TKR One Year Update: problems cycling

[Jennszoo]

Thanks for this post. I'm hoping to take my bike off the trainer soon and trybthe road. So I'm following along for info.

 

[kmak81230]

I've been slowly transitioning to the road from the trainer and/or stationary bike and going to spin class twice a week for about 45 minutes (~10 miles at low resistance). What I have noticed is that when I clip in and as I increase the mileage I have experienced some soreness in the medial area. My new leg is straighter and I'm wondering if the clipping in a slightly new position for this new knee is working areas of muscles that have not previously been worked. I am taking it very slow with the bike - just started spinning about 3 weeks ago.

 

[Clipless]

Hi there. Beware bike "tech talk" ahead: First off, have you tried raising your saddle? Have you tried riding with flat pedals instead of clipless, letting your foot find it's place on the pedal?

Both of my knees were replaced a year apart and both were a bit slow regaining bend. I started out pedaling a spin bike that I've had forever. To get back on my road bike comfortably I had to raise the saddle a little (a temporary solution). I also switched to flat pedals. Then I wanted to ride my mountain bike. I raised the saddle, I switched to flats. It still hurt too much, but why? Upon examining all three bikes I discovered that the mountain bike crank arms were longer- 175mm vs 170mm road bike and 165mm spin. I had the bike shop replace my mtb's 175mm cranks with 170mm cranks and it made all the difference. You see, the shorter the cranks the less the knee must bend. It can take up to two years to regain full flexion after TKR. So, if raising your saddle and switching to flats isn't enough, look at your cranks or have a bike shop do it for you. The crank arm measurement is stamped really small into the inside of one the arms.

Another option would be to get your bike professionally fitted by a qualified technician. In a pro bike fitting you and your bike are put on a trainer and everything is measured. Changes are made and parts swapped until you have the optimal fit for your type of riding.

Word of mouth will find you a good bike fitter, so ask around or try an online forum like roadbikereview.com. My go-to guy had a degree in bio-mechanics and a career fitting prosthetic limbs before he started his own bike shop, so he is REALLY good.

P.s. Almost two and three years on from my TKRs I am back to clipless pedals and my saddle is back where it belongs. Good luck!

 

[LoveGiants]

I had both knees done - staged 10 weeks apart - and started riding 6 weeks after the last one. Stiff to get started but manageable. Some pain but more stiffness. Now at 12 weeks (4 30+ mile rides this week) still some stiffness but getting slowly better. I'm still pretty slow (can't keep up with my team) but getting faster. I felt some mild pain but more the problem was and still is stiffness. FTIW - prior to surgery I was a pretty avid cyclist - 200+ miles a week so I started from a strong base. My "guess" with yours is that over the year since surgery scar tissue has formed and that is causing you pain.

If I were you I'd try slow short frequent rides slowly increasing mileage. Icing after every ride. If it is scar tissue it will take a while to get it better - but it will. But not without some pain along the way. As long as you are not seeing significant swelling afterwards I'd say just keep at it but with expectation of slow improvement.

Hello, thank you for your response. You're doing *amazing* at 12 weeks!!!

I was riding around 100 miles a week prior to my meniscus injury that was the last straw that led to my TKR.

I have a Specialized Roubaix SL3 (love that bike) and a Kinetic Rock n Roll trainer. I got on the bike on the trainer at around 6 weeks or so, and it's never felt smooth. I was on the trainer for months and just took the bike off and have been going around the neighborhood.

It's the rubbing/clicking (not quite the right word) that occurs on every downstroke that is incredibly annoying and pain-inducing.

Good idea to ice after rides. I'm going to keep at it.

 

[LoveGiants]

Hi there. Beware bike "tech talk" ahead: First off, have you tried raising your saddle? Have you tried riding with flat pedals instead of clipless, letting your foot find it's place on the pedal?

Both of my knees were replaced a year apart and both were a bit slow regaining bend. I started out pedaling a spin bike that I've had forever. To get back on my road bike comfortably I had to raise the saddle a little (a temporary solution). I also switched to flat pedals. Then I wanted to ride my mountain bike. I raised the saddle, I switched to flats. It still hurt too much, but why? Upon examining all three bikes I discovered that the mountain bike crank arms were longer- 175mm vs 170mm road bike and 165mm spin. I had the bike shop replace my mtb's 175mm cranks with 170mm cranks and it made all the difference. You see, the shorter the cranks the less the knee must bend. It can take up to two years to regain full flexion after TKR. So, if raising your saddle and switching to flats isn't enough, look at your cranks or have a bike shop do it for you. The crank arm measurement is stamped really small into the inside of one the arms.

Another option would be to get your bike professionally fitted by a qualified technician. In a pro bike fitting you and your bike are put on a trainer and everything is measured. Changes are made and parts swapped until you have the optimal fit for your type of riding.

Word of mouth will find you a good bike fitter, so ask around or try an online forum like roadbikereview.com. My go-to guy had a degree in bio-mechanics and a career fitting prosthetic limbs before he started his own bike shop, so he is REALLY good.

