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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@autp17

Thanks for this information. I guess I just need to give it time and use my Stimulator unit a few time a day.

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Good morning @autp. It looks like you have tried and been responsive to suggestions from your providers. I have had similar issues post TKR. Let me see if this will have meaning. Since the IT band is a connective tissue composed of thick fascia, it just might be responsive to myofascial release therapy, MFR. I would like to invite @jenniferhunter to jump in here with her broad understanding of connective tissue and its responsiveness to Myofascial Release Therapy.

May you be free of suffering and the causes of suffering.
Chris

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@artscaping

Good morning @autp. It looks like you have tried and been responsive to suggestions from your providers. I have had similar issues post TKR. Let me see if this will have meaning. Since the IT band is a connective tissue composed of thick fascia, it just might be responsive to myofascial release therapy, MFR. I would like to invite @jenniferhunter to jump in here with her broad understanding of connective tissue and its responsiveness to Myofascial Release Therapy.

May you be free of suffering and the causes of suffering.
Chris

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Thanks, Chris. @autp17 According to my physical therapist a tight IT band is a common problem without having had knee replacement surgery, and she has recommended using a foam roller to me. I see @autp17 you've tried it and it was painful. It is uncomfortable for me too. The IT band passes over the grater trochanter and I found this post on facebook that described tightness and adhesions there as a potential problem from "The Body Mechanic, Inc."

"A lot of people get pain on the down side hip when laying on their side. In my experience, this is most often caused by adhesions around the greater trochanter. It serves as an attachment point for several muscles and is prone to a lot of restriction. While it won't clear the adhesions, rolling on a lacrosse ball AROUND the trochanter, but not on it, can soften things up enough to help."

Here is a link to the post that shows an illustration https://www.facebook.com/ActiveReleaseSonomaCounty
Here is their description of myofascial release. https://thebodymechanic.com/active-release-technique-blog/self-myofascial-release/

I have been doing myofascial release for several years with good success and it's been part of all the rehab I have done for thoracic outlet syndrome, spine surgery and my recent ankle fracture. When you lay on a foam roller, essentially you are doing this, but if that is too intense, find something softer or smaller, a small ball partially inflated, a pool noodle, a strap that you can wrap around your leg to pull against the skin or get a friend to push with their hands. Only go as far as you can without intense pain and hold it. You go to the barrier and wait. A PT does this by sinking their hands into your skin and pushing with a shearing motion and holding that pressure until the fascia begins to slide. You might have enough tightness built up that it will take several sessions before it starts to feel better. Surgeries create fascial scar tissue that contribute to this tight tissue. Perhaps working around the greater trochanter to start will begin to break adhesions between muscles. These are really painful, but when everything can move again as it should, it makes a big difference. Working with a PT skilled with rehab after knee replacements is good. If you try some MFR work, that might get better. They can do some Graston tool work too which pushes against the skin with curved metal tool to work the fascia. Sometimes they uses a cold laser to reduce inflammation.

Here is our link to our myofascial release discussion where you can find a lot of information. There is a provider search on the MFR website.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

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Thanks, I will look at your links and let you know how it goes.

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@autp17

Thanks, I will look at your links and let you know how it goes.

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@autp17, I noticed that you wished to a link to a video with your message. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the link you wanted to post is not spam, so allow me to post it here.

IT Band Exercises. Full Rehab Routine For IT Band Pain Relief.
https://youtu.be/SIsnV-RG7ME

This is certainly something I can use. Do you follow this routine regularly?

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Since my TKR 17 weeks ago, I have IT Band Syndrome and very little improvement. The pain is located on the outside of my right knee. I done 14 weeks of PT and no improvement. I am going to have a procedure named Active Release Technique (A.R.T). Did it work for anyone else?
Terri

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@autp17 You will see that I have moved your question into a discussion where members are currently discussing IT Band Syndrome after TKR. I did this so you could more quickly connect and get support. It look like you partook in this conversation before. May I ask if you had a chance to scroll through the past posts and read suggestions and experiences from members like @mhort1213 @contentandwell @perryl

May I ask how Active Release Technique is different from myofascial release? I believe that ART is an aggressive form of myofascial release. Is this your understanding as well?

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@erikas

@autp17 You will see that I have moved your question into a discussion where members are currently discussing IT Band Syndrome after TKR. I did this so you could more quickly connect and get support. It look like you partook in this conversation before. May I ask if you had a chance to scroll through the past posts and read suggestions and experiences from members like @mhort1213 @contentandwell @perryl

May I ask how Active Release Technique is different from myofascial release? I believe that ART is an aggressive form of myofascial release. Is this your understanding as well?

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@erikas @autp17 I'm sorry, but although I have had two TKRs I have no experience with IT Band Syndrome. I wish I could be helpful, but unfortunately, I cannot.
JK

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@contentandwell

@erikas @autp17 I'm sorry, but although I have had two TKRs I have no experience with IT Band Syndrome. I wish I could be helpful, but unfortunately, I cannot.
JK

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I am glad you didn't have this issue. It has been rough but I think I am on the right path.

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I too have IT Band Syndrome and my TKR was 18 weeks ago. I am using the tape which helps some but I found a Dr. That does Active Release Technique (A.R.T.). I have had one treatment and it has helped me. I will need to do at least 4 treatments but having improvements is a big deal for me. You need to check into this technique.
Terri

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@itbsnaps

@kneelady I had TKR on the right knee in Oct of 2018. I have snapping and grinding of my IT band on the outside of the knee. You can actually feel it when you put your hand on the side of the knee. Uncomfortable, and somewhat painful, during the day, but excruciating/piercing pain at night when I roll over onto my left side. Wakes me up from a deep sleep. I have been going thru this night after night since Oct. Extremely frustrated. I have done 2 PT tour of duties (8 weeks) with little improvement. My OS says I have an IT band issue. No kidding!. He wants to wait until the middle of May and give me a cortisone shot. I am not a surgeon, but this would only seem to mask the underlying issue. He said that if that didn't help he may have to scope me this fall. I can definitely feel a more pronounced profile on my new knee meaning the IT and will have to stretch more than before. I feel that I either have to get a new, less pronounced insert put to replace what is there, or have the IT band lengthened. You asked if anyone has experience lengthening via putting holes in the band. I have been on multiple forums and I can not see where anyone has answered that question. At this point, I do not trust anyone. I am nervous about cutting on the IT band in fear that I may introduce another issue. I hope someone answers your question as I sure would like to get some level of confidence in that procedure. This really blows. Not happy at all.

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Check into Active Release Technique (Art) it has helped me so far. I understand the issue is in the hips. I will do a least 4 treatments. I had IT Band Syndrome since September 8th.
Terri

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