TKR Recovery back to cycling

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7 weeks: with OS and PT blessing decided to push myself a bit on the bike again. Pedaled a virtual route in Italy using an app called Rouvy. 11km, ave power 69, 27 minutes. I love Rouvy - real video, unlike the Zwift cartoon landscapes. I get to pretend I’m on a cycling holiday!
I’m supposed to pay attention to my morning swelling/pain. As long as it isn’t significantly worse, I’m ok to do this again…but I’ll alternate hard/easy days, because recovery essential for healing and tissue adaptation.

Still having patella clunk during upstroke. My vastus lateralis (outside quad muscle) is like a tight cable all the way to its attachment point in kneecap. I experimented with pushing it inwards during riding to simulate it not pulling the kneecap laterally. It stopped the clunk. But of course I can’t hold it the whole time riding.

The bike is proving a useful tool to experiment and problem solve issues like this. Now I know that when that muscle can relax again, my kneecap should hopefully stop clicking as much.
 
No ill after effects today, and slept well with only Tylenol at bedtime!
Goes to show you can think something is irritating the knee when in fact it could have been some other cause. Or sometimes you only need an extra day or two before trying again.
 
Still having patella clunk during upstroke.
Many of us have clunking or clicking for many months post-op. Unless there is pain in conjunction with that sensation, you don't need to be concerned. Here's a bit more information you may find helpful:
 
@Fluttershy I'm not sure why he wants me off the bike x3 months, did mention he didn't want bone to fracture near the implant. My guess is that at one time he had someone ride and did just that, maybe a one in a million freak complication and he doesn't let his PKRs ride except with PT.

I asked him post op day 1 when I could ride, same answer. Hahaha felt like a teenager trying to con their parent into something.

Liz
 
I asked him post op day 1 when I could ride, same answer. Hahaha felt like a teenager trying to con their parent into something.
Lol! Maybe he thought your definition of a bike ride was shredding a black diamond or riding up a steep mountain pass….

My OS is an endurance athlete and likes to help get people active in sport again. said I’ll eventually be able to do all the biking I want. When building up to it, I was advised to watch how I react the next day and modify accordingly.
 
Lol! Maybe he thought your definition of a bike ride was shredding a black diamond or riding up a steep mountain pass….
Hahaha well he did get my number!

I love Rouvy (though we dropped it for another app "big ring VR) never really liked zwift and I think it encourages you to be a bit too competitive (though there is a place for that...) plus the scenery is wonderful on both big ring VR and Rouvy.

Have you done the Whistler Gran Fondo? I did in 2019 and it was awesome.

Keep up the good work! Guess we need to remind ourselves this is an endurance ride, not a kilo at the track!

Liz
 
I'm needing less daytime ice (as long as I elevate lots and use compression). It seems that letting the tissues get warm is good for them at this stage
My doc has been advocating warmth since about 4-6 weeks. Occasionally it has felt like ice was desirable, but heat is better for relaxing muscles.
 
having patella clunk during upstroke. My vastus lateralis (outside quad muscle) is like a tight cable all the way to its attachment point in kneecap
After my first knee replacement my vastus medialis was clearly shrunken. I did lots of leg extensions. For my second knee it did not disappear, maybe because I never did the two-step on the stairs.
 
Lol! Maybe he thought your definition of a bike ride was shredding a black diamond or riding up a steep mountain pass….
Hahaha well he did get my number!

I love Rouvy (though we dropped it for another app "big ring VR) never really liked zwift and I think it encourages you to be a bit too competitive (though there is a place for that...) plus the scenery is wonderful on both big ring VR and Rouvy.

Have you done the Whistler Gran Fondo? I did in 2019 and it was awesome.

Keep up the good work! Guess we need to remind ourselves this is an endurance ride, not a kilo at the track!

Liz
Thanks for the encouragement! Is it possible your surgeon says no biking until 3 months on an outside bike…but stationary bike still ok?
I’d love to ride that fondo as I’ve heard it was well organized. We’ve done one a few times in Idaho (Cour D’Alene) that ends with an Octoberfest party at the lake, which was a lot of fun; they love their craft beer there! I got into road cycling 6 years ago and only got a few years in before my knee started a rapid downhill slide.
Tried bigringVR also and like it. Rouvy had a family plan and so we got it as it’s economical.
 
I saw my chiropractor and he spent 30 minutes moving my knee and manipulating tissues and working on the outside quad as well as mobilizing my fibula. My lateral hamstrings are snapping less while walking and my kneecap stopped clicking on the bike - lasted 20 minutes and then it started to click again. Maybe it tightened up again. But now I know the treatment helped!

My big issue now is muscles that aren’t cooperating and I’ve atrophied so much from quads shutdown early on. So I’m to start challenging my balance and proprioception (ability to sense joint position without seeing). I still feel like I have an alien rock strapped to my leg. I was going down steps one at a time pre-op or doing a modified step using rail….but I was good going up. I’ve lost so much strength, but also wonder if I still have arthrogenic muscle inhibition because of the tenderness I still get around the kneecap? Anyone else struggle with this and when did one legged strength increase enough to go up or down a step normally without a cane or handrail to take the weight?
 
I'm needing less daytime ice (as long as I elevate lots and use compression). It seems that letting the tissues get warm is good for them at this stage
My doc has been advocating warmth since about 4-6 weeks. Occasionally it has felt like ice was desirable, but heat is better for relaxing muscles.
Heat before Pt/exercise for relaxing and warming up the muscle. Ice for post PT/exercise for keeping inflammation under control.

I still do that..
 
Thanks all for the thoughts! I’m finding that elevation is enough lately to reduce swelling and I ice if it starts to feel hot and painful. Ice is still a good pain reliever for me. I’m trying to cut out Tylenol at night (use NSAIDs daytime taken with food, which are a huge help not only for my new knee but the rest of the body).
 
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