P.s. Almost two and three years on from my TKRs I am back to clipless pedals and my saddle is back where it belongs. Good luck!

Hello, thanks for your response!

I had a professional fit when I bought the bike five years ago and have the saddle as high as comfortable, which is how I prefer it. I had them put platform pedals on after my meniscus injury and they're still on the bike.

Flexion isn't a problem for me (my doctor was astounded by how well I could bend/extend my knee). My cranks are 172.5.

Getting another fit is a interesting idea—thanks for that. My bike has always been extremely comfortable, but maybe my knee would benefit from another look. I don't have another bike, so this one needs to be dialed in.

Thank you for good things to think about. I do appreciate it.

 

[lovetocookandsew]

Hi, Julie. Glad you're coming along, even though you have a bike problem. I still can't ride mine at all, so I hope you can figure out your problem and get to biking again. I can't help with any advice, but I do hope you are soon back on our wonderful river and lake bike paths!

 

[Roy Gardiner]

When I came back to riding, I could barely ride at all. I couldn't get comfortable on the bike, couldn't pedal properly. I kept on fiddling with the foot adjustment (I use Speedplay click-ins), no good. Then I thought "Wait a minute, my legs have been hacked about, but one thing I can be sure of is that my knees are now *straight*" Sure enough, looking at the shoes clicked into the bike on their own, they were miles out of alignment. So I set them up by sight to be absolutely straight and correct, problem solved.

Er, except it wasn't. Felt worse than ever!! So I went out and rode at maybe 8mph, pedalling really slowly, to try and figure it out. Lo and behold, my legs were automatically and subconsciously trying to compensate for dodgy knees that weren't any more. If I pedalled consciously and carefully straight, it felt right. It took me days of pedalling like this to make my legs work properly.

Some weeks later I met a cycling clubmate who rode up behind me "I thought it was you, but you were pedalling straight instead of your normal way." I didn't even know my previous style was wonky.

Maybe some of this might apply to some of you here trying to ride again.

 

[LoveGiants]

Hi, Julie. Glad you're coming along, even though you have a bike problem. I still can't ride mine at all, so I hope you can figure out your problem and get to biking again. I can't help with any advice, but I do hope you are soon back on our wonderful river and lake bike paths!

Kim! I've thought about you! How are you doing? How's your knee?

It's funny, I was riding the bike trail so much that I was getting a little bored, but oh I would *love* to be on that trail now.

When I came back to riding, I could barely ride at all. I couldn't get comfortable on the bike, couldn't pedal properly. I kept on fiddling with the foot adjustment (I use Speedplay click-ins), no good. Then I thought "Wait a minute, my legs have been hacked about, but one thing I can be sure of is that my knees are now *straight*" Sure enough, looking at the shoes clicked into the bike on their own, they were miles out of alignment. So I set them up by sight to be absolutely straight and correct, problem solved.

Er, except it wasn't. Felt worse than ever!! So I went out and rode at maybe 8mph, pedalling really slowly, to try and figure it out. Lo and behold, my legs were automatically and subconsciously trying to compensate for dodgy knees that weren't any more. If I pedalled consciously and carefully straight, it felt right. It took me days of pedalling like this to make my legs work properly.

Some weeks later I met a cycling clubmate who rode up behind me "I thought it was you, but you were pedalling straight instead of your normal way." I didn't even know my previous style was wonky.

Maybe some of this might apply to some of you here trying to ride again.

Thank you for your post, Roy. I took my Shimano clipless pedals off and have platforms on now. Overall, my fitment on the bike still feels good, but that knee pops/moves/doesn't feel good on every downstroke.


I had a scare with my knee last night. I stepped over a newly replaced tile in our bathroom/closet with my good leg and I slipped, stretching and twisting my new knee. It hurt like hell—still does. It's quite swollen and there's bruising.

Last winter I fell while snowshoeing, but that was fine. This time I'm a hurting mess. Back to elevating and icing.

 

[lovetocookandsew]

My knee sucks, actually. I'm having a revision the last part of Feb. or so. I didn't want to do it now as we have plans to visit our daughter for Christmas and New Year's, and my OS doesn't want me in the hospital during flu season, so we settled on late Feb or so. Other than that, I'm well, thanks.

 

[lovetocookandsew]

I hope your knee mends quickly after slipping. It always worries us when we twist, fall, slip, etc on our new knees. I should be icing my knee a lot but I hate the hassle. I did, however, break down and buy a cane for when I need to go places. I hated to admit it, but I do need it for now. Take care of that knee.

 

[LoveGiants]

I hope your knee mends quickly after slipping. It always worries us when we twist, fall, slip, etc on our new knees. I should be icing my knee a lot but I hate the hassle. I did, however, break down and buy a cane for when I need to go places. I hated to admit it, but I do need it for now. Take care of that knee.

I hear ya on the icing. I'm SO over it. I'm sorry about your knee and hope the revision goes well.