IT Band release surgery? Anyone been through it?

Nemo Brauch

 I have a buddy who has been struggling with IT Band issues for a long time.  She's avoided the cortizone shots and tried rest, stretching, PT, ice, and NSAIDs but isn't getting very far.  Anyway, a doc recently recommended she consider surgery.  I've heard of this before but never knew anyone who when through it.  So I'm just kinda doing a little research for my bud.  

Anyone in the haus been through this surgery before?  If so, what was your experience?

 

Thanks

ghernand

Hi Nemo,

Just as important as the ITB release concern, is the affect on performance afterwards, assuming your friend wants to be active afterwards.  I will do some research on this and get back to you.

Correcting biomechanics is key for ITB syndrome.  Surgery is pretty extreme, unless an actual structure has been identified that is causing excess rubbing of the tendon and can be removed.  I assume she's seen a sports med doc who actually bikes and runs? 

A focused plan for ITB syndrome rehab with analysis of running and/or biking technique, bike set up, fuel belt use (always carries heavy bottle on one side, etc) is required in most stubborn cases, but not always easy to find someone who can do all that.

Finally, many times patients try to stretch, but doing it effectively and properly to the extent that it will fix the problem is pretty rare.  It is very hard to do and requires a lot of patience.  How often have you heard that someone takes a year off to improve flexibility vs. i am going to take a year off to just focus on bike or run or swim? 

Sincerely,

GH

 

 

 

Nemo Brauch

Thanks Gilberto! I know she's seen several sports docs (lives in the DC area, hard to turn around without bumping into one there- but that doesn't mean they are "good"). I don't know that they have really figured out the underlying cause for her trouble, other than "overuse". She runs several marathons a year (like 5-6), teaches Spin classes, does sprint/oly distance triathlons, etc. But she wasn't always this active and went from couch potato to energizer bunny over a few short years. So there's lots of possible causes.

jburbatt

Nemo,
I will say that three years back when I was having a ton of trouble with my knee and ITB, ITB surgery was recommended for me by my doctor, especially since I was born with some leg defects the assumption was that surgery was the best option. One of the doctors did suggest that I could try a long (think 8 months) of rehab with a clinical therapist to hopefully work out the issue instead. I did that, and while it sucked, was really glad I chose the non-surgical route, especially since I run with no issues these days. Obviously everyone is different, and sounds like she's done a lot of different things, but I don't hear of too many people taking off a full year for recovery unless they've had surgery, so thought I'd toss it out there.

Leigh Boyle

Going to second the others on this one. I've seen probably 4-5 people on a post op basis and none of the results were the miracle cure they were hoping for. Ultimately, chronic ITB is a functional problem (meaning caused my muscle imbalances or form that have built up over time) and the underlying cause will need to be addressed at some point to truly cure the problem. Can the release help? sure...but losing that outer stability can also stir up a whole other type of problem to compensate for it.

In the case of a structural problem (true leg length discrepencies, bone abnormalities etc)...then it's a different story but usually the solution is bone related and not simply releasing the band itself.

DocHoffart

echoing the others on this. I've never really seen a case come in my office where the IT was primary but instead a secondary issue to other tissues/biomechanics being involved as precursors. IT is a lateral stabilizer but gets called in to work overtime often with weak force production in the posterior chain from adhesions in hammies, knee biomech issues, foot pronation issues, etc. Once the IT has to generate more force to compensate for those other problems/issues then the frictional rub and inflammation develop a life of their own and take center stage.

The change in personal landscape post surgery, for many, is not conducive to added stability and a future in endurance or force production activities. Exhaust all conservative measures and when that doesn't work, keep looking for more conservative measures.

Vince

Hasanbaydoun

Nemo,
I can't stress enough what everybody else has said already
I'm a surgeon, and I have a stand on IT surgery similar to that of the "most interesting man in the world" on rollerblades - NO
http://www.funnyordie.com/videos/35b7452628/the-most-interesting-man-in-the-world-on-rollerblading
stay thirsty my friends

Nemo Brauch

Hassan- that cracks me up especially because just YESTERDAY I nearly pulled out my old rollerblades and went for a roll. No Joke!!

Thanks everyone for the feedback. I'm gonna pass this all along to my friend. I know she's gotten this input before, but sometimes it helps to hear the message from various sources.

ghernand

Nemo:

good advice from all.  i did some reading and no compelling info in terms of long term research for (>10years) follow up for IT band release surgery.  best to solve without surgery and along the way get body and sport technique super balanced.  when your friend gets older, she'll be happy she did!

@Hasan:  i just noticed your facebook message.  sorry for the delay, but i don't 'really' follow facebook, just keep it to not fall behind the times.  In response to your question:  I am not yet an orthopaedic sirgeon, but headed there in 2012.  i have my MD (all sub-I's were in ortho) and finishing up a PhD, then ortho oncology whereever there is interest in my research.  

 Until the next case!

GH