By Lacy Clevenger, PTA
If you’re experiencing a nagging, achy pain on the outside of your hip or knee, you may be dealing with IT band syndrome. This is common with running and endurance sports or any activity that requires repetitive bending of the knee. The IT band is a thick connective tissue that starts at the top of the hip and attaches below the knee. Pain starts to occur when there is friction between the IT band and the bones of the hip or knee, though pain is more commonly experienced at the knee. Weak hips and lack of lower extremity flexibility can make you more prone to this.
Here are 5 stretches/exercises to treat IT band syndrome and help prevent recurrence:
- Foam rolling: Lie on the affected side with the foam roller just below the hip bone. Slowly roll until the foam roller is just above the knee joint, then roll back to the starting position. Repeat this 10-15 times. Discomfort is common with this, but will improve with time.
- Hip flexor stretch: Sit on the edge of a bed and hug one knee toward your chest. Lie back, then actively pull the opposite heel down towards the floor as well as back towards the bed. This should create a stretch along the front of your hip/thigh. Hold this for 30-60 seconds and repeat 3-5 times.
- Glute stretch: Lie on your back with knees bent and feet flat on the floor/bed. Cross one ankle onto the opposite knee then pull your knee towards your opposite shoulder. A stretch should be felt on the back and/or side of the hip. Hold this for 30-60 seconds and repeat 3-5 times.
- Clam shells: Lie on your side with both knees bent. Try to keep your shoulders, hips, and knees in a straight line so that your feet are resting behind you. Keep your heels together and lift the top knee, stopping just before you feel the hips start to roll backwards. Repeat slowly 20-30 times. An elastic band can be added around the legs, just above the knees to add resistance and increase difficulty. \
- Side leg lifts: Lie on one side and lift the opposite leg up towards the ceiling, keeping the knee straight. As you lift the leg, keep it slightly behind the hip which helps to engage the glutes. Do not let your hips roll backwards. Repeat 20-30 times or until muscle fatigue is felt.
Frequently, I see patients whose first question is, “Am I ready for replacement of my arthritic joint?”
This is not a question that is easy to answer, and the answer depends on many factors and variables:
- Joint Replacements have an excellent outcome, with greater than 90% of patients reporting that they are glad they proceeded with the surgery and are better than before surgery.
- Patients often ask if they are too old for surgery. Well, I believe that age is a relative factor. Some 50 year olds have multiple medical problems, while some 90 year olds have no medical issues and are not even taking any medications. So age must be evaluated by each individual.
- There are many treatments for arthritis of a joint:
- Activity modification
- Anti-inflammatory medications
- Anti-inflammatory injections
- Support aides, like canes or walkers
- Braces or shoe modifications
- Weight loss
- Physical strengthening
- The main reason for undergoing joint replacement is pain! However, limitation of activity or loss of function is another reason people think about undergoing surgery.
- The best answer to the question, “Am I ready for a joint replacement?” is, “You will know when it is time.”
If you want to discuss the options of surgical treatment for your arthritis, please make an appointment here or by calling 918-392-1400. By seeing you in person, myself or another member of our qualified joint replacement team can provide you an individualized assessment and discuss your concerns and expectations.
J. Scott Reid, MD, performed the first augmented reality (AR)-guided total hip replacement in the region at Union Pines Surgery Center on the campus of Tulsa Bone & Joint today. The system, which received FDA clearance in January, is the first intraoperative AR guidance platform for joint replacement to display 3D models of the patient’s anatomy, implants, and instruments inside the body in real time.
Union Pines is the third site globally to have the augmented reality-guided hip replacement surgery performed. Previous surgeries have been performed at New England Baptist Hospital in Boston and Duke University Hospital in Durham, North Carolina.
Traditional hip replacement technology gives the surgeon access to two-dimensional X-rays. However, the augmented reality guidance Dr. Reid employed projects holograms on AR glasses that give him ‘X-ray vision’ into the patient’s body.
“Hip replacement surgery has a long history of improving the quality of life of patients suffering from diseases affecting the hip joint,” said Dr. Reid. “Despite the excellent track record, complications still occur. HipInsight is a platform that gives the surgeon more information about the patient than we’ve ever had before. The ability to anticipate any challenges before the surgery and then visualize the anatomy in real time is beyond any currently available technology.”
The AR-guided system is the first FDA-cleared surgical platform for joints to be contained entirely within a head-mounted device. Unlike robotic and traditional navigation systems, there aren’t any large external workstations, cameras or screens. Over 400,000 hip surgeries are performed each year in the U.S., making them one of the most common and highest total spend elective operations, according to a 2020 study by researchers at Johns Hopkins. With the aging population, hip surgeries are expected to grow by 71% by 2030, according to a 2018 study by researchers at the University of Pennsylvania. Technologies like the one employed by Dr. Reid aim to help surgeons improve outcomes with minimal complications.
Dr. Reid has been using the Hip Xpert system, the precursor to HipInsight, for several years. “Hip Xpert is innovative in that it is not tied to one implant system, technique, approach or company,” Reid says. “It provides immense detail, but we are still applying data from the software without being able to actively visualize implant data in real time. HipInsight changes that. We still get all of the information we need to best position implants, but we get to see all of that as it happens. I am very excited to be on the front end of the HipInsight rollout.”
Below is footage of the HipInsight augmented reality tool at work during surgery.
By Jennifer Peterson, MD
While hip surgeries are common here at Tulsa Bone & Joint, we take a conservative approach to treatment. That means helping you stay out of the operating room if and
when possible. If you’re suffering from knee pain, here are 6 things you can do to treat the pain that do not require surgery:
- Try over the counter anti inflammatories like Aleve or Ibuprofen.
- Ask your doctor about trying prescription anti inflammatories like naproxen, meloxicam, or celebrex.
- Try physical therapy: Physical therapy can help you strengthen the muscles around the hip, and help treat any gait abnormalities that develop with arthritis.
- Steroid injections are a great way to treat the pain of hip arthritis, and these can often be done in the office under ultrasound.
- Head to the store and get yourself a stylish cane. Hold this in the hand opposite your bad hip. (Right hand for Left hip) This will help decrease the forces going through the bad hip and help
- Last but not least, the hardest of all…weight loss. 3-6x your body weight goes through your hips with every step. That means 10lbs of weight loss is at LEAST 30 lbs less weight that your hips feel with every step.
If you need guidance regarding your hip pain, I am accepting new patients and would be happy to help you find relief. Call 918-392-1400 to schedule an appointment.
Tulsa Bone & Joint Associates is delighted to welcome Jennifer Peterson, MD, to our practice! Dr. Peterson and her family recently moved to Tulsa after she completed an Adult Reconstruction Fellowship and Orthopaedic Surgery Residency at The Cleveland Clinic Foundation in Cleveland, Ohio. We welcome you to Tulsa and the practice, Dr. Peterson!
Dr. Peterson completed medical school at the University of Virginia School of Medicine.
Dr. Peterson is an avid swimmer, and she was was a Swimming Olympic Trials Qualifier and Competitor in 2008.
Dr. Peterson specializes in hip and knee replacements and hip and knee revisions. She utilizes the direct anterior hip approach, a minimally invasive technique, when appropriate. She also performs robotic total knee and robotic partial knee replacements, which allows her to use computed tomography (CT) scans to build a virtual model of the patient’s knee.
Dr. Peterson is a member of the American Academy of Orthopaedic Surgeons, the American Academy of Hip and Knee Surgeons, and the American Medical Association.
Dr. Peterson is now accepting new patients! Click here to request an appointment, or call 918-392-1400.