Day 12

I've removed the final bandage today. The incision hasn't healed completely yet, there's some scabbing and light bruising there. The picture is here for those interested, but I don't think it's presentable enough to be displayed directly in the post just yet.

I've been icing twice a day since the sutures were removed. The swelling/hematoma decreases noticeably after icing. It would probably have been a good idea to use the ice during the time the old thick bandage was off for showers.

There is a new sensation from the knee. I feel a distinctive longitudinal line of tension midway between the lateral epicondyle and the patella, like there is a thin band stretched there that gets tight when I bend the knee under load. Could be that they had cut the IT band away from the fascia along that line during the operation, or it could be some scar tissue. We'll see how it develops.

The functionality is still slowly improving, though maybe not as quickly as in the first week. It's good that I'm about to start physiotherapy soon, it should help to kick start the recovery and keep it on the right track so I don't develop bad patterns of movement.

Day 10

The stitches are finally out! That feels a bit better. I can't really tell what the scar looks like yet as I have a new adhesive bandage over it, not to be removed for two more days; luckily, I can shower with this one on.

In other news, the swelling around the incision is actually the hematoma doctor told me to expect - I thought a hematoma would include more visible bruising for some reason. I told the doctor I wasn't really icing it so far since the thick adhesive bandage on it make it really hard for the cold to actually reach the site. He urged me to start using ice regularly now. Other things to look forward to are:

• Start physiotherapy next week to rebuild the quads.
• Free to start swimming next Wednesday.
• Free to start cycling and/or running in six weeks, so beginning of September. I can do very short runs or rides before, but nothing longer than 20 minutes.

Otherwise, the knee is improving slowly. I'm walking up stairs almost normally now, though it still hurts a little. I'm also going down stairs facing forward (no longer sideways), but with a sort of a hop-skip on the left leg to avoid the painful eccentric contraction. Still doing glute and hamstring stretches daily, but I've given up on hip flexors and TFL, it seems to hurt more than it helps at this time.

Day 8

I will be doing two day updates now, not enough is changing daily I think.

I had the bloated, swollen feeling in the knee again yesterday, but feeling just fine nothing today.
The knee is feeling better all around, the little pains during various movements are disappearing (for example, putting my feet up or down when sitting on the sofa). I'm going up stairs almost normally, though not all stabilisation and quad muscles are firing yet. Going downstairs is almost painless when going sort of sideways.

I've started going to the office for work this week. It feels better to change the environment a little during the day, plus the little extra walking should help with the recovery I hope.

The sutures are getting annoying, I'm hoping they will be removed at the follow-up - it will be ten days then since the operation.

I started carefully stretching hams, glutes and TFLs. Trying to do anything to make getting back into shape as quick and easy as possible.

Day 6

The knee felt sorry of bloated and tight in the morning, and there was a distinctive feeling of pressure all around the incision site when fully flexed. It also gets sore quicker when standing for a while or when having it fully flexed for a period of time. I took a paracetamol to calm it down a little.

The useful range of motion (with some load, not just passive) seems to be improving, and I am becoming able to apply more force with the quads.

The area around the incision started itching in the evening. It stopped when I removed the adhesive bandage - guess it's just the hair growing back and not a sign of an infection.

Day 5

No big change since yesterday, improving slowly and steadily. I've been more active today - I've climbed the three floors to my apartment three times today, and while it did hurt a little, it did not feel like a bad pain. Still not using the bad leg when descending stairs though. I'm starting to activate the quads a little when walking and climbing stairs.

I also climbed and walked on the arm and back rests of the sofa to check something around the window frame. It probably looked precarious but I felt quite stable. I was sparing the bad leg and it worked fine.

I feel like at least some of the tension on the knee when extending under load comes from the sutures. Looking forward to getting them removed next week.

Day 4

The knee still felt a little inflamed in the morning. I took an ibuprofen with breakfast for a change and it helped. Feels better otherwise: I'm able to do a few steps up stairs before it even starts hurting, and it also hurts less trying to go down stairs. I actually climbed the full three floor to my apartment semi-normally later in the day.

