If you are scheduled to have total knee replacement surgery, one of the most common questions cyclists ask is: can I still ride a bike after the surgery? The short answer is yes. In fact, riding a bike is actually a great form of physical therapy following knee replacement surgery.
Contents of This Post
- Tip #1: Getting Started: Passive Range of Motion
- Tip #2: Physical Therapy and Becoming Active
- Tip #3: Working Your Way Up to Cycling with a Stationary Bike
- Tip #4: Achieving Full Range of Motion
- Tip #5: Advancing to Outdoor Cycling
- Final Tips for Returning to Activity after Knee Surgery
- Extra Content: How to Prevent Cycling Knee Pain with a Complete Stretching Program
For many people, knee replacement is a sensible option. If you are suffering from pain and stiffness due to arthritis, it can interfere with your daily activities. Total knee replacement is also known as total knee arthroplasty. is a beneficial option for treating the pain, stiffness, and loss of mobility that is associated with knee arthritis.
Once you’ve had your knee replacement surgery, here are a few recovery tips to help you prepare to get back on your bicycle.
Tip #1: Getting Started: Passive Range of Motion
For the first couple of weeks, one of the main goals is decreasing the swelling and reaching a full passive range of motion. So, you need to be prepared to work on this. Being able to cycle after total knee replacement depends on getting your entire body back in motion as quickly as possible after the surgery.
Even if your knee pain limited your activities before the surgery, you will need to work hard afterward to get your knee back to where it was before.
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Tip #2: Physical Therapy and Becoming Active
One of the most important factors of rehabilitation following knee replacement surgery is physical therapy. Usually, within 24 hours after surgery, a physical therapist will visit. Your physical therapist will help you stand, sit, walk, and use a continuous passive motion machine.
Focus on the Outcome of Your Physical Therapy and Listen to Your Therapist
During the early stages of your physical therapy, you will experience a certain level of discomfort, stiffness, and pain, but it is important to focus on the outcome. To succeed in getting back to cycling, you must follow the advice of your physical therapist and become active as quickly as possible.
Most rehab centers won’t allow you to go home until you can climb the stairs and walk, so the faster you get yourself active, the sooner you will be back to cycling.
Tip #3: Working Your Way Up to Cycling with a Stationary Bike
Range of motion is a critical part of your recovery following total knee replacement surgery. The good news is that using a stationary bike during your physical therapy is a great way to improve range of motion. And using a stationary bike will also prepare you to get back on your bicycle.
It is important that you check with your doctor and your physical therapist to find out when you can start using a stationary bicycle.
Get Your Stationary Bike Set Up Correctly
Be sure to set the seat height appropriately. Your knee should be straight down and resting on the pedal, with only a slight bend in your knee.
Start Cycling Slowly
Start out slowly and keep in mind that you may not be able to turn the cranks all the way around. Slowly pedal forward and backward for a few minutes. Continue this routine until your range of motion improves, which often happens quite quickly.
Tip #4: Achieving Full Range of Motion
When your knee is able to bend about 90 degrees, you should be able to turn the cranks fully around on your stationary bicycle. Once you can complete a full revolution, consider adding light resistance to help improve the endurance and strength of your muscles. If you start feeling pain in your knee, decrease the resistance.
In most situations, you can begin riding a stationary bike about two weeks after your knee replacement surgery.
Tip #5: Advancing to Outdoor Cycling
After about six weeks of riding a stationary bike, your doctor may clear you to start riding your bicycle outdoors. It is important that your doctor clear you before you begin riding outdoors. Once you start cycling outdoors, take it carefully and slowly, and always stop if you feel pain.
See our comparison of 5 of the Best Affordable Indoor Trainers.
Final Tips for Returning to Activity after Knee Surgery
The most important thing you can do to prepare for resuming cycling after knee replacement surgery is to keep all of your scheduled follow-up appointments, follow the exercise and therapy routines recommended to you, and avoid overdoing it.
Dr. Nakul Karkare is a trusted knee and hip replacement surgeon based in New York City and Long Island. For more information, visit newyorkhipknee.com.
Extra Content: How to Prevent Cycling Knee Pain with a Complete Stretching Program
Cycling Knee Pain is a major concern for many cyclists. Here’s an easy way to prevent cycling knee pain, with a set of simple stretches – and also some basic exercises, if you want to be even more proactive!
My post called Average Joe Cyclist’s Miraculous Cheap Cure for Cycling Knee Pain is by far my most popular post ever. This shows how common the problem is.
It’s Better to PREVENT Cycling Knee Pain than Have to Cure it
One thing I learned when I was a life guard is that it is far better to prevent a problem than to deal with it after it happens (stopping a non-swimmer from jumping in the deep end is a lot easier and smarter than pulling a 200 pound man up from the bottom of the pool). So I have been working hard to find ways to prevent the cycling knee pain that threatens anyone who regularly rides a bike.
