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Biking after total knee replacement

Old 09-03-14, 05:26 AM
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Old 09-04-14, 10:53 AM
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Thanks for all of the great information, and good luck patentcad!

I'm 58, and managed to ruin my left knee. I was thinking it was all the hill climbing, but I also used an elliptical stair master for years. I think that may have helped with the deterioration.

I have the TKR scheduled in December. The surgeon and his staff claim that I won't be able to do hill climbing without pain if I put off the surgery. I can ride without pain now, and have started back riding hills. I'm going to start getting up our local mountain (Mt Diablo) his week, which is a 7 - 8% grade climb. If I find that there's no pain from this, I will be really confused! I can't go forever without that surgery, but putting it off another year will be attractive. I have no ACL, no cartilage, arthritis & bone spurs. I've been doing physical therapy to gradually strengthen the knee, and riding doesn't give me any trouble.
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Old 09-06-14, 11:26 AM
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dachshund, I have a couple questions for you. Are you in pain enough that sleep is difficult? Do you need pain meds now? Does knee pain keep you from doing what you want, when you want? I put mine off longer than I should have. Fear. But the TKR got me moving again pretty quickly. I know I won't wait again if my other knee requires replament. Certainly not as long as I did the first one.
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Old 09-07-14, 05:51 PM
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zjrog, I don't have much pain at all. I realize I'm sort of splitting hairs because I need the surgery, I have it scheduled, and I might as well get it over with. But I've built up to riding 7-10% grades, and still don't have any pain. So the part of me that would like to put off the disruption, pain, and physical therapy is focused on the fact that my knee isn't giving me much trouble at all.
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Old 11-19-15, 09:46 AM
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I realize this post is old but wanted to comment. I had a TKR back in 2008. I am big 6' 4" 260 lbs. I ride about 3000 miles a year with about 100,000 ft. of climbing. Was at Dr. for routine checkup and some xrays and was told that the plastic insert was almost worn out. I am going to continue to cycle and am researching a revision specialist. I am led to think that possibly replacing just the plastic piece is an option.
My hope is to find a specialist that also enjoys cycling because I do not want to give up cycling. How to achieve this is not going to be easy. Going in I knew with my size and activity level knee would not last as long as normal but am shocked to find out I wore it out in 7 years
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Old 11-19-15, 05:52 PM
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Sasquatch16, revision is what I hope is all I will need, I'm heavier than you though, and 5 years post. It was something I did discuss with my surgeon. I recently started my process for the other knee. Had my first cortisone injection 6 weeks ago and doing ok. But ready for the gels. But my cartilage, is under 2mm already. I just won't let the pain get so bad before replacement.
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Old 04-16-17, 02:08 PM
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8 week (first outside bike ride)

I love riding my bike! I am almost 60. Have had a partial left knee, total right knee (8 weeks ago), total left hip and resurfaced right hip. All four surgeries since age 50. Today, I rode 8 miles with my 20 year old son running alongside me. Felt great. I am sure I'll pay for it tomorrow with pain and swelling. I am icing and elevating it now. Eight weeks seemed to be the turning point for me with this surgery. Looking forward to many more bike rides as I am retiring in June!
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Old 04-16-17, 02:35 PM
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12 weeks out of my left TKR. Bought a new bike as motivation to return to the sport! I picked it up about 10 days ago and have been able to start riding. Need to build a lot of muscle back up on that leg, very weak. But I got 34 miles total in last week with rides 6, 12, and 16 miles in. Pretty slow deliberate pace but it felt great to be back doing it!
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Old 07-23-17, 12:00 PM
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Originally Posted by Miami Biker
Update two years later. Now 69 and have ridden 3,500 miles this year. Average 2014 ride 48 miles and 16.6 MPH but over 17.5 since new bike in April.

No problems with knee at all--TKR and original left one. Everyone is different however now 9 years since surgery, 6 years biking over 17,000 miles with 8,500 in past 18 months. Still getting stronger. Go for it if you will.
Just read your story. Amazing and inspiring!
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Old 07-23-17, 07:13 PM
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Plenty of folks in my bike club have bionic knees. So far, I've never heard of one falling and breaking the replacement. If the possibility really bothers you, get a trike.




Last edited by BlazingPedals; 07-24-17 at 06:00 AM.
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Old 07-24-17, 08:31 AM
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Originally Posted by BlazingPedals
Plenty of folks in my bike club have bionic knees. So far, I've never heard of one falling and breaking the replacement. If the possibility really bothers you, get a trike.



