IT Band Lateral Knee Pain After Knee Replacement Surgery
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- Опубликовано: 9 фев 2025
- Knee to Know Ep. 52
IT Band Lateral Knee Pain After Knee Replacement Surgery
In this episode we talk about IT Band pain or the pain along the lateral outside part of the knee. We discuss why this is common after knee replacement surgery and what you can do to manage it effectively.
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My lateral knee pain has gone ,starting to feel much better now.thankyou for all your video,s they definitely made a positive contribution to my on going recovery.
Happy to help!
Great video. I have developed exactly this problem following my knee replacement on 9/28/2023. This was one of my main sources of trouble soon after surgery when if I tried to sleep on my non-operated side with the operated knee bent I had extreme pain and popping on the lateral side of the operated knee. After watching the video it makes sense, since my original knee had mostly collapsed in the lateral compartment with very little space. So the IT band would have shortened to adapt to that over the years.
Now at 10 weeks post surgery the pain is less but I can make it pop any and every time by pressing my foot to the floor while sitting in a chair (or car) with the leg bent. I know it is the IT band because if I press lightly on the IT band above the knee or directly on the joint line the popping doesn't happen. This area of the knee also gets painful when trying to go down steps foot over foot as the operated leg bends and picks up weight whilst the good leg steps down to the next step. I assume that is added tension making the IT band too tight.
This is one of the main issues I have in my recovery at this point but the video gives me some hope and a new focus on hip and glute strengthening. I was doing that in PT but mostly now I have just been walking and indoor cycling. Even though the pain is much less now than immediately post-op it is still a PITA and I really hope it resolves over time as you suggest it will.
Thank you for watching and sharing your personal experience. IT band syndrome can be thought of as a friction syndrome or pressure. Friction as the band moves over the bone and other structures, and pressure on underlying structures when there is increased tension on the IT band. Knee flexion, usually about 30 deg increases tension on the IT band and this in combination with the weight through the leg is probably why stairs are causing increased pain. As you continue to heal and recovery inflammation will continue to decrease and building strength will help provide stability to the knee joint, decrease overall sensitivity and decrease pressure through the IT band and underlying structures. This definitely takes time for the structural adaptations to the tissues to occur. Best wishes to you!
That’s interesting about the effect of massage and foam rollers on IT band pain. Almost counter to what most people say to do when there’s IT band pain.
Yes it is… there is a big industry of foam rollers, massage stick, balls, guns… when really you may be irritating that area more than you are helping it.
@@KneeReplacementTherapists Thanks. I’ll quit using foam rollers for my IT band. Do you recommend using foam rollers for the calf and quad muscles after TKR?
@@slundgr This is perfectly ok... using the foam roller on the muscle bellies as you noted and the glutes and hamstrings can be a good management strategy for pain and soreness.
I read somewhere online that the IT band is thick and tough. stretching it is like trying to stretch a tuck tire. just not gonna happen.
Thanks for your advice on this topic. Currently experiencing this at week 5 of TKR. I appreciate your tips on what to do about it.
Glad it was helpful!
This has been going on since my knee replacement 5 months ago . I’m fairly active and had good flexibion from the first week . I experience swelling every day especially in the afternoon or evening. Is the pain in the back of my knee from the surgeon cutting the ACL ? Not sure that they actually did that and I’m not sure why they do it . Things aren’t going as easy as I expected but I hear some stories that are much worse. Always working on strengthening. I used to play a lot of basketball so I have arthritis in my right foot . My surgery was in the left knee . Never had lateral knee pain before. My problem was in the medial part . I enjoy your videos .
Thank you for this video! It explains my "clunking" and pain/burning in the left knee 6 weeks post bilateral TKRs. The right knee is nowhere near as painful. I've not had a decent night's sleep yet since surgery but now I know what the clunking and burning pain is I can stop worrying and focus on recovery. Strangely, walking is mostly pain free. Its everything else that hurts; sitting, standing, lying down, sleeping!😆 Thanks so much for tjis clear explanation!
You are very welcome! It sounds like you are experiencing a lot of common symptoms early on after surgery. It does get better slowly with time and persistence. Best wishes to you in your continued recovery!
Thank you!😁
Thanks for your advice and encouragement, I really appreciate this talk on lateral knee pain, something which I have, and now understand better thanks to you.❤
You are very welcome, thank you for watching! Glad you found the video helpful!
That makes a lot of sense to strengthen that area.
Yes, I agree! Thanks for watching!
