Getting the Most Out of a Stationary Bike After Knee Surgery
by Mike McClellan
Question: How can I maintain the gains I’ve achieved in Range of Motion and leg strength after my in-home X10 Therapy rehabilitation is complete?
Only X10 Therapy monitors, records and graphs your daily rehabilitation progress in Range of Motion and Leg Strength. Here are some recommendations on how to optimize and maintain your progress.
Starting X10 Therapy prior to surgery delivers faster and better post-surgery results
Our studies show that starting X10 Therapy at least one week prior to surgery (aka “Pre-hab”) enables patients to regain lost strength before surgery and accelerates their recovery after surgery.
Post-Surgery Rehabilitation Phase: X10’s data driven approach.
Once our patients have reached acceptable levels of both Range of Motion and Strength (usually in 2-4 weeks) we recommend continuing your daily therapy until you reach a plateau over several days with no setbacks.
A Stationary Bike can help you maintain your newly gained strength and flexibility:
You are ready to go back to the activities of daily living, but how can you prevent regressing once your X10 Therapy has ended? Several of our patients have found that a stationary bike can help patients keep the extension, flexion and strength they’ve worked so hard to achieve during X10 Therapy.
X10 Therapy and a stationary bike were a winning combination for Melissa
One of the most exciting stationary bike brands out there today is Peloton. Melissa used her Peloton both before and after bilateral knee replacement.
At age 47 she was able to take full advantage of the stationary bike for strength training, and even for knee range of motion. Melissa shares her thoughts in this video shot four weeks after surgery.
The Stationary Bike
A stationary bike is one of the most useful and convenient tools you can use, whether recovering from a knee surgery or just trying to get/stay in shape. They are so accepted as a workout staple that almost all therapy clinics and gyms have them. If you buy one you will have the luxury of owning a tool that can single-handedly build your leg strength, cardiovascular endurance, and support knee joint mobility and stability. Around 110 degrees is generally the range of motion you will need to be able to perform all common daily activities, so if you can comfortably pedal a stationary bike all the way around then you are well on your way to a full recovery. I present here how you can get the most out of a stationary bike after knee surgery.
The first step in using a stationary bike – ensuring you have a proper setup
- Seat Height: A basic stationary bike will allow you to adjust the seat height up and down. You want the seat to be at a height where when your foot is at its lowest point throughout the pedaling motion, with the balls of your feet on the pedals, there is slight bend in your knee (about 5-10 degrees).
- Some higher-end bikes will have more advanced settings you can adjust, such as seat angle, seat position (seat slides forwards or backwards), and handlebar position (up/down and forwards/backwards).
- Seat Angle: You always want the seat angle to be parallel to the floor so you aren’t having to reach too far for the handlebars or sliding off the seat while pedaling.
- Seat Position: If you can adjust the seat position (forwards/backwards), start out with both feet on the pedals. Next, move the pedals so both crank arms are parallel to the ground. Once your feet are in this position, adjust the seat position so your knee that is in front is directly above the pedal.
- Handlebar Position: Adjusting the handlebars just comes down to finding the position that feels most comfortable to you. One tip is that moving them higher can reduce strain on your back and neck because you won’t be leaning over as much with them in this position.
Quads, Hams, Calf
If used properly stationary bikes can be extremely useful in building quadriceps, hamstrings, and calf strength. The key is to make sure you are pedaling your legs in a circular motion rather than just up and down. If you’re pedaling up and down then you will mainly be using your quadriceps muscles; however, pedaling in a circular motion incorporates all three muscle groups. The top half of a circular pedaling motion while pressing forward and downwards will work your quadriceps, the bottom half while pulling backwards and upwards will work your hamstrings. If you extend your foot at the bottom you can work your calves as well. If your bike has the option of strapping your feet in, be sure to do that as it will make it much easier to push and pull the pedals in a circular motion.
