IT band - surgery?

[amyzilla]

Hey everyone, I know IT band questions have come up on this forum a lot, but I haven't seen surgery mentioned. Sorry if this is a repeat. I've been dealing with IT band syndrome for the past five months or so (maybe longer, but I didn't realize what it was at first).

To backtrack, I was in a bus accident about a year and a half ago and most of my injuries were to my right leg. As a result of injuries and surgeries, my knee has gone through a lot of stress. I had a couple of screws put in the lateral part of my knee (about an inch above my kneecap) to anchor a rod in my femur. A couple of months later I had surgery to trim my torn lateral meniscus. After that, I had the screws taken out of my knee, and later I had an ACL recon. According to my surgeons, I make scar tissue like crazy, so as you can probably imagine, there's a lot of junk in there now.

I started having problems with my IT band when I began rehab after the ACL (I hadn't noticed it much before then). Since then I've been doing everything I can think of to try and alleviate this problem. I'm on prescription anti-inflammatories, I take glucosamine supplements, I use heat and ice often, and stretch a few times a day. At my therapist's recommendation, I'm "taking it easy" as far as exercise goes. My therapist used iontophoresis, but that didn't help. I don't overpronate. I switched knee braces from a Townsend to a Donjoy because it was irritating my knee. I stopped wearing the brace alltogether because the Donjoy wasn't much better. My knee feels slightly better without the brace, but still gets inflamed. I can't walk more than a few blocks without being in pain. I can't walk up/down stairs, and even as I'm sitting here it's aching.

So here's my question: I've heard that surgery is an option for IT band syndrome sufferers when all else fails. Does anyone have any experience with this, or know anything about that kind of surgery? It seems to me that going in again would just create more scar tissue and wouldn't help, but I don't know. Before I think about going that route, does anyone have any ideas of other things I can try?

[PrincessGruntyPuffs]

Hey amyzilla, I had IT Band syndrome as well, and I had surgery on it back in '03. It went really well and I haven't had a bit of pain from it since.

[Vinman]

2 things

1 the innury to the lateral part of your knee is almost definitly connected to this. I'm wondering if the fractures and subsequent surgery with screws has changed the shape of the lateral femoral condyle which would in turn effect how your ITB functions.

Second, obviously the amount of scar you produce is a factor here and likely related to the above.....

no advise to give on the surgery sorry, but to me it is no wonder conservative therapies have not helped you so far.

[mel221]

One last thing to try is strong massage along the length of the IT band. The stretching and foam roller didn't work for me. During my physical therapy, the only activity that helped was deep massage along the IT band. I ended up buying the quad - action percussion massage and use it every other day.
http://www.amazon.com/HoMedics-PAQ-3...751711&sr=1-14

This has greatly helped and I can once again walk up and down the stairs without knee pain.


I also do single legged deep knee bends to strengthen the muscles.

[amyzilla]

Thanks for the replies, everyone.

PGP: it's nice to hear from someone who actually had it done. I have a few questions for you: how long did you deal with IT band problems before deciding to go under the knife? What caused your IT band problems? What was the recovery like? I'm guessing it's a fairly minor surgery.

Vin: I agree that the side of my knee is probably shaped a lot differently than it used to be, so I think my IT band just doesn't move smoothly anymore. I'm no doctor, but I think if I were to have surgery, it would probably be different than the usual IT band surgery. This site talks a little about the surgery. I'm hoping my doc could scoop out some of that scar tissue and maybe smooth things down a bit. I have an appointment with him in a couple of weeks, so I'll talk to him about it.

Mel, thanks for the tip. I have done some massage but I haven't been very good about that because it hurts so much. I have not tried a roller yet. I'm a little hesitant to try that because I hear it hurts, and my knee is very tender. But I'll give it a try before deciding to have surgery.

[PrincessGruntyPuffs]

The funny thing is, it came on really quickly. Like you, I'm a scar tissue-making machine. I have a congenital defect in both of my knees....patellar tracking disorder. So in '03 I had a knee scope for a meniscus tear (1 of 6 so far, ugh), a lateral release, and the IT band surgery since I was already going under the knife for the other stuff.

So if I had IT band syndrome only, we probably would've done some other therapy to try to heal it first, but they decided to fix it while "trying" to fix my patellar tracking problem.

Anyhow, since I was healing from 3 different things at once, I didn't really notice how long it took the IT thing to heal. All of it healed within a month though, and I was pretty happy about that.

The surgery involved making a 2 inch cut in my leg at the bottom of the IT band, scraping out all the dead scar tissue crap, and grinding down the bone so it would regrow and reattach itself to the IT band. It sounds awful but it really wasn't that bad.

[amyzilla]

I suppose I should post an update, although there isn't much to say yet... I saw my knee doc yesterday and he scheduled an MRI for me. He said he thinks my problem is just due to tight muscles, but he wants to check for any more cartilage damage or muscle tears. I'm not sure he really believes me about my level of pain (which has been getting worse daily). He told me that I'm just bound to hurt after having so many injuries, and it'll get better eventually. That doesn't explain why it's getting worse, though.

Most of the pain is right next to my kneecap (on the lateral side) and around what I think is the tibia condyle. I'm also noticing more pain around my hamstring tendons and my fibula (which was fractured in the accident). And everything in between is really sensitive. I guess I'll just have to wait and see if the MRI shows anything.

