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TKR Cycling

Bikeknit

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I wondered if you used cyling shoes with cleats? I suppose there is some risk of hurting my new knee if my foot is is fixed in position wearing cycling shoes
I quit wearing clip in cleats a few years before the surgery. I could still ride comfortably for 20 miles or so but as my knees got tired, I somehow found it harder to clip out. I have pedals with clips on one side and not on the other so I've been using the non-cleat side. Don't want to have the complication and they did warn me about twisting. I have a friend who got a new knee two years ago and he uses cleats. You might ask your doctor or maybe others can chime in.
 
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Eddy

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Thats really interesting. Thanks for the feedback. I hadn't considered clipping out.
 

allin1

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Hi, I had my surgery on 5/20. I was back on the bike on 6/17, albeit for less than a mile. I had to raise my seat a couple of inches so I could get enough bend in my knee to get the peddles around. And I definitely didn't use my clip in peddles, clipping out was unthinkable. As my knee felt better, I lowered the seat and increased distance. At some point I went back to my clip in shoes and peddles, don't remember exactely when. Probably once I got up to around 10 miles rides. Yesterday I did my longest ride, 28 miles around a pretty flat course. My knee will sometimes ache a little once it gets tired, but once I stop the pain doesn't persist.
 

Mrs. Ciz

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Do any of you cyclists remember what your ROM was when you first got back on your bikes? I can ride both the easy and the hard recumbent bikes at my PT clinic, but I’ve been afraid to try my real bike.

I don’t have a trainer to put my bike on. Today I took it out of the garage and made an attempt, but when the pedal got to the top, it put too much pressure on my left knee, which is the one that’s healed best so far (bilateral TKR on 7/6/20). If I raise the seat much, I won’t be able to reach the pedals. I’m afraid my ROM just isn’t there yet.
 

Roy Gardiner

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Tried my trainer again today, very gently, and realised my knee was too tight and stiff to achieve anything so I stopped.
You can still use a static trainer for mobility exercises - even if you can't make a single rotation!

  • Set the bike to zero resistance
  • Set the saddle as high as possible and rock the pedals back and forth as far as you can with discomfort but no pain
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
I hadn't considered clipping out.
No need to wear cycling shoes for this exercise, probably in fact better not to - more control of your foot's position
 

allin1

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Do any of you cyclists remember what your ROM was when you first got back on your bikes?

I’m afraid my ROM just isn’t there yet.
Mine was in the 105 to 110 range. I couldn't have done it if I couldn't raise my seat. You should be able to raise it some and still reach the peddles. I only had the left done, not sure how much the bilateral changes the equation.
 

Homemadesalsa

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I used flat pedals for quite some time on both the gravel and the mountain bike. Hard initially to get the flexion to clip in, plus there's a lot less pressure to clip out or to get the foot in a particular position. I went back to clipless when I missed the advantage I get from them (can argue that one all night...) AND when I had flexion enough to clip in. It's still something to be more aware of- when I drop the seat descending and then need to throw in a pedal stroke. One day I did that, not remembering how tight the flexion angle would be, and I got white light explosions in my knee and brain. Sortof like a MUA, but not under anesthesia!

But now I just need to warm up a bit, get that flexion started, and I clip right in. I did realize that it was pretty important to clip the right (TKR) leg in first in technical terrain, as I don't have the proprioception to nail the clip in right away under pressure.

Good stuff! #ridebikesbehappy
20200725_112417.jpg
 
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Eddy

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All these replies are great and encouraging. I met my (excellent) PT yesterday nearly 3 weeks since my TKR. He was happy with progress and has given me a new set of exercises to progress, including upper body and core strength in addition to specific knee strengthening. He encouraged the use of bike as part of my recovery. He also recommended 'massaging' the scar to assist with tightness and healing.

I Had another go on my home trainer...had to put saddle up around 1 inch and I could pedal, but very tentatively and slowly and I only tried for a few mins. I Plan to do a little every day. I'm not going to use my Cycling shoes yet. I think my ROM is 100 - 110 and everything feels quite 'tight' as I rotate. Fortunately my pain is much reduced and walking unaided feels easier everyday. Good luck to all you bikies out there ......col de tourmalet next year???
 
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Eddy

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Hi all,
An update from me @ 3 1/2 weeks post tkr to right leg and seeking some reassurance from you pros.
I dont really need my crutches now. I can walk quite well over most terrain. Still a little stiffness as I bring the 'new knee' through but no pain. Also my left knee is completely shot and bowed so it hurts more the the right sometimes and my gait is not completely balanced. . I take one crutch with me as insurance if I have to stand for any length of time or for steep downhill. After a 30 min walk the right leg is a bit achey and I elevate and ice and rest.
On my my indoor trainer I can manage a few revolutions but new knee is still a little tight at the top of the pedal stroke so I'm not pushing cycling at the moment.....just a couple of minutes every day until it feels easier.
I've started some step ups at a low height and can manage quite well. Im maintaining the leg raising and flexing exercises given to me by the hospital with reasonable ease.
I suppose my question is to do with walking. I feel I could do some more but I'm cautious and don't want put too much strain on the knee. Physio said to tolerate pain level around 2 to 3 and not cause any swelling. I haven't had any swelling to date. Main consequence of execise is aching and stiffness which seems predictable and respond with ice, elevation and rest in bed.
Grateful for your thoughts on walking...little and often or More sustained?
 

