Tight IT Band After Knee Replacement (Experience and Tips)

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Knee replacement recovery is a long process accompanied with many types of aches and pains. While some people only experience swelling and stiffness, others may experience pain around the knee.

A tight IT band is a common feeling after knee replacement, however, it is not specific to knee replacement. In fact, many athletes and people without a history of knee problems experience the same issue.

If you are recovering from knee replacement surgery and you have a tight IT band (and pain), don’t be alarmed. There are stretching and strengthening exercises you can do to relieve the tightness.

As your body adjusts to a new knee, the muscles and ligaments should begin to relax and loosen up. I’ll share my experience below and why I believe it’s important to stay active and limber during knee replacement recovery.

The IT Band and Why It Can Feel Tight

The Iliotibial Band (IT) is the connective tissue (ligament) extending from the Pelvic bone (hip) to the tibia (shinbone). The IT Band helps to extend, abduct and rotate the hip. It also helps to stabilize and move the side of your knee protecting the outer thigh.

When overused, the IT Band can become tight and cause pain in the knee joint and knee cap. The tightness (IT Band Syndrome) is often caused by repetitive bending of the knee during physical activity and overuse.

After knee replacement, this band can become tight due to the trauma of the operation and due to the new structure and positioning of the knee. Tightness in the knee and along the IT band, even though it may feel uncomfortable, is understandable.

Activities like swimming, running, cycling and climbing (strenuous hiking) are often the cause. When overused, the IT Band can become tight and cause pain and discomfort.

My Experience With Tightness and Stiffness After TKR Surgery

Before my TKR, I had never experienced tightness in my IT Band. After surgery, I had a solid physical therapy program which I continued on my own with no significant problems.

My first experience with IT Syndrome came a year and a half after my TKR. I began to feel pain in my hip and knee after two days of strenuous hiking. I tried to continue to exercise for a day or two but the pain became worse.

My first thoughts were that I had worn out my hip and that I needed hip replacement. My right hip began to hurt while hiking (same leg as my TKR) but I continued to hike another 3 miles back to the car.

The pain got progressively worse during the next week. I had pain when walking and by the end of the week I could no longer do any physical activity. It got so bad that I had trouble sleeping at night because of the pain.

Finally, I went to the physical therapist that I worked with during my TKR recovery. He eased my fears of more surgery by assuring me that he was pretty sure I had IT Band Syndrome. He gave me a series of stretching exercises that I will share in this article. After rest and stretching the pain went away after a month.

Tips To Reduce The Tight Band Feeling After Knee Replacement Surgery

  1. Stay moving, get up out your chair and choose some activities that you enjoy. Warm up properly, take the time to stretch and even apply heat during your stretch.
  2. Stretch the muscles around your hip and knee on a regular basis but especially before activity. Improve your mobility, the tighter the IT Band, the more likely it will rub and develop pain. Continue to strengthen the muscles around your knee and hip after your formal physical therapy.
  3. Check your shoes and make sure they are not wearing unevenly. Change/buy new shoes when needed. Don’t look for cheap shoes, it is worth spending more for a good pair of shoes.
  4. Massage the area around your knee and hip before and after activity. I also use a hand-held massager right before I go to bed.
  5. Cool down after exercising, spend some time stretching and don’t immediately sit down for an extended time. After strenuous activity (for me long hikes) ice the area around your knee and hip.

My Exercises For A Tight IT Band After Knee Replacement

My physical therapist suggested the following exercises/stretches for me. Consult your physical therapist or doctor to see what exercise is right for you.

  1. Sit with your legs extended. Cross the leg that is sore over the other leg placing your foot flat on the floor. Rotate your body (trunk) towards the painful leg as you try to look over your shoulder. Hold for 30 seconds. Repeat 3 times.
  2. Stand upright. Cross the sore leg behind the opposite leg and lean away from the sore side. Hold for 30 seconds. Repeat 3 times.
  3. Lie on your back. Bend the sore leg. Hold behind the bent knee with both hands and pull that leg toward your opposite shoulder. Hold for 30 seconds. Repeat 3 times.
  4. Wall squats using a stability ball. Do regular squats with the ball between your back and the wall. 15 squats. Repeat 3 times.

Your physical therapist can give you more or different exercises that might fit your physical condition better.


Don’t overdo it! Listen to your body when you exercise. Prepare for strenuous exercise. Take a break after a strenuous exercise session or hike. Let your body recover.

Stretch on a regular basis before and after activity. Use heat, ice and massage all along the IT Band area from knee to hip. Listen to your physical therapist and be diligent with assigned exercises. Make stretching a life-long activity.

If you have prolonged pain and discomfort that doesn’t get better with rest and stretching, see your physician. Continue to stretch and work on your IT Band after the pain goes away.