It would be nice to see where you are pointing to on your body as you describe the locations, maybe even a full skeleton dummy. Thank you
Appreciate the feedback, thanks for watching!
Thank you so much for sharing this information
Glad it was helpful!
I am 10 mo post op RTKA and 6 mo po LTKA. I’ve had textbook recovery with a 135 deg flexion on both knees. My IT band was cut bc I had a severe valgus deformity on the R. I just started having pain on the lateral R side of my knee. My surgeon suggested IT band stretches. I read through the comments other viewers had and I saw the exercises you suggested. I swim 4 days a week with water aerobic classes and then I swim laps. I’ll add the bridges, clam shells, and the other exercises and see what happens. Thanks this was very informative. My surgeon is great but after X-ray and reviewing the films and examining my knee he said everything was great but didn’t give as much info as you did. Think what caused the pain is I starting walking steps for exercise. May not have been the best option.
Thank you for sharing your personal journey. I’m glad overall you are doing well after two surgeries. You are probably right that adding the walking may have caused your pain. This is a great form of exercise but it may be your muscles and tendons just need some time to adapt to the new activity level. I would try decreasing the walking some and then slowly build back up as tolerated… in addition to the exercises noted. Best wishes to you!
Hi Peterson Asiyah is here this video is very encouraging to me I have pain on my lateral side of knee I am very much worried about this and I am planning to go to the surgeon but I see your video I understand that it will take time I have to continue my physical activity and exercise. As you know I had my knee surgery six months ago, so now have to wait .
Hi Asiyah. Yes, it can take a long time to have a complete resolution of pain and symptoms so giving it time and continuing with your exercises is a good plan at this point. If you do have any concerns, increased intensity of symptoms, or new symptoms don't hesitate to reach out to your healthcare provider for more individualized assessment and treatment.
Thank you so Peterson your answer is very encouraging God bless you.
Viewed a lot of advice and explanations, this is the best.
I appreciate your kind words. Thank you for watching and I'm glad you found it helpful.
Thank you for this information. I'm on week 6 after my 3rd knee replacement this time on the left hand side. I have more pain, specifically what I call nerve pain, then on the others. They want to do a manipulation here soon. I don't bend well and I don't zero well. The IT band problem is new and it's just always here. I wake up after an hour of sleep with absolutely burning leg, excruciating pain. I can offset it a little bit by walking around which I did last night for half an hour and then in and out of bed for the rest of the night to relieve pain because I could not get comfortable at all. This even with two 10 mg oxy still per day. I don't know how to get rid of the nerve pain and I am so over it I don't even know anymore how to take the pain and I'm totally hysterical about it like nervous mental breakdowns. But your it presentation gave me some explanation and I will not massage anymore and use my massager on it.
Sounds like you are really having some difficulties in your recovery, I'm sorry to hear that. I hope this video gave you some helpful advice, and I hope you start to feel some relief of your pain and symptoms soon.
Katia comforting hearing your experience because I’ve been feeling the same especially at night waking up multiple times disturbing my mental health not being able to get relief or sleep. Saw my surgeon today and said it was my IT band …mine is snapping very painful. He recommended exercise which brought me to this video. Gives me hope…knowledge is good helps to redirect our focus….we’ll get through this!
Thank you for your videos, they are so helpful….
You are so welcome!
Thanks 🙏
You are very welcome!
This is what I have. Only 2 weeks after TKR. I have to hold or press around the fibula head when I bend my knee while the band slips. It’s so incredibly painful. Keeps me from progressing. 😢
Sorry to hear that you're dealing with this issue. Please keep working with your PT and update your doctor if the pain persists or worsens. Wishing you a smoother recovery ahead!
Thank you for this informative video,lam going through this lateral pain ,after t.k.r. and just need reassuring l will get better.lam 5 weeks after surgery. An in pain.
You are welcome... For the vast majority of people this pain will decrease as the soft tissue around the knee and leg adapts to the new knee
I have this - 8 months after TKR, can’t even lay on my left side, and pain is from the knee to the hip. Hurts to bend the knee also. Had other knee done 6 months ago and no problems, feels normal, never hurts.
Sorry to hear about your pain. Hopefully, this video provided some useful tips and advice to help manage what you're dealing with. Let me know if you have any further questions, thanks for watching!
This information is very helpful. I had my total knee replacement surgery about 4.5 months ago. Your videos are empowering!