I'm allowed my first full shower today. I removed the adhesive bandage so I could take a look at the actual incision for the first time too. It's not very pretty, but it looks fine. I won't be embedding a picture directly in the post, but here's a link to it for anyone interested.

I took another ibuprofen with dinner after the shower, just in case. That's two ibuprofen for the day, no paracetamol.

I'm other news, the ankle swelling send to be gone, while the one under and around the incision is unchanged, noticeable only when the knee is flexed.

Day 3

I have a full range of motion today, from fully extended to fully flexed. However, I'm still not able to exert any force throughout the range without pain. I am capable of taking a few steps up and down stairs using the affected leg, but it still hurts.

I went outside in the afternoon, spent some time with friends in a park and walking around. It was nice, but I overdid it a little, so it feels a bit tender and inflamed in the evening. 

I've taken two paracetamol in total - one morning, one evening - and no ibuprofen. It helps settle things down a little, but I don't have any major pain that would need constant medication. No sign of a visible hematoma appearing, just the little, very localised swelling that's not changing. The swelling around the ankle is still there, but it is receding.

Day 2

I had no pain this night, or at least none that would wake me up - guess the paracetamol did its thing well. There is less pain today, it is now more of a soreness. The swelling around the ankle looks about the same as yesterday.

I removed the outer bandage today, that was a big relief. The first layer or two over the knee were quite snug, they actually caused some light abrasions around the patella. That explains the pain there from the first night. Other than the marks from the bandage, which disappeared during the course of the day, the knee looks pretty good. There is visible localised swelling at the incision site when the knee is flexed, but no hematoma in sight. I took a paracetamol after removing the bandage to prevent swelling and inflammation now that the pressure is off.

The ridges in the middle are marks from the edge of the protective pad under the bandage. The redness to the left is a light abrasion; another one is just about visible to the right.

This right after removal of the bandage; most of the marks disappeared within an hour. The adhesive bandage won't be touched for a couple more days.

As soon as I removed the bandage, max knee flexion went up to 90 degrees (if done carefully, no load). At that point, internal pressure at the incision made it too uncomfortable to go further. Range of motion has kept improving throughout the rest of the day.

Day 1

Didn't sleep very well this night. I would get into an position that's uncomfortable to the left knee and the pain would wake me up. Some of the pain came distinctively from the patella region for some reason; it wasn't from somewhere inside the joint, but from the outer edges of the patella.

The pain is not too bad during the day. In total I've taken one aspirine (in the morning before picking up the prescribed medication), two paracetamol (one at the end of the day before going to bed) and one ibuprofen during the course of the day.

Knee flexion has improved since yesterday, I can do 40+ degrees from straight now. This is just passive flexion, no weight on the leg, no pressure on the knee. When not moving I'm keeping leg extended and elevated most of the time.

I'm able to walk slowly and carefully. Bearing weight is no problem, but the part where I need to bend the knee and bring the foot forward can be tricky. When stepping forward I can't really use the stabilising muscles around the knee because that puts strain on the IT band; instead I just lock out the leg and put weight on it completely straight and that seems to work fine at the speed that I'm going. I go up and down stairs using the right leg only to do the work. I've had two walks of 15-20 minutes to keep the leg moving and to stimulate circulation.

I've noticed some swelling in the ankle and foot in the evening. Can't tell if it was there before, I wasn't really looking. I'm guessing it's a light swelling that started in the knee area and then the fluid descended to the foot. It's not big or painful so I'm not really worried.

Day 0

T-minus-zero, D-day.

In preparation for surgery I had no food or liquids after midnight of the previous day. Showered with an antiseptic solution the evening before the surgery as well as the morning before going to the hospital. I arrived at the hospital an hour or two early, so I had a few hours in the room before the surgery itself. During that time I laid in the bed some, changed into the gown, laid some more. A nurse came to shave the area at the knee and around it. I put on a compression sock on the right leg as instructed, laid in the bed some more. Another nurse brought some Xanax in preparation for the general anaesthesia and then I waited some more.

