Struggling with IT band and to rebuild muscle after TKR

Hi @chickenhaslips (love the username and would love to know the back story behind that choice 🙂

I was going to point you to these 2 related discussions, but I see you've already participated in both.
- Has anyone had a tight band feeling after total knee replacement? https://connect.mayoclinic.org/discussion/has-anyone-had-a-tight-band-feeling-after-total-knee-replacement/
- Swelling and stiffness, 3 years after total knee replacement https://connect.mayoclinic.org/discussion/swelling-and-stiffness-3-years-after-total-knee-replacement/

Sounds like you still don't have answers. Does this pain only happen when you are active? By the way, I love that you're cycling and working out. Seems like the pain isn't holding you back. Does stretching help? Do you still do PT?

Hi Colleen,the chickenhaslips story is something funny that happened in Med school years ago.My TKR was 10/1/2019 .Uncomplicated.There was a significant loss of quadriceps
loss .I’ve almost got it back.Problem is this IT Band discomfort on the side of my knee.There’s much less discomfort going up the leg to the hip .However,if I work out with leg presses and other leg exercises for the next week the knee feels stiff and there’s discomfort over the head of the tibia.But I need the exercise to regain strength.I can still golf ,ride a bike easily for an hour.If I wear a knee sleeve it’s so much better.The doctor wants me to exercise to build up the quads .He feels “ balancing “ the muscles will help the IT Band .I don’t stretch much.Go to Y and ride the stationary bike for 40 minutes.
I think it’s slowly getting better but it’s been a year and a half.And when it’s bad I do walk straight leg .Just not right yet

Chicken, I appreciate the further explanation. Clearly motivation is not an issue and you're not a stranger to exercise and hard work. For that reason, I modified the title of this discussion to encourage others like @contentandwell @artscaping @bonzobear72 @babette @pittkd @ellerbracke @kwk01 @mikec @ehlerhardie to join in and share their experiences about regaining muscle and returning to physical activity.

It sounds like things are getting better. I understand the frustration of patience. It took more than a year for me to regain full use of my shoulder after an injury (no surgery). It seemed to take forever. Stay the course.

After 2 shoulder repair surgeries, 1 knee scope, and 1 TKR, I can attest that it takes 9 months to a full year to get close to normal. It helps to be in great shape before going under the knife.... sounds like “chicken” is doing good in that respect. While after each procedure I was off opioids within about 8 days, driving after 2 weeks (yes, with shoulder in sling), and playing tennis 4 months after 1st -right- shoulder surgery, and traveling in Austria with full size suitcase, in the middle of winter, 4 months after TKR (getting in and out of trains is a b....ch with snow on ground). BUT: to really feel whole again took the better part of a year, each time.

Good afternoon and a huge bow of gratitude @ellerbacke for what for me is close to reality. This race to expect ROM improvement quickly and approval to go down on your knees in time to get the garden planted......they were not goals of mine. Take your time......work with your surgeon and PT’s. Make sure everything has healed before engaging in physical endeavors beyond the limit of your capabilities. Don’t promise to do your stretches and then head to the coffee shop.

My experience with my surgeons and PT folks has been supportive and respectfully compassionate. My post surgery issues have been mild to non-existent. I have only experienced one clinician who just wanted to cut and sew and get out. Other than that he was an excellent surgeon and highly respected by his colleagues. As patients it was strongly suggested that we schedule all follow up with his PA.

I have a note or two for you Chicken. Your IT band.....with pain on one side. Have you given thought to MFR (Myofascial Release) therapy. The IT band itself...while made of fascia may be too thick for MFR but the connective tissue may be restricted in those areas and can respond.

You say you need the exercise to maintain strength only to have to deal with discomfort from the exercise. It sounds like your priorities as a human are overriding the feedback your body is giving you. You know what...that is part of being human.

May you be free,safe, and protected from inner and outer harm.
Chris

Hey Chicken. I am almost 3 months out. I had horrible IT band pain. Prior to surgery I dropped 10 pounds and was riding my Peloton hard for hour rides. I may have got a little cocky thinking recovery would be a breeze. I am so glad PT identified that it wasn’t really my knee that was causing the pain but rather my IT band (I did no stretching prior to my surgery). I have discovered stretching and yoga and both have helped tremendously! Also used Voltaran and my PA said to give that another whirl. Anyway, I still have a lot of soft tissue swelling. I did buy a percussion massager as PT could massage my IT band and give me relief. It also has helped. If I go hard on my bike, it swells. I am hoping after a year, I will back to normal or better.

@chickenhaslips I have had two TKRs, the R in 2013, the L in 2017. I wouldn't say I have pain in either but I do get some discomfort on the outer side of my R leg when I have exercised a lot. My biggest complaint is my flex, which is about + or -120. I exercise a lot but even now I do feel discomfort in my quads after a lot of exercise. I would not say pain, just discomfort and fatigue. I reached the point I am at fairly soon after my TKRs. I guess I do have some awareness of my knees most of the time, they will never be the same as natural knees but I just accept that and live with it.

Is your doctor aware that you are doing leg presses? I was told both by my doctor and my physical therapist to not do them, and I have read that in articles about good and bad exercises also. It can put too much pressure on your spine according to the article I read. The doctor and therapist did not specify why I should not do them. To me, they appeared to be an ideal exercise but apparently not, at least not for me. Perhaps your situation is different and your doctor recommends them. 🤷

My doctor loves the recumbent bike for exercising the knee, which I see you are doing, and he also loves pool jogging. During the pandemic, I haven't been able to go to my health club so I have been doing a lot of exercise videos, many of which have jogging in place and that does not seem to be a problem. I will never be able to do the stretch at the end where the person bends their leg up toward their butt. I can get nowhere close to that.

I hope you are able to move forward with some relief soon. If you do find a solution I hope you will share it, I'm sure there are many who could also find it useful.
JK

@chickenhaslips I came across your entries about IT Band issues from a year ago and wonder where things stand now. I am 16 months post TKR on my right leg (19 months on left) and the pain on the lateral side right below the knee is still considerable. It started within weeks of the surgery and has been unrelenting. I have had months of MFR therapy, acupuncture, traditional therapy and nothing helps. We have tried genicular nerve ablation and traditional cortisone injections. Nothing provides long term relief. Two MRI’s show thickening of the IT band. My surgeon, from a top NY medical center, is reluctant to release the band but doesn’t expect much improvement. The tightness and swelling at the end of a normal day is continuous and icing provides only momentary relief…same for prescription strength Voltaren. Low dose prednisone did nothing. I exercise and work with a trainer. Are you in any better place? @goodpeople