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    yss
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    Limited leg ROM looking for options.

    Hello,

    10 years ago I had a bad accident and I have limited ROM in my leg - around 60 deg. I would really like to ride a bike with my kids. What are my options? I'd like to stick with a traditional style bike if I could.

    Thanks
    Bryan

  2. #2
    astro
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    Perhaps crank shorteners

    Quote Originally Posted by yss View Post
    Hello,

    10 years ago I had a bad accident and I have limited ROM in my leg - around 60 deg. I would really like to ride a bike with my kids. What are my options? I'd like to stick with a traditional style bike if I could.

    Thanks
    Bryan
    Bryan -

    You could try short cranks, or if it's only one leg, perhaps a crank shortener. I did this when I was having knee problems and had limited range of motion.

    I got mine at Hostel Shoppe (a recumbent shop, but you can put them on any bike).

    Good luck,
    Ed

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    LBKA punkncat's Avatar
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    Where is your range limited? At the bend, or bottom of stroke?

    60* sounds quite doable, but the issues will vary according to where the movement is. If you set your saddle low, assuming extension issues, you could ride, but it will lead to ITB issues and pain behind the kneecap if you ride long distances. Alternately, if it is bending issues, high saddle and shorter cranks can help.

    My knee has ROM issues as well and it has taken me a great deal of trial and error to find a comfortable and workable situation for my condition.
    One Foot Less

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    Faster but still slow slowandsteady's Avatar
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    I had very bad ROM after my leg surgery. Cycling has helped immensely to improve it. Have you done physical therapy to improve the ROM? About a month after the surgery all I could do is move the pedals on a stationary bike about 1/4 turn. Now, I am riding over 100 miles a week less than a year later. 60 degrees sounds very doable. Have you tried riding a bike? How far can you get the cranks turned?
    "Ride lots." -- Eddy Merckx

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    yss
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    I have done years of PT it's as good as it's gonna get. It's my left leg and The actual ROM is about 45-50 degrees. I have tried to ride a bike - not possible WO changing something.

    Thanks for the replies...

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    Faster but still slow slowandsteady's Avatar
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    Quote Originally Posted by yss View Post
    I have done years of PT it's as good as it's gonna get. It's my left leg and The actual ROM is about 45-50 degrees. I have tried to ride a bike - not possible WO changing something.

    Thanks for the replies...
    Well, then it looks like you will have to go with shorter crank arms. What is the length of the crank arms on your bike now? Do you have your seat adjusted to the proper height(down leg almost straight)?
    "Ride lots." -- Eddy Merckx

  7. #7
    Faster but still slow slowandsteady's Avatar
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    What is your inseam? Here are some 160mm crank arms. That is pretty short. I ride a 165 and my inseam is 27.5.

    http://www.ebay.com/itm/NOS-Shimano-...item5ae8c14183
    "Ride lots." -- Eddy Merckx

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    yss
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    Quote Originally Posted by slowandsteady View Post
    What is your inseam? Here are some 160mm crank arms. That is pretty short. I ride a 165 and my inseam is 27.5.

    http://www.ebay.com/itm/NOS-Shimano-...item5ae8c14183
    I'm 6'2" not sure what my inseam is - i'll find out - says 32 on my pants... I gave my bike to a friend years ago because I didn't think I would ever ride a bike again. I used to ride a lot. I did RAGBRI several times and I rode nearly everyday. After seeing so many people with disabilities do so many things you didn't think possible I decided to start looking and I came across this site. I'm afraid to spend 1000's to find out it can't be done. I'd love to see a video of someone with similar knee ROM riding. Thanks for the help.
    Last edited by yss; 08-10-12 at 10:24 AM.

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    yss
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    This was about one month after the accident... Yes it hurt...
    Attached Images Attached Images

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    Faster but still slow slowandsteady's Avatar
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    Quote Originally Posted by yss View Post
    This was about one month after the accident... Yes it hurt...
    I shattered my leg too. I had a tibial plateau fracture. Bone was split down the middle and some areas were shattered in little pieces. Pain was unreal. I actually had to have an anesthesiologist because the morphine and dilaudid dosages were so high. My ROM 6 months out was about 10 degrees. I still can't fully straighten my leg. ROM isn't normal but I can ride a bike. I have arthritis now too so it is pretty messed up. Biking has been great.

    I would go with the shortest crank arms you can find. A 160mm might be okay for someone with a 32 inch inseam and the ROM you mention. Maybe you can go to a bike shop and try out a small woman's bike. They will come standard with a 165mm. Jack the seat up and see if you can get your leg around or at least close. That should give you an idea if it will be doable before you spend any money. It won't cost thousands. A new crankset can be pretty inexpensive. Less than $100 if you go for a lower end one. $300 for a high end crankset.

