Riding a Bike After a Knee Replacement

Riding a bike after knee replacement surgery may be recommended as a part of your rehabilitation treatment. In fact, most people can start riding a stationary bike in as little as two weeks after surgery.

Even if you were an avid cycler before, riding a bike after knee replacement may be awkward at first. Your physical therapist can show you how to do so safely. As your range of motion and strength improve, you will be able to move from a stationary bike to an outdoor cycle.

This article discusses bike riding after knee replacement surgery. It includes step-by-step instructions for how to ride a bike after knee placement and what you can expect as you heal.

Physical Therapy After Knee Replacement

Biking can be a great exercise after a total knee replacement (TKR) as part of your physical therapy. This can help to reduce pain and improve your strength and range of motion (ROM).

The first step is typically to use a continuous passive motion (CPM) machine to help improve the ROM in your knee. This may be done in the hospital after surgery and before starting outpatient or home-care physical therapy.

For the first couple of weeks, one of the main goals of physical therapy is to decrease swelling and reach a full passive ROM. Your physical therapist will give you gentle exercises to help regain normal knee strength and mobility before moving on to bike riding.

Stationary Bike Riding Tips

Riding a stationary bicycle is used in physical therapy to maintain muscle tone and keep your knee flexible. 

Many people can start using a stationary bicycle one to two weeks after TKR, under the guidance of a physical therapist.

When riding, it's important to achieve the maximum degree of bending and straightening possible, without putting too much stress on your knee. Follow these steps:

1. Check the seat height. To make sure the seat height is set correctly, sit on the bike seat with your operated knee straight down and resting on a pedal. There should be a slight bend to your knee when the pedal is at the lowest point.
2. Pedal in reverse. When starting to pedal the bike, start slowly and in reverse. Most likely, you will not be able to pedal all the way around. This is normal. Just pedal around until your knee that was operated on bends as far as you can tolerate.
3. Go slowly. When your knee is bent as far as possible, hold the position for a few seconds, before continuing to pedal in reverse. Again, start slowly and allow your knee to straighten. Continue pedaling backward until your knee once again bends as far as possible.
4. Continue pedaling. Repeat this sequence of backward pedaling for a few minutes. Do not pedal in a forward motion until you are completely comfortable cycling in a backward motion.

Most likely, you will find that your knee ROM improves quite quickly with this method and you will soon be able to pedal around fully on the bicycle.

When you have reached 90 degrees of knee flexion (bending), you most likely will be able to pedal fully on the bike. Also, don't be surprised if you find it easier to pedal backward on the bike before forwards. This is a common occurrence after TKR.

Progressing on the Bike

Once you are able to fully pedal on the bike, you may wish to add some light resistance to help improve the strength and endurance of your leg muscles.

Check with your physical therapist, and make sure you add a little resistance at a time. Your therapist can help you determine the right amount.

A slight increase in knee discomfort can be expected when increasing the resistance on the bike. If you start feeling a sharp pain in your knee, inform your physical therapist and decrease the resistance or stop biking.

You can expect to be able to ride a stationary bicycle one to two weeks after your total knee replacement operation. Remember that everyone is different, and your specific condition may require that you wait a bit longer before starting a bicycling program for your TKR rehabilitation.

A Word From Verywell

While biking may be an important component to regaining ROM after TKR, be sure that you work on other exercises that your physical therapist may prescribe to help improve your strength and functional mobility like walking and stair climbing.

By working hard in physical therapy, both on and off the bike, you can be sure to maximize your chances of a full recovery and a rapid return to normal activity.