When I asked my surgeon about the risks from a crash he commented that it was unlikely to damage the prothesis in a crash, but more often what happens is a broken femur because there is no flex in a prothesis. Last summer I crashed and landed on the left side of my head, and my left --- not to distantly replaced --- knee. I embedded a rock right on the incision scar, but no broken anything.
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Old 07-24-17, 08:47 AM
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I had one knee replaced this January. Getting on a stationary bike was part of my physical therapy. It took 3 weeks before I had the range of motion needed to complete a full circle. After that, things improved more quickly.

I'm only riding my 11 speed Campy equipped LOOK on a trainer, as continuing therapy. I plan to get the other knee replaced in November. With my insurance maximum out of pocket expense met, the second knee should be almost free. Not sure if I'll ever resume road riding. The chances of damaging a knee are certainly good and so is the probability of just wearing out the mechanical joint. Getting a second replacement at some point is not uncommon, but after that, another is extremely difficult, perhaps impossible.
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Old 07-24-17, 08:55 PM
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Originally Posted by Miami Biker
Update two years later. Now 69 and have ridden 3,500 miles this year. Average 2014 ride 48 miles and 16.6 MPH but over 17.5 since new bike in April.

No problems with knee at all--TKR and original left one. Everyone is different however now 9 years since surgery, 6 years biking over 17,000 miles with 8,500 in past 18 months. Still getting stronger. Go for it if you will.
That's what I need to hear. I'm going to see the surgeon tomorrow to set up my knee replacement. I'm still riding now but walking is painful and forget about stairs. I have every intention to be back on the bike asap. A couple of weeks ago the pain got pretty intense and I had to use a cane. I went to see the Doc who did my hip replacement and after x rays and a CT scan I found out the knee was shot.
Now two weeks later the pain calmed down quite a bit and once again riding is doable' with pain meds. I'm just concerned about how much I'll get back after the surgery. Now I'm good for 150 - 200 miles a week with a fair amount of intensity. I just cleared 5K miles for the year. What I really want is to be able to keep on riding and maybe not cringing every time I look at a flight of stairs. Anyway I can't see anyway around it so hearing your experience gives me some hope.
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Old 08-03-17, 06:51 AM
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I'm 66 and had TKR, left knee, back on 6/5, but the surgery did not go perfectly. As the surgeon was doing a "medial release", remove tissue with an electrical cutting tool, it arced and blew out the side of my knee. So I had many bonuses: A bonus incision, bonus bleeding, bonus swelling, bonus pain. So, I was behind schedule on everything-the first two weeks are just a fog of pain and begging for my percocets a few minutes early...Would post a pic, but this site needs to have pictures hosted?


Now, i'm caught up at 8 weeks and thinking about trying to get up on the bike. Have been riding a recumbent stationary at PT and my flex is around 120 degrees, so i should be ok. In theory. My hybrid is setup with 170mm cranks.


Very apprehensive about falling, but I need to get back on it. My wife is definitely not a fan of the idea.
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Old 08-03-17, 07:10 PM
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Originally Posted by Sam9
I'm 66 and had TKR, left knee, back on 6/5, but the surgery did not go perfectly. As the surgeon was doing a "medial release", remove tissue with an electrical cutting tool, it arced and blew out the side of my knee. So I had many bonuses: A bonus incision, bonus bleeding, bonus swelling, bonus pain. So, I was behind schedule on everything-the first two weeks are just a fog of pain and begging for my percocets a few minutes early...Would post a pic, but this site needs to have pictures hosted?


Now, i'm caught up at 8 weeks and thinking about trying to get up on the bike. Have been riding a recumbent stationary at PT and my flex is around 120 degrees, so i should be ok. In theory. My hybrid is setup with 170mm cranks.


Very apprehensive about falling, but I need to get back on it. My wife is definitely not a fan of the idea.
Sorry to hear that. Am I wrong or is a medial release done to realign the kneecap? I have never heard of that before. Where did you have it done?
I'm scheduled to have my right knee done on Sept 7 but as of right now I'm still riding the bike 175 miles a week and working out. It's walking and stairs that are the problem. I'm ready for a healthy dose of pain with the rehab, my wife had bilateral knee replacement and I saw what she went through. I just hope that mine goes by the numbers with no surprises.
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Old 08-07-17, 06:32 AM
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Originally Posted by TCR Rider
Sorry to hear that. Am I wrong or is a medial release done to realign the kneecap? I have never heard of that before. Where did you have it done?
I'm scheduled to have my right knee done on Sept 7 but as of right now I'm still riding the bike 175 miles a week and working out. It's walking and stairs that are the problem. I'm ready for a healthy dose of pain with the rehab, my wife had bilateral knee replacement and I saw what she went through. I just hope that mine goes by the numbers with no surprises.