    Here is a 155mm for $95.
    http://www.pbwbikes.com/product_info...products_id/65
    "Ride lots." -- Eddy Merckx

  11. #11
    Faster but still slow slowandsteady's Avatar
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    Quote Originally Posted by yss View Post
    I'm 6'2" not sure what my inseam is - i'll find out - says 32 on my pants... I gave my bike to a friend years ago because I didn't think I would ever ride a bike again. I used to ride a lot. I did RAGBRI several times and I rode nearly everyday. After seeing so many people with disabilities do so many things you didn't think possible I decided to start looking and I came across this site. I'm afraid to spend 1000's to find out it can't be done. I'd love to see a video of someone with similar knee ROM riding. Thanks for the help.
    It can probably be figured out using geometry if you measure your upper and lower leg. Try asking the question in the road forum. There are some math geeks in there that can probably get you an answer as to what size crank arms go with a particular ROM. It has been so many years since I had done geometry I won't attempt it.
    "Ride lots." -- Eddy Merckx

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    yss
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    Quote Originally Posted by slowandsteady View Post
    It can probably be figured out using geometry if you measure your upper and lower leg. Try asking the question in the road forum. There are some math geeks in there that can probably get you an answer as to what size crank arms go with a particular ROM. It has been so many years since I had done geometry I won't attempt it.
    Thanks so much for the insight...

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    Hey yss,


    I have about 30 degrees flexion in my left leg. Even the folks closest to me don't seem to be able to imagine how 'I managed to let that happen' or the challenges it creates. My understanding is that one needs about 90 degrees of knee flexion in order to ride a normal bike off the rack. While a shortened crank can make up for some of the difference, they don't work for me and wouldn't work even if the pedal was effectively fixed to the cartridge at zero crank length. As far as I can tell, after discussing it with countless medical professionals and scouring the internet for adaptive devices, I'm left with few options for riding a bicycle. I'm not sure if the same is true for you but I thought I'd offer a few suggestions that might be helpful in your quest.


    First of all, you might want to check with bike shops in your area for those that have the proper equipment to assess your "riding style". The better shops have computerized equipment that, if anything, can determine if you if a shortened crank will work for you and make appropriate recommendations. A true enthusiast will be more than happy to accommodate your particular needs towards the goal of seeing you ride again. Secondly, there are hand-crank bikes, trikes and quads available in both upright and recumbent configurations. Technology continues to make these bikes increasingly viable options. Thirdly, there are electric bikes and electric assist bikes that can increase your riding range, alleviate some of the doubts and fears you may have, and most importantly get you out and get you moving. I find that I can overcome the worries of pain for the sake of doing something that's enjoyableand I tend to recover much more quickly from the pain itself that resulted from the doing. Give me an activity that includes a "woohooo! look at me now!" amd I'm there. Just a thought based on my own experiences with the cycles of depression and feelings of being defeated. Finally, I came across this website a short time ago: http://kneepainrehab.com/. I've been hesitant to purchase the articulating crank mostly because I've only found it available from the inventor who is in Great Britain and the cost with shipping comes to over $500 shipped. I lost my job in December so i have to take particular care before I make that kind of purchase. I think that some combination of all of these things I've mentioned is what will work for me. I just need to congeal my thoughts into action.


    I hope I've offered something useful to you.


    Regards,


    Tom

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    LBKA punkncat's Avatar
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    A simple and overlooked solution...take the crank arm off that side. Attach a pedal or something to rest that foot/leg on and do the work with the other side...Many amputees do it.
    One Foot Less

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    could probably use a unicam. have installed them at my shop now for a handful of people with limited movement
    Eric - Owner - Vivid Reflections Auto Salon

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    Junior Member shasta68's Avatar
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    I don't think I'd be hijacking this thread since this may be relevant to the original poster. @slow chevy: Can the Uni-cam be purchased stateside? I've only found it available through the individual who claims to have invented it. He is in the UK. Shipping is about 25% the cost of the unit itself. Can you comment on durability and/or end-user experience or satisfaction with the product? I'm interested in purchasing one but I'm hesitant to pay $500-600 for a product with no local representation. I've arranged for a cycling evaluation (not sure what to call it exactly) at a local bike shop that should determine if i can use one of the shorter cranks that the folks here have kindly provided links for. It may save me from dishing dollahs for an item i cannot even test prior to purchasing.

