Spearmin

Hi,
About 6 months since TKR and my operated knee won't bend enough for me to clip into my Spd pedal. It is painful to do so.
I am using double sided pedals. My right leg is fine and clips-in but I have to place my operated leg an inch or so further forward on the pedal than my right.

I really hope (I am sure it will) the situation improves. However, it would be great to hear from anyone who has experienced the same difficulty after tkr. In particular, I would like to know whether riding with my feet in different positions will have long-term effects.

redshift1

I haven't had a TKR but a far far more minor incident a couple of months ago - I completely removed my right foot big toe nail dragging a heavy chair towards me. So while it healed, I stopped using my cleated pedals and shoes ( road bike ) and started using flat pedals with flat soled shoes.

Have you considered using flat pedals and flat sole shoes, just for a little while ?

Maybe you will find less stress ( possible "twist" for one thing ) on your left knee. Also you might find during the ride, you can try sliding your foot back incrementally and see how you feel.

I'm not sure the greater freedom of movement will suit your TKR situation, but you could try it if you think it's safe.

These are the ones I bought - they are very good quality.

https://www.cyclingtips.com/2021/09/...pedals-review/

drlogik 

Ouch!

I had partial replacement years ago and have had no problems at all; however, I had the most ruthless, cruel, sadistic therapist that made me use this crazy electronic contraption that worked/articulated my knee in increments. It was absolute torture; however, I was up and walking inside two weeks and never looked back. Six months since surgery it may be too late but you might ask your surgeon about that machine. I laid on the couch while it worked my knee.

Steve B.

I'm thinking you need a few weeks of PT.

79pmooney

Various ideas here. 1) That your feet now don't sit identically - doesn't surprise me. I'd work on getting each foot/leg to the place where it is at its best and let the symmetry or no be what it is. But watch for issues cropping up from the asymmetry. Your body will be the best indicato of what works. 2) Consider all the options. You may well want different pedal types for each leg. A pedal like the Look Keo can be used with different cleats with different releases and on many clipless, you can adjust the release resistance. I use the same pedals left and right and same shoes but I have the right show toed in by the cleat a lot with the left shoe nearly straight. Run laces on my shoes and lace them completely differently. Odd but it works. If I set them up symmetrically, rides and after would be painful and at least one knee would be up for TNR. As is, I've staved off that TNR now for 45 years and hope to go a few more. If/when it happens, I'll have to follow the advice I" am giving you,

If you are one who puts his right foot down; so the TNR leg stays on the pedal, consider an old fashioned toeclip for that side. No twisting at all. You can ride with the strap loose enough to always be able to pull your foot out or reach down and pull it tight and it is fully the equal to clipless. (But you do have to remember to release the strap or you fall over when you stop. Now it you just relax and accept that you just made a fool of yourself.very little happens other than a couple of minor bruises and some slightly dirtied clothing. I've been riding with toeclips 50 years and I still forget. If your TNR leg is also your "put down" leg and you want to go toeclip for it or both, get back to me and I"ll pass on tricks to make the toeclips easier to get into.

Spearmin

I'm in Europe and the operation is free. However, my rehab only included 2 short visits to a physio and 1 phone consultation. So, I didn't really have any PT except for the exercise instructions (stretching and muscle strengthening) in a booklet I was given. I initially struggled with pain, and it took 6 weeks before a could turn the crank on my exercise bike full circle.

Spearmin

I decided on flat sole shoes and flat pedals with spikes on them. Thanks for the advice.

rickpaulos

Try some maintenance. Most spd pedals have adjustable spring tension. You can loosen up the spring tension. Spray some chain lube on the pedals and cleats. And see if the cleats are too close to the rubber shoe tread. You might trim some of the sole back with a sharp blade. All this can make it a lot easier to clip in.

zandoval 

Yep... You need to get back with Physical or Occupational Therapy. Specifically tell them you need to get back to ridding and let them make an appropriate plan. Take your bike in and show them your set up. They will size ya up and get ya started. It may only take a two visits...

Calsun

Sounds like you stopped the physical therapy too soon. Tough now to fix the problem but a lot depends on your pain threshold as to whether a PT can help. This is one of those no pain no gain situations.

Juan Foote

There was a pedal I was introduced to when I was first an amputee. It was basically a huge "bear trap" type with a big velcro strap used to secure your foot to said. It was a place foot, attach strap, ride type thing and did not allow for ease in getting that foot loose. I do not recall anything specific enough to link, unfortunately.

