knee in addition to the ITB issues. At this point it's been more than 4 months and I, too, would have hoped that by now you would have gotten some relief. As I recall, you were going to try myofascial release. Did you try it and if so, did it help? I may have mentioned that acupuncture gave me some relief when I was recovering from both of my TKR's. Is that something you would be interested in trying?

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@debbraw

Hi @dickiedo – I'm sorry to hear that you've gotten that catch in your knee in addition to the ITB issues. At this point it's been more than 4 months and I, too, would have hoped that by now you would have gotten some relief. As I recall, you were going to try myofascial release. Did you try it and if so, did it help? I may have mentioned that acupuncture gave me some relief when I was recovering from both of my TKR's. Is that something you would be interested in trying?

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Hi @debbraw and @dickiedo I have tried one session of myofascial release for the tight band feeling that I have had right below my knee since my TKR in Oct 2017. I don’t know whether my problem is caused by scar tissue, fascia problems, or nerve damage, and neither does any medical professional I have consulted. It will take several sessions to know if this will work. It was very intense and painful. Too soon to tell if I am on the right path. If it doesn’t work, guess I can eliminate one of the possibilities of this daily 24/7 pain. Will keep y’all posted. Waiting to hear from anyone else who has good results with this treatment.

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@debbraw

Hi @dickiedo – I'm sorry to hear that you've gotten that catch in your knee in addition to the ITB issues. At this point it's been more than 4 months and I, too, would have hoped that by now you would have gotten some relief. As I recall, you were going to try myofascial release. Did you try it and if so, did it help? I may have mentioned that acupuncture gave me some relief when I was recovering from both of my TKR's. Is that something you would be interested in trying?

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Have not tried MFR as of yet. Meeting with new PT next week to discuss. Saw PA this morning. Clicking and catching of knee cap caused by scar tissue node which is catching on patella. Will require surgery to remove. Nothing major. In an out same day. Can’t be done until 6 months out from TKR. As for ITB they gave me cortisone to reduce inflammation. hopefully all this will help.

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@debbraw

Hi @dickiedo – I'm sorry to hear that you've gotten that catch in your knee in addition to the ITB issues. At this point it's been more than 4 months and I, too, would have hoped that by now you would have gotten some relief. As I recall, you were going to try myofascial release. Did you try it and if so, did it help? I may have mentioned that acupuncture gave me some relief when I was recovering from both of my TKR's. Is that something you would be interested in trying?

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Official name for catch in knee cap is “patellar clunk”. Cause is scar tissue build up that catches.

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@scgraham

Hi @debbraw and @dickiedo I have tried one session of myofascial release for the tight band feeling that I have had right below my knee since my TKR in Oct 2017. I don’t know whether my problem is caused by scar tissue, fascia problems, or nerve damage, and neither does any medical professional I have consulted. It will take several sessions to know if this will work. It was very intense and painful. Too soon to tell if I am on the right path. If it doesn’t work, guess I can eliminate one of the possibilities of this daily 24/7 pain. Will keep y’all posted. Waiting to hear from anyone else who has good results with this treatment.

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@scgraham – I just hate hearing that your pain is 24/7 – and that it has been going on since 2017. Wishing you better luck if you continue through a few more sessions to give it more of a chance.

@dickiedo – I'm glad you found out what was causing the clicking and that it can be done fairly easily. At least by November or so, that part of the problem should be out of the way. Does the cortisone give you relief from the ITB?

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@bonzobear72

I had my rt knee replaced Dec 4th 2018. This one is being a bear. I have been diligent with therapy, go to the Y everyday plus my stretches. I can't get my range past 100. The calf muscle and the one behind the knee are swollen and tight. I am staying in therapy for straight aggressive stretching. When I walk or try to pull my knee in to bend I keep feeling a catch. I release, straighten and feel a "pop" and than I can complete my pull in bend. It also happens when I walk. HELP! My left knee was a dream compared to this. I ride the bike, do the ARC (gazelle), step-ups with a weight, and all the stretches. Any advice is welcome!