    TIA
    Tom

    BTW, the tinyurl link on your profile to your business, Vivid Reflections Auto Salon is a dead link. I was looking to determine if you were stateside. A google search places your business in Illinois if I've found the right one. If that's you then I'd tell you that you do nice work.

  17. #17
    yss
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    Quote Originally Posted by slow chevy View Post
    could probably use a unicam. have installed them at my shop now for a handful of people with limited movement
    I'd be interested in speaking. I'm in Antioch Thanks.
    847.875.4246
    Bryan.

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    yss
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    Quote Originally Posted by shasta68 View Post
    Hey yss,


    I have about 30 degrees flexion in my left leg. Even the folks closest to me don't seem to be able to imagine how 'I managed to let that happen' or the challenges it creates. My understanding is that one needs about 90 degrees of knee flexion in order to ride a normal bike off the rack. While a shortened crank can make up for some of the difference, they don't work for me and wouldn't work even if the pedal was effectively fixed to the cartridge at zero crank length. As far as I can tell, after discussing it with countless medical professionals and scouring the internet for adaptive devices, I'm left with few options for riding a bicycle. I'm not sure if the same is true for you but I thought I'd offer a few suggestions that might be helpful in your quest.


    First of all, you might want to check with bike shops in your area for those that have the proper equipment to assess your "riding style". The better shops have computerized equipment that, if anything, can determine if you if a shortened crank will work for you and make appropriate recommendations. A true enthusiast will be more than happy to accommodate your particular needs towards the goal of seeing you ride again. Secondly, there are hand-crank bikes, trikes and quads available in both upright and recumbent configurations. Technology continues to make these bikes increasingly viable options. Thirdly, there are electric bikes and electric assist bikes that can increase your riding range, alleviate some of the doubts and fears you may have, and most importantly get you out and get you moving. I find that I can overcome the worries of pain for the sake of doing something that's enjoyableand I tend to recover much more quickly from the pain itself that resulted from the doing. Give me an activity that includes a "woohooo! look at me now!" amd I'm there. Just a thought based on my own experiences with the cycles of depression and feelings of being defeated. Finally, I came across this website a short time ago: http://kneepainrehab.com/. I've been hesitant to purchase the articulating crank mostly because I've only found it available from the inventor who is in Great Britain and the cost with shipping comes to over $500 shipped. I lost my job in December so i have to take particular care before I make that kind of purchase. I think that some combination of all of these things I've mentioned is what will work for me. I just need to congeal my thoughts into action.


    I hope I've offered something useful to you.


    Regards,


    Tom
    Yes thanks. The unicam looks like the best option for me. Thank you.

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    I'm not sure if it's OK for me to post this here as my business is short cranks. But since I've helped at least 100 people with RoM issues, I'm probably the most qualified to give advice.

    The following text is going to be the basis of a web page I'll be adding to my web site.

    Crank Length for Range of Motion Limitations

    People with range of motion limits often contact me looking for one very short crankarm and one standard length arm. Usually at the advice of a bike shop owner, M.D. or P.T. However this advice is almost always wrong.

    If RoM limits on flexion are the only reason for shorter cranks, and both legs are the same length, both arms should be the same length. If you can get over the top comfortably with a 120 while pedaling a 170 on the other side, you could also do so with two 145s and be able to use the strength you have in both legs. (120+170)/2 = 145 Of course this means the seat will have to be raised.

    We are looking for optimum extension on both legs because the more time spent with less bend in the knee the more power you will get. And, it's good to exercise the limited leg through the full range of motion it does have.

    Here is a simple method that has been proven to give a good length for dozens of people with RoM limits.
    • Make a stack of boards, books or whatever will allow you to vary the height of the stack.
      * (Starting the stack on a stair tread or sturdy box may simplify this.)
    • Try to stand flat footed, pelvis level, with your bad leg on the stack and your good leg on the floor.
    • If you can do so comfortably, add a magazine, book or board.* If not remove one.* Keep adjusting till you get a maximum comfortable height without tilting your pelvis.
    • The height of the stack is the total length of both cranks.
    • If leg lengths are equal and range of motion limit is only on flexion then just divide by 2.
    • So if the tallest stack you can stand on comfortably is 290mm you should be able to pedal 145mm cranks etc.

    Scar Tissue
    If your RoM limits are due to scar tissue, riding may gradually improve you RoM. One gent got the wrong treatment for a knee injury, leading to much inflammation and an infection which left him with a lot of scar tissue. He started out at 120mm, but pedaling gradually broke up the scar tissue. So every 6 months he ordered another set, 5mm longer. (As a Cardiologist, he could afford to. )

    Power

    Don't worry about losing power on the good side, due to shorter cranks.. Unless one leg is just along for the ride, the increase in output on that leg will more than make up for any slight reduction on the other.