Thanks for the info, my question is how long this ITB pain should last? I had TKA of left knee in March of 2023, and just had my right knee TKA in March of 2024. ITB pain started 8 weeks after my left knee replacement, and 3 weeks after my right knee. My left knee still has some ITB pain, although it has dropped a bit with my lack of activity during the right knee surgery/early recovery. The ITB pain in my right knee is pretty constant, and like the left is pretty strong (4-8 out of ten). I was in good shape from bicycling and targeted exercises prior to both surgeries, and my doctor said after my 6 week visits that I'm in 99th percentile for flexibility and strength after the TKAs. I'm 67 and otherwise active and healthy. Both massage and stretching have been given by my PT as helpful, as well as strengthening exercises of the hips and knees/legs. I feel like the pain has really hurt my recovery in both cases and not sure what to do or expect. My main goal is to get back to bicycling.
Thanks for the question. In terms of timeline there is going to be a lot of variability. Milder cases of ITB syndrome can resolve within a few weeks, but more severe cases can take a number of months or longer. The massage and stretching may help temporarily but for long term recovery really focus on staying active including strengthening of the hips and glutes and also make sure your you are doing things with good alignment and mechanics. In rare cases conservative treatment does not work and more invasive treatments such as cortisone injections may be required.
@@KneeReplacementTherapists Thank you for the response, that is helpful. I've been doing the hip strengthening with my current PT for a month, she also provides some message and cupping on the ITB. I'm also focused not to limp or favor either leg and my PT says mechanically I'm sound.
Greetings. I appreciate all the time and effort you put into these videos. I am 2 years post TKR of my left knee (Jan 2023). I have very good ROM (0 to 135 or more). I still experience symptoms which are consistent with ITB syndrome. My doctor used the term Patello-Femoral syndrome. During normal walking/stairs, my knee feels "stretchy" like a bungy, but is not too painful. Doing things like squats (just a 90 degree bend) increases the discomfort level to moderate pain. I have been to three physical therapists, and done my exercises religously. I have tried massage therapy, and accupuncture. I experience some partial, temporary improvements with these programs, but nothing permanent. I am quite active (cycling in the summer, power walking, boot camp, weight training). Wondering if it could be scar tissue, and if you have any suggestions/thoughts. Thanks in advance.
Thanks for watching and your comment! Pain and the body can be complex and often multiple factors play a role in the pain and symptoms you experience. The pain you are experiencing at this point can be described as persistent or chronic pain, which is really a different animal than post surgery pain. I recommend looking up and reading about pain science in particular related to persistent pain. You can also look of cognitive functional (behavioral) therapy and potentially someone who practices this near you. Briefly, your pain is less likely due to something structural or mechanical and more likely due to negative nervous system
Adaptation and response to certain activities such as squatting or stairs. Hope this helps!
Thank you for this information. 9 weeks out and suffering greatly with the IT Band. Wondering if you can provide video or advice on how to deal with foot and ankle pain after TKR where the new joint corrects past valgus. Foot is very sore/tender from different walking stress, although PT tells me my gait is good. Sometimes can barely walk because of the foot pain! Mostly on the outside of the foot and outside ankle.
Thank you for watching. Here is a video of an exercise you could try: ruclips.net/video/KmaCLKtzijE/видео.html
You can also try any balance related exercises such as standing on one foot. These exercises engage a lot of the muscles in the foot and ankle and over time can build strength and stability. Likely it will just take some time walking and moving with different alignment and stresses through your body because of the valgus correction.
@@KneeReplacementTherapists thank you so much! Trying that exercise now!
Thanks for the info. This may be too much info, but I had a TKR on my left knee in Jan. 2020 and have had chronic IT Band Syndrome since then. I have had two Surgical releases done on the IT Band, a year apart and have had almost no relief. I have stretched and exercised religiously, I continue to work with physical therapists. I have wondered if my implant is too big. The X-rays show good alinement. I do have a very tight hip and am working on that too. It has been very rough way to go, if my leg stays bent very long I have pain from my knee to my hip. This makes it very hard to sleep. I am just struggling to get relief. It’s a shame because I have great range of motion now, just can’t get The IT Band to cooperate. Sorry for the long post.
Hi, J Young. Thank you for sharing, and I am sorry to hear about your difficulties. Do you have any back pain? Possibly some of your symptoms are stemming from your low back and nerve compression. Did you have these issues before surgery at all? or on the other leg? This may help determine if it is specifically an issue with the replacement or more of a focus on good strength motor control at the hips/low back.