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Along with ITB issues I now have patellar clunk. Knee catches when straightening getting up etc. saw PA last week said I need surgery to have scar tissue removed so knee cap does not catch. Anyone have this procedure done. Had cortisone to relieve ITB inflammation. No help yet. Been 5 days. No more swimming due to catching.

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I had the surgery to remove scar tissue sorry to tell you but it's a waste of time. Doesn't help

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@kneeproblem

I had the surgery to remove scar tissue sorry to tell you but it's a waste of time. Doesn't help

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Did you try anything else or do you still have same issue.

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@debbraw

@scgraham – I just hate hearing that your pain is 24/7 – and that it has been going on since 2017. Wishing you better luck if you continue through a few more sessions to give it more of a chance.

@dickiedo – I'm glad you found out what was causing the clicking and that it can be done fairly easily. At least by November or so, that part of the problem should be out of the way. Does the cortisone give you relief from the ITB?

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2nd visit with new PT. Included MFR along with aggressive massage for ITB and scar tissue. Tough but feel it was worth it. Also applied KT tape to stabilize ITB. Am sleeping better at night since cortisone but still can’t lay on right side.

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@dickiedo

2nd visit with new PT. Included MFR along with aggressive massage for ITB and scar tissue. Tough but feel it was worth it. Also applied KT tape to stabilize ITB. Am sleeping better at night since cortisone but still can’t lay on right side.

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@dickiedo – Wow. That doesn't sound comfortable but it does sound worthwhile! Good for you. When I was having trouble with sleeping it helped if I would bend my knees and pull them forward toward my chest. Have your tried bending? Does it bother you that you can't sleep on the right side?

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@scgraham

I am 19 months post TKR surgery. The surgery went well. I have great ROM. But, from the beginning I have had a tight band feeling just under my knee, and a compressed feeling in my calf muscle. Feels like I have on the tightest knee sock imaginable with a tourniquet for a top band. I was prescribed gabapentin, didn’t help. I went through PT 3x trying different things to treat this, including astym and dry needling. I still have bruised areas on my leg and it’s been 7 months since the last session. My surgeon and PT have not been able to explain the what or why of this phenomenon. But was told at my one year appointment that there was a good chance I would just have to live with this. It takes a great deal of mental energy to rise above this pain to have a productive day. I am a 65 yr old female. Anyone else out there have any information or tips for dealing with this?

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I wanted to reply to you as today I went into see my OS as I am now 6 weeks post op for a TKR. I have been is severe pain since my surgery and it was getting worse since I started Out Patient PT so I called as I can’t sleep, the pain is a dull ache, throb, and some sharp pain all coming from below the knee cap, behind the knee, along the side of my calf and thigh. My Surgeon told me after seeing an X-ray and examining me that I have IT Band Syndrome, I mean this pain brings me to tears. I think he felt so bad for me as this was my 6th surgery, 3 Cervical neck, 1 Back surgery and I first had a Meniscus tear repair that was a failure. He suggested that we try Cortisone injections in the areas that were so painful. It has been 10 hours and the pain is finally subsiding. He told me to rest my knee, ice it and elevate it. I was wondering if your pain finally went away as having to live with chronic pain is much harder then most people understand as I do with my neck pain. I feel sad reading your story when you stated that it takes so much mental energy to rise above the pain, I can relate so much as I try on a daily basis to do just that. I go to pain management for my chronic neck pain, but this TKR has really got me down. I am praying everyday that This to, shall come to pass, I pray that there will be a light at the end of the tunnel. My 36 lb. dachshund pulled me down with her leash 11/2/2017, I had my first knee surgery in January 2018, I lived in constant pain, it was so much worse from the surgery so having no choice, I went to another surgeon for the TKR, it took 48 hours in the hospital to get my pain under control, it was hell and I was forcing myself to do the PT from day one. I was told my range of motion is very good, I think that I over did myself and that is what caused the IT Band Syndrome. I read that sometimes you can go beyond where you should and cause an injury to those bands. I am hoping that the Cortisone will help me as there is no way I want to go in for anymore surgeries. I just wanted to touch base and see how you are doing after all this time has gone by. I really do hope that you were able to get out of pain. Thank you for sharing your story, God Bless you.

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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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