[altagirl]

Mel, thanks for the tip. I have done some massage but I haven't been very good about that because it hurts so much. I have not tried a roller yet. I'm a little hesitant to try that because I hear it hurts, and my knee is very tender. But I'll give it a try before deciding to have surgery.

I agree with this. I woke up one morning at 3am in excruciating pain. I was absolutely convinced I tore my lateral meniscus because I could barely weight my leg, it was super painful to move, etc. And it was so sudden onset. And after a few hours of googling, I tried a few IT band stretches and voila, the pain subsided. (Not totally by any means, but enough to convince me that was the problem). So I do as much stretching as I can, but the one thing that REALLY helped was a hot stone sports massage. I went to a massage therapist who specializes in sport massages, but also does hot stone stuff and she dug those hot stones into the IT band and it really helped. Mind you, it hurt like hell at the time, but it did wonders. The roller helped some too, but it really is excruciating. I did it at PT and half the time my PTs were like "um, you're not actually resting any weight on your leg, you're just doing a side plank..." It's so hard to not cheat and really do that, but if you can tolerate it at all, it helps. And I guess I'd at least try all of those types of things before resorting to surgery again. I was going to say "It can't hurt"... but I guess its actually the opposite. It's pretty much guaranteed to hurt while you're doing it, but hopefully it will help in the long run!

[amyzilla]

Thanks for the advice, AG. My therapist doesn't want to do anything until we get the MRI results back. As long as nothing shows up in the MRI, I'll talk to him about doing some stuff with the roller. Sounds like it hurts, but it probably won't be so bad compared to some of the other stuff I've been through.

[splat]

orthobionomy.

[amyzilla]

Well, my MRI results look good, other than mass amounts of scar tissue everywhere. My surgeon said he could scope that scar tissue out, but it could grow back just as badly. He said he wouldn't recommend that, at least not yet. He told me to wait and it'll get better. I'm getting pretty frustrated because my pain level plateaued a couple of months ago, and since then it's been getting a lot worse, despite me doing everything "right". I have PT on Thursday, so I'm going to ask my therapist about rollers, hot stone massage, or anything else he can think of. I really just want to get back to the gym again... I've lost over 10 lbs since surgery in September, and I'm sure most of that was muscle

[cberry]

There seems to be plenty of good advice for ITBS on this forum and wondering if I could get any suggestions. I’ve been dealing with ITBS for 5 years now- having given up running entirely and having cut back on my skiing. A summary of my injury:

-Developed ITBS in both hips in 2001, worked with trainers daily with hot bath, stretching, ultrasound, pool sessions, followed by ice bath. Recovered in 3 months and went back to running.

-ITBS came back to both hips, then migrated to both knees, in 2002. I worked with trainers as in 2001 but saw no improvement after 3 months. Upon graduating from school I lost access to trainers but continued stretching and resting for another 3 months. I returned to running 6 months after the injury but pain quickly resumed, so stopped running after 1 month.

-In 2003 I started on Celebrex, stretching, and deep tissue massage. The massage wasn’t covered by insurance and was increasing inflammation, so I quit after 3 months. Continued to Celebrex and stretching, things improved slightly but pain never subsided. In 2004 I developed gastritis from the Celebrex so quit that.

-Since 2004 I haven’t done much- stretching as much as I can and getting the occasional massage but otherwise just not being as active as I would wish.

I have a constant dull pain in both knees. I can ski hard for a weekend or even a week-long trip, I can hike with a light backpack for 5-6 hours, I can jog across campus if I’m running late for class, and I can do a light bike trip or seated rowing session, but all of these will increase the level of pain in the knee, and I since 2002 I haven’t attempted any sustained activity such as regular running or skiing.

A lot of people recommend the foam roller, but I’m wondering if this would make things worse as the deep tissue massage did. The idea of surgery is tempting after 5 years but I’m wondering if this works for all patients? Otherwise kind of running out of ideas.

[Arty50]

I don't have IT band issues, or at least I don't feel like I do until I get on the roller. Holy fuck! That thing is like a medieval torture device. It feels super good afterwards though. So I'd try that route. The roller is a really good way to release tension in there.

[altagirl]

What stretches are you doing? Have you tried yoga?

[amyzilla]

Wow cberry, I thought I had it bad. If I were you I'd see about getting another opinion, especially since it hasn't gotten better over time.

An update on my knee: I went to physical therapy last week and mentioned to my therapist that my knee popped worse than usual when I was doing my exercises at home. He asked me a bunch of questions and then realized I'm having patello-femoral problems. I don't know if this is in addition to IT band stuff, or if this is what the problem has been all along. Anyway, he watched me walk around barefoot and noticed that my heel isn't moving properly (it's stiff from having dislocated my foot) and so he thinks that's a big contributor to the knee problems. He tried some knee mobilizations on me and realized my patella isn't moving much at all! Since then, I've been doing a lot of work on it, and it seems to have loosened up a little. It also seems to be feeling a little better.

[splat]

You could have a tibia override, a mispositioning of the bottom of the tibia over the foot bones. It will track all the way through your body, causing misalignment of everything above.

An orthobionomist can fix it in two minutes. My old girlfriend kate fixed Punani's after it haunted him for two years. I fixed yogachick's based on what I learned from my own tibia getting displaced. You guys prolly figure I'm blowing shit with my references to orthobionomy. Too bad. It fukkin rules.