I had it done locally, small town (80K) hospital. But the surgeon has done a ton of TKRs, did all his studies at UAB which has a great rep for orthopedics, has access to the latest tech, MAKO robot assist...Both of my next door neighbors had TKRs done by him, I probably know a dozen others, and all went well. So, sometimes things go awry.

You'll probably be fine, but there are risks. Risk of infection alone is about 1%, I've read.
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Old 09-13-17, 09:11 PM
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TKR and cycling question

Hello,

I had my right knee replacement last July, right after my 48th birthday.

Brief background:
I ride a Specialized Roubaix road bike and had been riding around 100 miles a week prior to the meniscus injury and surgery that left me bone on bone. I have had bad knees my whole life (patella femoral syndrome and knee pain since I was 13). My kneecap was also a mess and had to be augmented with a "button" during surgery. I'm a woman, if that matters.

Question/Problem:
When I ride, I feel a rubbing/something moving/not feeling normal in my knee. It happens on every rotation and feels extremely uncomfortable and then sore/painful.

Has anyone else had this happen? It's making cycling extremely difficult.

I did have a follow-up appointment with my surgeon regarding this issue and he examined my knee as well as complete x-rays and blood work to eliminate the possibility of infection. He showed me the x-rays and said that everything is fine.

I've been walking and swimming to strengthen my knee, but cycling is my favorite and I miss it.

Sorry for the long post, but would appreciate any feedback.

Thank you.
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Old 09-14-17, 11:13 AM
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Originally Posted by bornonthefourth
Hello,

I had my right knee replacement last July, right after my 48th birthday.

Brief background:
I ride a Specialized Roubaix road bike and had been riding around 100 miles a week prior to the meniscus injury and surgery that left me bone on bone. I have had bad knees my whole life (patella femoral syndrome and knee pain since I was 13). My kneecap was also a mess and had to be augmented with a "button" during surgery. I'm a woman, if that matters.

Question/Problem:
When I ride, I feel a rubbing/something moving/not feeling normal in my knee. It happens on every rotation and feels extremely uncomfortable and then sore/painful.

Has anyone else had this happen? It's making cycling extremely difficult.

I did have a follow-up appointment with my surgeon regarding this issue and he examined my knee as well as complete x-rays and blood work to eliminate the possibility of infection. He showed me the x-rays and said that everything is fine.

I've been walking and swimming to strengthen my knee, but cycling is my favorite and I miss it.

Sorry for the long post, but would appreciate any feedback.

Thank you.
He can tell you everything is fine but obviously if you are unable to ride without or at least minimal pain than everything is not fine. I would go and have another doc take a look at it see what they say. Perhaps a muscle imbalance in the quads causing it to track incorrectly.
My wife had bilateral knee replacement 11 years ago. Her problem was Patella Alta which was caused by a too long patella tendon. She can now ride without issue she does have an issue from time to time with a bone spur which seems to flare up when she gets swelling in the area. I don't think that sounds like what you're encountering.
It's got to be frustrating when you have a major surgery done and then you can't ride your bike which is supposedly best activities you can do with a new knee. Good luck.
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Old 09-14-17, 06:12 PM
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Originally Posted by TCR Rider
He can tell you everything is fine but obviously if you are unable to ride without or at least minimal pain than everything is not fine. I would go and have another doc take a look at it see what they say. Perhaps a muscle imbalance in the quads causing it to track incorrectly.
Thank you for your thoughtful response. I am wondering about a muscle issue, too. I've always been a bit strong/athletic, but that doesn't mean there isn't something that can be improved. I've been thinking about searching out a personal trainer with experience with post-surgery strengthening.

I'm glad your wife is able to ride.
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Old 09-15-17, 08:47 AM
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One other possibility you might want to explore is trigger points. The surgery involves reattaching ligaments and tendons and that process could cause trigger points to form. That would cause shortening of the connective tissue resulting in improper tracking of the joint. From my personal experience I have had some positive results searching out trigger points and treating them myself. You might want to take a look at this book I have relied on it many times to get rid of pain https://www.amazon.com/Trigger-Point...erapy+workbook
I also generally splurge and get myself a deep tissue massage once a month which also helps. The older I get the more work I have to do to keep myself on the bike but to me it's worth it. Just be sure to find a massage therapist that has experience working on athletes.
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Old 09-18-17, 07:28 PM
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Originally Posted by TCR Rider
One other possibility you might want to explore is trigger points. The surgery involves reattaching ligaments and tendons and that process could cause trigger points to form. That would cause shortening of the connective tissue resulting in improper tracking of the joint. From my personal experience I have had some positive results searching out trigger points and treating them myself. You might want to take a look at this book I have relied on it many times to get rid of pain https://www.amazon.com/Trigger-Point...erapy+workbook
I also generally splurge and get myself a deep tissue massage once a month which also helps. The older I get the more work I have to do to keep myself on the bike but to me it's worth it. Just be sure to find a massage therapist that has experience working on athletes.
Thank you for that post. I hadn't heard of trigger point therapy and will look into it.

