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.