Strategies for Using a Stationary Bike After Knee Surgery
The first thing you will use a stationary bike for after surgery is range of motion. If you don’t have the ability to pedal all the way around, there is a commonly used technique that can help you slowly improve your range of motion. While doing this technique make sure you start off with the resistance levels set very low, you can always move it up later if the low resistance is too easy. First, start off in a position where both feet are on the pedals in a comfortable position. Begin by pedaling in one direction as far as you can and stop and hold that position for 10-15 seconds.
Next, pedal in the opposite direction as far as you can and hold that position for 10-15 seconds. Continue doing this back and forth, trying to pedal a little bit farther as often as you can for about 30 minutes. The more often you do this, the faster you will gain back your range of motion, so multiple times a day is preferable if you own your own bike. If you’re going to a gym to use a bike, try getting there daily and having longer sessions.
ROM, then Strength
Once you achieve the range of motion required to pedal full circles, continue riding the bike daily to maintain that range of motion. This will also be a good time to start focusing on building up your strength. To do this try bumping up the resistance. Make sure you ease into it for the first couple weeks, increasing the resistance every few days. As you continue to get stronger you will find that you can pedal longer at the same resistance you were struggling with days or weeks before. If your main goal is building leg strength, 10 minutes of high-resistance pedaling will help you accomplish this. If you want to build muscle endurance, you’ll need to lower the resistance so you can pedal for 20-30 minutes.
HIIT (High Intensity Interval Training)
After Initial Range of Motion Gains
Once you’ve gained back your range of motion and have built up your leg strength you can begin using the stationary bike to reach other goals like losing weight or bettering your cardiovascular health. A basic method for this is riding the bike at a moderate intensity and steady pace for an extended period of time, usually 45 minutes to an hour. One of the most effective methods for building the most strength, cardiovascular endurance, and burn the most fat is HIIT (high-intensity interval training). A simple form of this exercise is bumping up the resistance and pedaling as hard as you can for 15 seconds, then turn the resistance down and slowly pedal for 1 minute. Turn the resistance back up for 15 seconds of hard pedaling then slowly pedal at low resistance for another minute. Continue to do this for 8-12 minutes. As you continue to do HIIT training you may want to increase the high-resistance pedaling time and decrease the low-resistance rest times to make your workouts more difficult so you’re constantly improving. It may not seem like very long, but if you really push yourself you should feel extremely fatigued after each session.
HIIT, Weight Loss, Better Health
This is such a powerful workout that multiple studies have found that performing HIIT every 2-3 days for just 10 minutes results in more fat loss and better cardiovascular endurance than riding the bike at a moderate intensity for an hour. If you are interested in using the stationary bike for losing weight or cardiovascular endurance and HIIT training sounds too intense for you at this point in your recovery process, there are all kinds of other workouts you can find online to accomplish your goals. Remember, as with any new exercise regimen, always be sure to consult with your doctor or PT before beginning.
A Key to Getting Back to Sports
If you’re still on the fence about a stationary bike after knee surgery, just think about how much it can allow you to get back to. If you’re someone who enjoys playing sports, riding your bike outside, or just living an active lifestyle in general, a stationary bike can be one of the most powerful tools to get you back to doing what you love. All of those things require a good range of motion and the leg strength to support it, and a stationary bike is one of the best, most convenient ways to get both of those things and make sure that you maintain them.
Don’t Lose Your Rehab Momentum
One of the biggest problems that people have after knee surgery is that they put in all kinds of work to rehab and get their knee back in tip-top shape, only to go back to work and find themselves living a largely sedentary lifestyle. The days go by and their range of motion dwindles away as they continue to be inactive and not maintain that range of motion they worked so hard to reach. What easier way could there be to make sure that doesn’t happen to you?
The Stationary Bike Can Be Your Best Friend
Eventually you will just hop on your stationary bike once a day for a quick session, riding your way back to a healthier and more active you.
For insight into how to prepare for knee surgery read Yvonne LaCrosse’s article here.