Around noon I was taken into the operation room. The anaesthesiologist said "Hi", applied IV to the left hand, the assistant placed a mask over my nose and mouth: Night, night!

I woke up in the post-op room around two. An hour later I was taken back to my room to wait for the doctor to let me know how it went and to send me home. In the mean time received around a liter of saline solution plus some paracetamol IV. Even before the paracetamol I only noticed some pain around the incision site, but nothing drastic. I found it hard to flex the knee beyond some 20 degrees from fully straight, but I experienced no pain when bearing weight on the leg. I was able to walk - carefully - to the toilet by myself and I had no problems whatsoever with my appetite by the time dinner arrived.

All bandaged up and smeared in iodine

The doctor came around seven, when he was done with the other patients for the day. He let me know that the operation went very well and that he was optimistic that my ITBS will be resolved. What he did to the IT band in the end was a simple straight 20 mm perpendicular cut starting at the posterior edge of the band. No part of the band was removed and nothing was done to the tissues underneath.

Doctor's orders:

• "Live normally": walk around normally (without overdoing it), stay mobile within my capabilities.
• No need for the compression sock since all went really well (I put it on anyway since I already had it with me).
• Take the outer bandaging off after two days.
• Wait for four days before taking a normal shower. Remove the adhesive bandage from the incision site and replace it with a new one after.
• Ice the knee daily.
• Take 4 x paracetamol and 3 x ibuprofen daily for pain.
• Expect a large, painful hematoma to form around the incision site.
• Come for a follow-up next week to assess the situation and discuss my recovery program.

I was able to hobble home without help or aids right after that (with my dear SO by my side just in case). Since it was already quite late and I didn't feel that much pain, I didn't pick up any of the prescribed medicine but went straight to bed.

Prologue

Hello!

This is a blog where I will be presenting the progress of my recovery from the surgery that I had to fix the IT band issues in my left knee. I presume people reading this blog already know that the Iliotibial Band Syndrome is and probably have some experience with it, so I won't be going into the subject here.

At the time of my surgery, I've been able to find very few blog or forum posts from people who had similar surgery done with more details than "Had surgery X months/years ago. Ran a PB X months later." In fact, the only detailed account I know of is this one, though it describes a more complicated intervention than my own. (I've no affiliation with that blog, I found it through Google and the only parts of it I read are the ones related to the author's surgery and recovery.) I hope to make this blog a useful resource for anyone facing a similar surgical procedure for their ITBS.

I'm a recreational road cyclist, and my ITBS started while cycling, though an ill-advised run was probably a factor as well. This is a short history:

• The pain first started midway into a 130 km ride in February of 2015. The ride was unusually long for me at the time, but I was well used to rides of around 90 km, so having the pain start at 60 km was unexpected. The best guess was that it was caused by a combination of factors: first I made made my first attempt at running just a few days before the ride, where I ran far beyond my capabilities at the time; then, I went for a long ride before fully recovering from the run; finally, I had raised my saddle as an experiment right before the long ride.
• During the spring of 2015, I made some attempts of taking a break and then gradually getting back into riding, but pain would invariably come back after a while.
• During the summer I didn't ride at all, but I did experience some pain on easy hikes a couple of times.
• In September I finally found an orthopedist with some experience with ITBS. Under his orders I did some passive physiotherapy during the autumn including stretching, massage, ultrasound and ESWT (link), followed by a gradual return to cycling during the winter. I had gotten back to 90 km long rides with no pain until it returned again in February 2016.
• Had a couple of cortisone shots and did a round of self-guided hip and glute strengthening exercises during the spring of 2016 with no success.
• Finally had a surgical procedure done on the 18th of July 2016.

The procedure done on my knee is resection of the posterior portion of the IT band, also known as open surgical release. This type of surgery typically includes removal of a piece of the IT band where it presses against the lateral femoral epicondyle, but in my case just a straight, perpendicular cut was done form the rear edge and about halfway across the band. I asked about the option of an arthroscopic technique to remove some of the synovial tissue under the IT band, but my orthopedist opted for the more conventional approach after consultation with one of the doctors who originally developed the arthroscopic procedure.