In my own case I have a ROM issue with my left knee and was able to work with seat height, cleat placement, and (something you can't do) foot position and length of the prosthesis to achieve the working range so my knee didn't pop as it went round. You might be able to work with crank length, seat fore and aft and so forth to find a workable spot.

sean.hwy

I had a motorcycle accident 2016. Operation on both knees after PT did not help in 2017. I have tried mtb style, road bike style and then I tried speed play pedals. Speed play with the extra float was easiest on my knees but still hurt on longer rides.

I use 510 pro flat pedal shoes and flat pedals bigger at least 100 x 100. The smaller pedal I tend to get host spots on my feet.


If you really must clip in instead of flat pedals I would look into speed play pedals after you have dial in your fit ( seat height, bike frame, crank length etc.. )

esther-L

I think those are Power Grips pedals. https://www.powergrips.com/ I have a set that I can put on 1 of my bikes. I converted them to the "extra long strap set" in order to get enough toe-out for my prosthetic foot. The longer strap set is also much easier to install and adjust than the standard set.

Leisesturm

There's no Velcro anywhere in a PowerGrips set though. The other straps actually sound more like the trick straps the BMX kids like.

Spearmin

I’m now 9 months post op (TNR), and I’m making progress. I recently cycled around the island of Gotland in Sweden (365 km) using flat pedals and shoes. I had to take pain medication occasionally, but I managed. On my return home I noticed my knee was able to move better, so I changed pedals and shoes to XT double sided and spd cleats.
I clipped in for only a short time at first, but yesterday I was clipped in for the whole ride.
The problem I have now is my hamstrings are really sore. Could clipping in cause the pain or is it a set up problem?

rosefarts

This is a good update to hear. I was sure you were due to need a knee manipulation under anesthesia, I'm glad to hear you are doing better.

I personally wouldn't change any fit items on my bike over the hamstring soreness yet. Try a few more rides, ease up to longer distance, stretch. Start slow. It's been a while with some major physiological changes. Give it time for your body to start fitting your bike again.

FWIW, my two racier bikes have been in storage for two years. I'll be reunited with them this fall. I'm scared how they'll "fit" after two years of gravel and mountain biking.

esther-L

I agree with rosefarts. Stretch those hamstrings, use heat/ice (whichever works for you), and think about getting a sports massage on those muscles.
My cats used to love it when I did the "legs up against wall" stretch for 5 minutes for hamstrings - they would rub on me and demand petting.
Stretch like a cat - don't force the range of the muscle when you stretch.

Spearmin

I once read that rehab after tkr was a long and painful process for cyclists. I will win in the end, but the two steps forward and the one back is tough. It seems the knee is re-learning all about riding the bike.
Anyway, I ordered new shoes and cleats (they should arrive tomorrow). Let’s see how many steps forward they take me.
On bad days, I reread your advice. Thanks for that.

Juan Foote

Ugh, wow I felt that again!

When my knee broke (another other things) they made me keep my leg straight in a brace for about six or seven weeks. I got the ok to start some movement and it would bend a few degrees and just get stuck. The PT nurse that was coming told me about this and as we were working just tugged it real good. Nice loud crack, lots of pain, and quite a bit more ROM instantly. It felt a whole lot like cortizone flare in there for about two weeks but moves better aside from a click part of the way through movement now. I had to modify my pedal stroke NOT to apply power there as it basically makes me fall down and cry very hard.

Ultrasherpa

Advancing and severe hip arthritis & related issues from long-ago car wreck meant I could no longer ride starting about 3 years ago. I've been looking at recumbents & handcycles, not convinced those were the best route, and then I somehow stumbled across the concept of swing cranks - basically a pedal swing and crank shortener. It's specifically for people with severe ROM limitations in knee and hip. It's adjustable, if/as you regain ROM. There are several brands - I got the Easy Knees from T-Cycle. I feel like PTs & LBS need to know products like this exist but they don't seem to. We have a huge well-known LBS here and they were amazingly clueless when you consider how many people have these issues. Installed it last Wednesday and finished my third pain-free ride yesterday. TBH I thought I would never ride my bike again & was thisclose to selling it & now DH & I are thinking our Katy Trail roundtrip project may be within reach again. No idea if it would help you but possibly worth a look.

Peruano

Wow ! I hope it works for you. See you on the trail.

Spearmin

Well,
I bought new shoes and cleats, but I decided to stick with flat shoes and pedals. My knee is fine as long as I am able to switch foot position when it gets uncomfortable.

I just completed a 450 km multi day tour with no problems. I am 10 and a half months post-op, and I think I’m getting there. Until next time.

Spearmin

It is now 12 months since I underwent TKR. During the summer, I completed two multi-day tours on the bike. I still use fat pedals, as I don't feel comfortable with clip-in pedals.

The knee got stronger and more flexible after each tour. At the end of the month, I am going to Taiwan to cycle around the island (960 km). I'll let you know how it went.