@@KneeReplacementTherapists Thanks for responding, I never had any IT Band issues before my TKR. I have had mild lower back pain, and some slight degeneration. They tried a steroid injection under X-ray, and also metal allergy testing but it didn’t help. I do get IT Band pain in my other leg on and off. My therapist thinks my TKR leg is a little longer than my other leg, causing that to flare up. I’m 9 weeks out from 2nd surgical release. It has helped a little but not nearly enough. I still am getting tightness, pain and rubbing. I have swelling on the lateral side of the TKR that has never gone away. I am wondering if my TKR might be a little too big. I have an upcoming appointment with the surgeon. So hopefully we can figure something out. It has been rough 1.5 years. I can’t do the things I want like take long walks, bicycle and hike. It gets to be mentally hard because I have worked very hard to recover so I can stay active. Again thanks, I apologize for the long post and all the info. I’m just struggling to find the cause of this issue.
@@jyoung5594 Usually these situations have more than one factor playing a role. It may be the replacement is bigger than your natural knee joint was, also the mechanics through your hips and legs may be such that you may be prone to these pains. Hope you are able to find some relief soon.
@@KneeReplacementTherapists Thanks, for taking the time and being kind enough to respond. You have a great channel.
I can relate to what you say. going from sitting to standing is the worst!
I am four months out from a tnr and my hip pops with every step and my knee feels like a burning sensation often on the side. What are your thoughts on how long you should wait before having IT surgery?
It sounds like you're dealing with some challenging symptoms.
It really depends on your specific situation and the severity of your symptoms. Generally, it's important to give your body time to heal and undergo physical therapy, which can address many issues. Discuss your symptoms and concerns with your orthopedic surgeon-they can provide guidance on whether surgery is necessary and the best timing for it.
Thanks for the info...very informative. So I am 4 1/2 months out from left knee TKR. Many things are going well....walking a lot, even some easy 1 minute jogs, but I have had the IT band problem for over 3 months now. It doesn't affect normal activity ie walking running, yard work etc. It doesn't hurt constantly, I just get this periodic snapping of the band across the bone on the outside of the knee and see stars for a few moments, and it definitely happens a few times when cycling so I have put that on hiatus. I've been getting massage and going to the gym. But my theory is that since the knee is still a little swollen compared to my good knee, that the band is not tracking right and hopefully will improve if and when the swelling subsides. Does that sound right? Thanks!
Hi Steve, swelling can certainly be a component to what you're experiencing. With knee replacement surgery, the volume of the knee joint does increase as more normal joint positioning and alignment are restored. This can place increased tension on the IT band that the tissues may not have adapted to yet. Swelling can further exacerbate this volume change. Often, with time the IT band, just like all the other soft tissues around the knee begin to adapt and pain and symptoms diminish. To help this process, you can focus on staying active (like it sounds like you are), focus on exercises for strengthening your glutes and hip muscles, and focusing on good alignment and mechanics throughout your hip, knee, and ankle with all exercise and movements. Hope this helps!
Thanks for the video BUT!!! I’m three months out and I’m having more pain now. I was told that I have a IT band tear that might be causing the pain, swelling and grinding. I had to stop PT do the pain and nothing was getting better.
What are your thoughts?
If you are have this severe of symptoms I definitely recommend consulting with your surgeon. Although these symptoms can still be present at 3 months out, it sounds that they are more significant than what I would consider within the realm of normal recovery. An orthopedist can provide a personal assessment and hopefully point you in the right direction for management options.
I am now 7.5 months after TKR and see no reduction in the pain (burning sensation on lateral knee area). My pain is as described plus some popping/snapping towards the lateral front lower part under the knee. I am very active, walking, doing aerobics with modifications because it doesn't bend much. Going down stairs or hills causes popping/snapping and pain.
If the popping and snapping is accompanied by increased pain I would recommend contacting your surgeon. There is the risk that your replacement is loosened or compromised in some way. That's where I would start.
@@KneeReplacementTherapists doesn’t t feel loose , popping is soft tissue rubbing under knee cap where Itband connects just in from of outside part of knee. ITBAND and feels like Riad rash at times. I am seeing doctor in 3 days. But have complained about it and am told all is good.
Forgot to mention, surgery caused pain in the butt also to flair up either piriformis or sciatica that pain is still present but much lessened.
Im about to have the IT band surgically cut with Z plasty.. nervous ..it started about 6 months post op now at 14 months post op.