What Causes Cycling Knee Pain
It is very important to have a bike that fits your own specific body, which can most easily be achieved by getting a professional bike fitting. Notice in this table how minor problems in your bike fit can cause major problems with your knees.
If you cannot afford a professional bike fit, or don’t want to spend that much money, it is possible to do it yourself. Here is a book called Bike Fit that will show you how to do it.
As you may notice from the table above, one cause of cycling knee pain is surprisingly simple – wrong saddle position! Here’s a video that will help with that:
A Simple Routine of Stretches to Prevent Cycling Knee Pain
But a bike that fits is not enough in itself. I consulted with legendary sport physiotherapists Karen Nichols and Saqib Niaz at Royal City Physio, and was given a simple routine of stretches to prevent cycling knee pain. I can personally attest that if one does these religiously (at least after cycling, and preferably before AND after), cycling knee pain can be dramatically reduced – or even prevented. I even find that when I start to feel knee pain, I can make it stop more effectively by doing these stretches than by taking pain pills.
So this is my simple, four-step routine to prevent cycling knee pain.
Step 1: Stretch your hamstrings (the muscles at the back of your thigh)
There are many ways to do this. My favorite is to hop on an empty desk, with one leg out straight and one hanging down. It is then easy to stretch the hamstring by leaning forward. Above, my daughter Emily shows how it’s done. She kindly agreed to model these exercises (trust me, she looks WAY better in stretch pants than I do!)
It is also easy to stretch the hamstrings by just trying to touch your toes, or leaning forward to grab your ankles. Or you can try lifting one foot onto a table, and leaning forward, as Emily demonstrates above. The key is to find a stretch that you can do comfortably.
Stretch each hamstring twice, for 40 seconds at a time. Do the stretches gently but firmly – and do not bounce!
Step 2: Stretch your quads (the muscles at the front of your thigh)
Some people are able to do this by bending their knee and putting their foot on a chair behind them, then leaning back till they feel the stretch. Personally, I find this hard. Most people can do this quad stretch by bending their knee and grabbing their ankle or foot behind their backs, as Emily demonstrates above. I find it easiest to lie down on the floor and bend my leg upwards. It’s basically the exercise above, but done lying down!
Again, stretch each quad twice, for 40 seconds at a time. Do the stretches gently but firmly – and do not bounce!
Step 3: Stretch your calves
The easiest way to do this is to put your toe on a big fat book and lean forward. You can also do it by leaning forward into a wall. Below, Emily leans into a wall with her toe on a box, for a very challenging stretch.
Stretch each calf twice, for 40 seconds at a time. Do the stretches gently but firmly – and do not bounce!
Step 4: Practice balancing on one leg
Basically the idea is to balance on each leg twice, for as long as you can. Make the balance more or less challenging, depending on how good your balance is. Emily demonstrates a simple balance here.
Below Emily demonstrates a more challenging balance. Folding your arms in front of you at shoulder height makes the balance much harder. Lifting your knee higher also makes it harder. And to make it even more challenging, try closing your eyes!
Balancing is a matter of use it or lose it – and riding a bike will not in itself provide enough balancing practice. My balance was terrible when I started doing balance work, but it has improved dramatically.
Apparently good balance is linked to strong, stabilizing core muscles, which help you to maintain good posture on your bike, thus avoiding cycling knee pain.
And that’s it. Just four simple steps, but they have dramatically decreased my cycling knee pain – I hardly ever get it any more. Try it – you have nothing to lose but your knee pain. And even if it does not work for you, you will definitely increase your flexibility and improve your balance!
Bonus: This video shows three vital exercises that will both prevent and cure cycling knee pain, demonstrated by ace physiotherapist Saqib Niaz:
Update: We Cyclists Also Need to Stretch Our Hips
Since writing this blog post, I started experiencing a new cycling-related pain – hip pain in what I all the wallet area. You know, the spot where men carry wallets in their back pockets. Pain so bad I thought I had some kind of wallet-area cancer. So I consulted with my trusty physiotherapist, and ended up adding in three stretches for the hips. These stretches worked like magic! So, I now highly recommend adding in these hip stretches. They are demonstrated in this video, by the trusted physiotherapist I just mentioned. Saquib is doing these on a table, but I have figured out how to do them on my bed!
One more tip: Ice Proactively
By which I mean, don’t wait for actual cycling knee pain to set in before hauling out the ice packs. I ice after every major ride, just to soothe my knees and reduce the chances of inflammation, irritation, and swelling. Use a good product that makes it easy. I have a set of Therapearl Knee Wraps that are easy to strap around my knees. Here is one of them, strapped around one of Mrs. Average Joe Cyclist’s knees:
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