Cycling After Knee Replacement – Is it Possible? What To Avoid.

If you are one of the many who suffer from acute knee pain and osteoarthritis, you may be recommended by your doctor to have a total knee replacement surgery or a TKR.

You can still enjoy riding your bike after the surgery, but measures must be put in place before you get straight back into your favorite leisure activity.

Not long after your surgery most patients start riding the stationary bike as part of outpatient physical therapy.
TKR is primarily to treat pain, stiffness, and loss of mobility that can be caused by severe arthritis or a severe knee injury.

This can be a painful experience and is not a surgery that is suggested before exhausting other options.

Many require physical therapy following the procedure to help in reducing the pain and improving the strength of the joint and range of motion.

After TKR operations, there may be physical therapy services available within the hospital.

A continuous passive motion machine may be used to improve your range of motion at this stage.

They will also teach you exercises that you can use here and at home to regain the normal strength of the knee and mobility.

If you struggle to be able to leave the home post-surgery then you may choose to have home-care physical therapy.

Biking is a great exercise after a total knee replacement.
This, of course, is only to be undertaken after instruction from your doctor or physical therapist, ensuring that it is the right thing for your individual condition.

Stating on a stationary bike is important, and once you are able to pedal on the bike, you may add some light resistance to improve the strength and endurance of the knee joint and leg muscles.

Make sure that you only add a little resistance at a time and always double-check with your physical therapist.
Your therapist can ensure that you add the right amount by predetermining the resistance.

When you increase the resistance on the bike, an increase in knee discomfort can also be expected.

If a sharp pain can be felt in your knee then you should inform your physical therapist and decrease the resistance or stop biking altogether at this point in time.
After four to six weeks on the stationary bike, you may be cleared by your healthcare professional to start riding your bike outside.

You must check with your doctor before doing so. This will ensure that it is safe and will not impact the recovery of your knee joint.

You will expect to ride a stationary bike one to two weeks after your total knee replacement.

Your specific condition and your underlying knee joint issues will impact this timeline. It may take longer in some cases before you get to this stage in your recovery.

During therapy, the stationary bike may be recommended to maintain muscle tone and keep your knee flexible.

This is generally recommended by your physical therapist.

For the first few weeks, it is important to focus on decreasing swelling and improve the full passive range of motion.

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When riding, you will want to work toward the maximum degree of bending and straightening possible on the stationary bike.

This must be done without putting too much stress on your knee joint.

Follow these steps:
Be sure the seat height is set correctly. To do this, sit on the bike seat with your operated knee straight down and resting on a pedal.

There should be a slight bend to your knee when the pedal is at the lowest point.

When starting to pedal the bike, start slowly and in reverse. Most likely, you will not be able to pedal all the way around. This is normal. Just pedal around until your knee that was operated on bends as far as you can tolerate.

When your knee is bent as far as possible, hold the position for a few seconds, before continuing to pedal in reverse. Again, start slowly and allow your knee to straighten. Continue pedaling backward until your knee once again bends as far as possible.

Repeat this sequence of backward pedaling for a few minutes. Ride forward only after your completely comfortable cycling motion is possible backward.

The range of motion generally returns quite quickly once you begin stationary bike riding, especially if you follow the above steps. This will allow you to soon get back to normal bike riding.

When 90° of knee flexion has been reached, you will be able to pedal fully on a bike, with the OK from your doctor or physical therapist.

Initially, it may be easier to pedal backward rather than forwards. This is common after total knee replacement.

We need to begin by noting that everyone is different. Every patient is in a different condition healthwise and has a different rate of recovery.

Some people are born with more flexion than others, and greater extension in their knee joints.

Some have complications, such as severe osteoarthritis degradation, which can be more difficult to overcome after a knee reconstruction.

Knee stiffness and other conditions can also impact the range of motion post-surgery.

One of the best indicators of your knee range of motion after your surgery is the range of motion before surgery.
As a rule, knee flexion of around 125° will allow you to carry out all of your normal activities. For simple daily living, knee flexion of around 105-110° is a requirement.
An approximate range of motion for various everyday tasks is as follows;
65° to walk
70° pick an object off the ground
85° to climb upstairs
95° to stand from a sitting position
105° to tie shoelaces
115° (or greater) to squat or sit cross-legged
125°+ covers most activities. However, squatting or sitting on your heel may always prove challenging.
Every person has a different range of motion before surgery, and they all heal at different rates too.

As per the recommendations of US-based orthopedic surgeons and physical therapists, your flexion goals should be as set out below;

Stage 1 at 0-2 weeks post-surgery is 65-90° flexion. This allows for walking with no assistance, standing, and some stair climbing. Climbing stairs must be done with support. Before leaving the hospital your doctor will aim for 90 ° of flexion, or as close to this as possible.

Stage 2 at 2-6 weeks should be around 115°. Here you should be seeing noticeable improvements from early recovery. This means more normal movements, bending to the ground, sitting down, and even tying your own shoelaces!

Stage 3 is at 12 weeks + and this should allow you to reach a flexion of 115° or more. The timeframe for this range of motion varies between patients and it is something you should be working towards at this stage. A flexion of 125 ° is great and 135° or more is excellent.
During each stage, it is important to keep working with your surgical knee and artificial knee prosthesis.

The first 3 months of recovery are critical to work the knee and attempt to get it back to its original flexibility.
This includes bending, extension, and movement.
Staying idle, being inconsistent, or not being fully committed to your recovery will cause your knee to become stiff and it will be harder to work with later.
This means that revision surgery may be required at a later date and the joint will cause lifelong issues.