A deep tissue massage does sound nice!
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Old 09-19-17, 02:46 PM
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Originally Posted by bornonthefourth
Thank you for that post. I hadn't heard of trigger point therapy and will look into it.

A deep tissue massage does sound nice!
Worth looking into. If there are trigger points (knots) in the muscle or connective tissue it's going to cause it to shorten or even go into spasm. It's pointless to try to stretch the muscle before you get the trigger point to release. A good massage therapist will know how to find and treat trigger points. It's not a painless process but it works.
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Old 04-19-19, 03:39 PM
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Biking after total knee replacement

Hello, am now 8-weeks post right TKR, it really was the right thing to do, no more pain with walking, in the morning, etc. I am 68-years old, female, and we were biking 50-100 miles a week and did PT exercises for 8-months prior to the surgery (because I was headstrong and didn't want to accept that I really needed surgery.) Today on the road bike I noticed that my pedal strokes were pushing my knee medially, it was not comfortable, a simple 12-mile ride. It is like my leg is not pushing straight down, I have to consciously try to move it a little laterally with each pedal. Any suggestions for this? I am still doing all my post-surgery exercises twice a day, the surgeons are amazed at my progress. Am I pushing it to get on the outside bike (should I just stick with stationary biking for now)? Should I just stick with it and keep trying to correct this while biking? Thanks for any help! My knee is straight with my upper leg, but my lower leg is curved a little bit.
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Old 04-19-19, 08:57 PM
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Originally Posted by NewMexicoGardne
Hello, am now 8-weeks post right TKR, it really was the right thing to do, no more pain with walking, in the morning, etc. I am 68-years old, female, and we were biking 50-100 miles a week and did PT exercises for 8-months prior to the surgery (because I was headstrong and didn't want to accept that I really needed surgery.) Today on the road bike I noticed that my pedal strokes were pushing my knee medially, it was not comfortable, a simple 12-mile ride. It is like my leg is not pushing straight down, I have to consciously try to move it a little laterally with each pedal. Any suggestions for this? I am still doing all my post-surgery exercises twice a day, the surgeons are amazed at my progress. Am I pushing it to get on the outside bike (should I just stick with stationary biking for now)? Should I just stick with it and keep trying to correct this while biking? Thanks for any help! My knee is straight with my upper leg, but my lower leg is curved a little bit.
So, my wife did both knees at 64, got in the stationary bike as quickly as possible, went for her normal bike as soon as the Dr. allowed. What he Dr.s are worried about with outdoor bike is emergency stops putting the foot down and flexing the knee backward. That is particularly dangerous for someone in TKR recovery. I think, and this is not a scientific opinion, that clipless are a potential problem if you ride them exclusively. You want lots of float while you are healing. My wife has always used pinned pedals, so not problem. I have noticed that her leg motion seems more under-pronated, or knees-out, after the surgery..but she's not complaining.

But I switch off from clipless to platforms cause I think riding clipless all the time isn't particularly good for old knees and ankles. Since I am more of a running enthusiast than cyclist I will always switch off between clipless and different platforms, I do not want to subject my knees and lower legs to an overly restrictive motion for hours. Just my 2 cents.
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Old 04-19-19, 11:08 PM
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Biking after total knee replacement

Originally Posted by FrenchFit
So, my wife did both knees at 64, got in the stationary bike as quickly as possible, went for her normal bike as soon as the Dr. allowed. What he Dr.s are worried about with outdoor bike is emergency stops putting the foot down and flexing the knee backward. That is particularly dangerous for someone in TKR recovery. I think, and this is not a scientific opinion, that clipless are a potential problem if you ride them exclusively. You want lots of float while you are healing. My wife has always used pinned pedals, so not problem. I have noticed that her leg motion seems more under-pronated, or knees-out, after the surgery..but she's not complaining.

But I switch off from clipless to platforms cause I think riding clipless all the time isn't particularly good for old knees and ankles. Since I am more of a running enthusiast than cyclist I will always switch off between clipless and different platforms, I do not want to subject my knees and lower legs to an overly restrictive motion for hours. Just my 2 cents.

Thanks FrenchFit for your input, interesting, appreciate it totally I am now thinking that I will email my PT and ask her if perhaps some inner thigh exercises will help, since none of my exercises stretch that part. The best to your wife, hope her healing continues well!
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