OP after-treatment/painkiller
In the initial phase after a surgical intervention due to an iliotibial band syndrome, the treatment is mainly with painkillers such as Novalgin, Ibuprofen or similar. Preferably those that also have an anti-inflammatory (anti-inflammatory effect). A gradual reduction of the corresponding dose and subsequent balancing out of the painkillers is done in a pain-adapted manner.
After the hospital stay, pain can still be suppressed with ibuprofen or low-potent opiates. Since the patients’ perception of pain can vary greatly, it is not advisable to make generalized statements on dose, frequency and duration of use.It should also be remembered that almost all drugs are broken down by the liver. In the case of an existing pre-damage of the liver, a very specific pain therapy tailored to the individual case is indicated.
The use of cannabinoids and neurocerebral inhibitors has proven to be practical in these special cases. A rehabilitation of the liver can be achieved by medication and diet within about 3 weeks, provided that a previous damage of the organ is not yet too far advanced and thus irreparable. In the case of slight, still reversible damage, homeopathic remedies with little or no side effects can also be used.
Hospital stay after OP
After the operation, we mainly work with anti-inflammatory and painkillers. Full weight-bearing of the knee joint is not allowed in the first few days. At the same time, medication and physiotherapeutic thrombosis prophylaxis are used, as well as a therapy that may prevent oedema. The use of forearm crutches for 2-6 weeks to relieve the operated structures as well as consistent elevation of the operated leg to prevent oedematization is recommended. The article “Lymphatic drainage” may be of interest to you.
Physiotherapeutic intervention
The treatment of ITBS depends on the filtered out individual cause as well as the current wound healing phase. Thus, at the beginning, the focus is on protection, omission of the causative activity and passive movement. The structures have to be aligned to their function, so if the leg is only kept stiff, our tissue fibers also stiffen.
This is not the meaning of protection. Adapted stimuli must be given in the earliest phase of wound healing. Later on, the tension of the entire fascial chain must be released and muscular imbalances must be compensated: shortened muscles are loosened and stretched, muscles that are too weak are strengthened and trained for everyday or athletic stress by means of certain parameters.
A healthy trunk musculature also contributes to a physiological running pattern. Of course, surgery to lengthen the tractus iliotibialis all is not enough to be permanently pain-free. Especially not if the triggering factor (e.g. jogging) continues.
Therefore, consistent and permanent stretching exercises, leg axis training and variations in the training program are necessary to prevent a further shortening of the iliotibial ligament. If no stretching exercises are performed, the tractus iliotibialis shortens again as it adapts to immobility. If the patient is in the bandy leg position, a physiotherapist should instruct a leg axis exercise as a corrective measure to relieve the iliotibial ligament.
Some exercises from physiotherapy to strengthen the important pelvic stabilizers, whose weakness is often the cause of ITBS, are presented below. More exercises can be found in the articles:
- Stand upright, legs hip-wide apart, knees slightly bent. One leg is now slowly led to the side, slightly backwards and slightly turned outwards, spread out and then brought back up again.
Without putting the leg down in between, this procedure is performed 12-15 times and finally the leg is changed. The exercise is repeated over three sets. As an enhancement, a theraband can be tied around the ankle joints before the beginning and the leg can be spread against its resistance.
- To train the gluteal muscles, the so-called bridging is suitable.
In the supine position, the feet are positioned hip-wide and the pelvis is slowly lifted until it forms a diagonal with the trunk and thighs, then lowered again without touching the floor and lifted again. The arms are best placed crossed on the chest. Here 3 sets of 12-15 repetitions each are also performed for strength endurance. The trunk and buttocks are continuously and strongly tensed.
- Other exercises include wall sitting, lunges and knee bends. When returning to training, perform a running ABC every now and then.
- Exercises with an existing runner’s knee
- Physiotherapy exercises knee
- Exercises from physiotherapy for the hip