    My fastest triathlete is 5'-7" and on 130s The people at PowerCranks are convinced most average sized men should be on 145s.

    A 24 hour MTB race in Australia was won on 125s. The shortest guy on the team was 5'-10". With the shorter cranks they rarely had to stand. conserving energy. And they were able to get by with a single chainring because the useful RPM range is so wide with shorties.

    I have one customer, 6'-2" (188cm) tall, with range of motion issues, competing in long distance Brevets on 95mm cranks. Another gent with range of motion limits is climbing the hills of San Francisco with a single 38t chainring and a 12-25 cassette. Also on 95s. Because your legs are straighter, you push harder on the pedals, making up for lost leverage. The fellow in San Francisco bends pedal spindles.

  20. #20
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    old school solution

    Quote Originally Posted by yss View Post
    Hello,

    10 years ago I had a bad accident and I have limited ROM in my leg - around 60 deg. I would really like to ride a bike with my kids. What are my options? I'd like to stick with a traditional style bike if I could.

    Thanks
    Bryan
    Look for an old school bicycle with a front freewheeling drive system. The thrift/used bike world still has these and they are in expensive.

    The action of this will allow you to pedal each leg independently, not making a complete rotation unless you desire to. The chainwheel will continue to spin, whether you are moving either of the the cranks or not.

    For riding with your family, this would be a simple solution.

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    Limited ROM solution

    Quote Originally Posted by yss View Post
    Hello,

    10 years ago I had a bad accident and I have limited ROM in my leg - around 60 deg. I would really like to ride a bike with my kids. What are my options? I'd like to stick with a traditional style bike if I could.

    Thanks
    Bryan
    I have a similar problem due to a knee replacement. My riight flex is 112 degrees on my best day. I am getting a custom fit for a 44cm Fuji I just bought (I am 5'2"). I am assuming they will need to get me shorter cranks, but this also may also be a possibility for you, given you are taller: http://web.resna.org/conference/proc...2009/Tupi.html

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    Quote Originally Posted by TampaMom View Post
    I have a similar problem due to a knee replacement. My riight flex is 112 degrees on my best day. I am getting a custom fit for a 44cm Fuji I just bought (I am 5'2"). I am assuming they will need to get me shorter cranks, but this also may also be a possibility for you, given you are taller: http://web.resna.org/conference/proc...2009/Tupi.html

    Tampa Mom points to a good site. It outlines how things need to work for a limited ROM in the knee. I've got about 75 degrees of flexion in the right knee. The suggestions about going with a shorter crank doesn't make much sense to me since during a typical rotation the knee actually binds at a point lower than the centerpoint of the crank.


    So for me the answer is the hinged pedal which they describe at Resna. I've also heard it referred to as a drop pedal.


    I talked to a person on the west coast who was going to custom make a drop pedal crankset for a fairly extravagant amount of money, which I was actually willing to pay. He ended up never following up so I saved myself a couple of grand. Granted, it was going to be totally custom work with a lot of fine tuning, CNC turned cranks and possibly a custom offset or elliptical chainrings as well. So, a lot of work for a really slick looking end result. It could have been worth it.


    I figured it was a dead issue until a friend, who's a machinist, offered to try making something similar in his spare time. He butchered a set of cranks for me, giving me a similar system. We're at the phase one stage and I supplied him with a second set of cranks to play with for phase 2. I just transferred the frankencranks which were originally on a cannondale 29er to a gary fisher utopia.


    Now, for the first time in about 30 years I can actually sit and spin and climb. Even though I know the power output from the right crank is reduced, it doesn't feel that awkward. I'm not sure if I'd use this system for hardcore mountain biking but it works pretty well for road type riding, especially if you want to maintain a cadence.


    I don't know anyone who does this commercially and I'm lucky to have a friend who's a machinist. Granted right now they're an ugly set of frankencranks, but hey, it's a work in progress and it's free. If you do know somebody who does machine work, get a solid crankset for about 50 bucks for them to play with. My current cranksets are hollow core so my friend had to do some improvising to offset that.


    Jay

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    I ended up paying $100 for a crank shortener.

    It lets me put the pedal up toward the center of the crank arm.

    Works like a charm.

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    What kind did you end up getting? Also, what's your flexion on a bad day?

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    Here's something else that looks promising....

    http://www.highpath.net/highpath/cycles/swingcrank.html

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