Sara61

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At 3 1/2 weeks I think all the exercise you are doing is sufficient for your new knee, you seem to have a good balance and no swelling which is a good sign that the joint isn't irritated.
As the weeks progress then start walking a little more, if you notice swelling then cut back again.
When you do walk concentrate on your gait, this is important for the extension, use the heel to toe rolling method and try to walk tall but obviously keep an eye where you put your feet as you don't want to trip over.
 
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Eddy

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Thank you for this Sara. I tend to have a dull ache after walking but no real pain and no swelling. Will gradually build up the duration and concentrate on heal and toe walking.
 

Bikeknit

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I had a similar situation with the non surgical knee quite bowed. I kept getting a dip on that side when I walked. Once I didn't need the cane for my new knee (a few weeks still from where you are) my pt had me use a knee brace on the still damaged and not yet replaced knee and use a cane to support that knee. The awkward walking was messing with my extension. Can your physical therapist advise you on how your gait will affect your extension?
 

np7

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We are pulling for you. BTW, moving the seat out one stop on my recumbent bike allowed me to start on earlier than if I left it in the usual position. Even then, I start by just moving half way around a couple of times. Now after I have warmed up a bit, I can reset to my old, normal position.
 

Ghost Rider

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Hey Eddy thanks for posting the thread. Good luck with your recovery. I'm sure you will be cycling soon enough. Good advice here not rushing it. I would think your doctor or PT would be able to advise you when you are ready to start riding. I ride mountain bikes too.

I'm still getting all my ducks in a row before I schedule my surgery. I just had an MRI yesterday I'm hoping that will tell them more. Part of me thinks I'm not really bad enough because I've been feeling pretty good lately, one fast step and that's over.

Thought getting a trainer set up in the living room prior to surgery would be good. This is a cheap one.
 
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Eddy

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Due to the covid restrictions in the UK I am not seeing a PT regularly. It will be 4 weeks before I see him again. I'm managing OK with my bowed left leg and don't feel it is hampering my walking too much. If I dont concentrate when walking I can lapse into a kind of limping gait. So I just have to stay cincentrated.
Im happy with the advice to use my bike trainer little and often and get to cyling when my knee is ready. Whilst keen to use cycling as part of my recovery I'm not going to force it. There are plenty of other exercises I can focus on.
I think my next challenge is stairs. I'm a little reticent on them at the moment. Going up is easier than descending and I don't yet have the confidence to fully weight-bear up or down. I'm using step-ups to build up my strength in this respect.
I read something on the forum saying that recovery from TKR takes 12 months and I'm using that advice to keep reminding myself not to try and force my progress. I have the time to take my time!
 

Birdwatcher

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are you back to a reasonable level of onthe bike fitness? Can you complete long rides without pain? Can you climb big hills
Hi Eddy. I am almost 7 months post-op, and yes I am pretty much back. Especially bike riding is very good for me. I can do hills and long rides with no pain. My longest ride is 103 km in one day, last month. No pain afterwards, a bit of swelling, but it subsided within hours.

I am not back when it comes to running, which was the greatest part of my life, but I am enjoying what I can, and bike riding has been so good for me this summer.

Congratulations with your new knee and new life. It may seem like an impossible thought some days, but it WILL be good, you WILL be back in your old shape on your bike.
I often told myself: This too shall pass.
 
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Eddy

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100km is epic..i havent managed that distance for years..due to my broken knees. It is an ambition for the future...my right knee is now 4 weeks on from surgery. I hope to get the left replaced early next year. I'm a tennis coach so hope to get back to some gentle hitting soon and maybe feeding clients from a basket. I assumed running is a thing of the past for me...i used to love running but my knees have been a long standing problem. Are you a birdwatcher? Thats certainly something i can do now..most hides have a bench. It would be good to get out of the house for some peace and quiet !
 
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Eddy

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Bit of a breakthrough for me today @4weeks 4 days post op. Finally able to use my home trainer to cycle without too much difficulty. I managed 20 mins at around 50rpm with low/medium resistance. No pain, still a little tight but not enough to cause problems. Had a quiet weekend with lots of rest which helped.

Still waking up and feeling an 'alien' knee! Curios to know how long before you wake up and you are not conscious of it?
 

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