Best of luck with your upcoming surgery, I hope it provides relief from your pain and symptoms!
Hello, on average how long does it take after knee replacement for the ITBS to improve?
It fluctuates tremendously but if I had to give you a rough estimate you want to think 2-3 months at a minimum.
What role can the lateral collateral ligaments play in lateral knee pain?
The lateral collateral ligament provides stability to the lateral part, or outside of the knee. It is possible this ligament can be strained or torn through a traumatic event / injury. Depending on the alignment and mechanics of your leg and knee there may be more or less stress through this ligament. If you have had a specific incident / injury it may be worth further assessment of this ligament, but otherwise there are no significant considerations outside what was discussed in the video. Thanks for watching!
Does this also apply to MENISCUS TRIMS ? I've had so much lateral discomfort and it's 9 months after surgery . Had lateral tear trim
and nothing seems to help . Thanks .
Yes, the majority of the information in this video can be applied to your circumstances as well. Hope it helps!
my TKR was 8 years ago. i have had lateral knee pain ever aince . my surgeon called it tendonitis offered me a steroid which i declined because i have bad adverse reaction. then he moved 200 miles away. yep haha me. i have done the stretches and rolling as advised by a friend who is a PT. no improvement. seeing new doc next week.
Sometimes the stretching and foam rolling will actually exacerbate symptoms than help. I would consider exercises and activities to strengthening the muscles of your hips and pelvis to provide good alignment with movement and activities. Some examples are supported squats, step ups forward, lateral, clamshells, bridging, side lying leg lifts, and more.
Why not use some models or mock-ups
Good feedback, will consider if I make an updated video on this topic.
Does this syndrome cause a clicking feel at the knee. I feel when I move my knee past the 30 degree mark it clicks and causes pain I’m 4.5 months out ok TKR.
This is a possible sensation to feel with this syndrome. It may also be described as a popping or snapping sensation. It typically is the tendon moving over the bone / prosthetic components as you bend the knee. You may just need more time for the soft tissue to adjust as it is likely very tight around this area, it may be something to do with the body mechanics at your hip, knee, and ankle causing increased tension and discomfort, or it may be an issue of prosthetic fit or size.
@@KneeReplacementTherapists good to know because I get this almost a year out. When you wait too long for theTKR, and you think you are strengthening your muscles, like I was doing, you might be doing nothing if your muscles have "gone to sleep". All my muscles were not working correctly. In fact I had such calf pain (felt like bone pain) I started getting massages which really helped my calf muscles start to function again. Have learned a lot about my body in this year of recovery!! Thanks
I really think there is a nerve problem like there is nerve being constricted. It’s not just pain on the lateral part but swings around sometimes towards the around an inch or so under the knee cap. A lot of times it’s not just pain but tightness which is extremely uncomfortable
Ok, do you think it may be some sciatica-related symptoms? Any pain in the low back, hip, or thigh?
No no pain in hip or thigh. For a while had some back pain but that went away a long time ago
@@joansobsey4081 ok, well it’s difficult to provide more specific advice. I would recommend consulting with a physical therapist and they can do a thorough assessment of your symptoms and set you up with an exercise and management program.
Yes!!! I have a dull ache in my whole leg and it just keeps getting tighter and tighter no matter what I do. I was told it's scar tissue, I know one thing I had a knee replacement so I would not hurt 24/7. The Dr. Is ready to do my other knee but, Im not sure I am.
@@KneeReplacementTherapists Thank you very much for your advice. I was really scared of my knee pain. After seeing your videos i got the confidence. My TKR surgery is 7 months old, but still I am having a lot of stiffness in my knee . Sometimes it buckles. Sometimes I will have pain also. Some kind of discomfort will always be there. How long will it continue like this ?
Lesions on knee after knee replacement
Sorry to hear about this
show us the parts of the leg you are talking about
Can do, look out for a video soon!
Please, at this point anatomy lessons are a waste of time. I came here for stretches, exercises or massages that might help.
I understand. Stretching and massaging although may feel good in the immediate term, are not typically the best answer for these symptoms. The main thing is giving your body time to heal and adapt to the new knee. For exercises, I recommend on strengthening your hip musculature to take pressure off your lateral knee. Some good ones are bridging, sit to stands, supported squats, clamshells, side stepping, step ups, straight leg kicks laterally in standing or up toward the ceiling in a side lying position. Hope this helps!
loll we are not seeing anything except the microphone. No one told you that yet?
🙃🙃