Friday, December 1, 2017

Cycling to Strengthen Knee Following Surgery

Cycling is a great way to strengthen your knee and get back into shape following surgery. A rehab program must strengthen the leg muscles while also reducing the stresses placed on the ligaments and other structures of the knee. Bicycling is a non-weight-bearing, low-impact, controlled exercise that increases the knee’s range of motion, making it one of the most common exercises recommended by orthopedic doctors after knee injury or surgery. The circular movement also nourishes the knee’s cartilage, contributing to the healing and recovery process (1).
Biking strengthens the leg muscles, particularly the quadriceps, hamstrings and calf muscles, which reduce weight and pressure at the joint as stronger leg muscles are better able to absorb the forces encountered during daily activities. Strong leg muscles will protect an existing injury and reduce further injury. Cycling can be nearly as effective as weightlifting in increasing muscle strength while placing less stress and strain on the joint.

A cycling rehabilitation program should follow a systematic progression of increasing resistance levels that keep the knee pain-free (2). Start out slowly and gradually increase the resistance on a stationary bike or progress from riding on flat surfaces to climbing hills or interval training on a road bike. Increasing training volume and intensity too quickly can stress the knee joint and negate the benefits of cycling. Also, avoid standing up on the pedals as this puts too much stress on an injured knee.

Proper fit and positioning on the bike is essential to avoid stress on the joint, which can cause further injury (3). The saddle height should be adjusted so that the knee is bent approximately 25 degrees when the foot is at the bottom of the pedal stroke, and when the pedals are level, the center of the knee joint should be directly above the axle center of the crank arm (4). Additionally, you should be able to comfortably stand over the top tube with your feet flat on the ground.

Whenever possible seek professional advice. Personal trainers and coaches frequently work in cooperation with physicians and physical therapists to develop safe and effective knee rehabilitation programs. Most bike shops can help you find the right bike and make the necessary adjustments to ensure a proper fit. And finally, cycling clubs offer a community of athletes who have experienced similar challenges and can support you in your efforts.


(1) “Cartilage Health - Cycling for Knee Rehabilitation”

(2) The Physician and Sports Medicine: Knee Pain and Cycling, Vol. 32, No. 4, April 2004

(3) W.D. McLeod, T.A. Blackburn, “Biomechanics of Knee Rehabilitation with Cycling,”
The American Journal of Sports Medicine, 8(3):175-80.

(4) How to Set Up a Road Bicycle

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