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-   -   Total knee replacement (https://www.bikeforums.net/showthread.php?t=1149915)

Morango 07-16-18 05:29 PM

Total knee replacement
 
I’m 55. Got my first road bike at 45, and total knee replacement at 52. Right knee was degenerative and bone on bone from four knee surgeries in my 20s (basketball). I am now biking more than ever before because I took a new job and can now commute by bike (8-12 miles each way depending on the day). Hoping to start a discussion among those of us with joint replacements.

My replaced knee will never be like a normal knee but in general it works fine. I can do 60 mile road rides on weekends, plus the commute, etc. The only issue I am having is I cannot pedal up out of the saddle. Some weird twist/torque thing happens on the top of the stroke with my right leg, and it hurts like heck. My wife thinks I am just scared and if I keep trying I’ll get it. She might be right.....

Anyway I miss being able to climb up out of the saddle and power up a hill sometimes.

is anyone else biking with a tkr? Anyone else having issues like this?

OldTryGuy 07-16-18 06:22 PM

from search -----

https://www.bikeforums.net/pills-ill...placement.html

cb400bill 07-16-18 06:26 PM

Thread moved to 50+ Pills and Ills forum.

JohnDThompson 07-17-18 11:43 AM

My advice would be to get a referral to a Sports Medicine Physical Therapist, if your insurance will cover it.

metalheart44 07-17-18 05:17 PM

Sounds as if you need to talk with your ortho doc about the possible causes of the pain, could be lots of things. My ortho doc advised that I never get out of the saddle to pedal because, in his words, that places about a 100 times more load on the knee than sitting while climbing." Now, maybe his numbers are off, but the general message was that standing to climb is likely to wear more quickly the polyethelyne component of the prothesis.

I do get out of the saddle to take a positioning break and I sometimes get out on a hard climb, but I then use the easiest gear I have and limit revolutions and how many times overall I do that during a ride. I would ask your doc about the potential consequences for your prothesis if you stand while climbing, assuming you get the pain issues resolved.

Morango 07-23-18 11:24 AM


Originally Posted by metalheart44 (Post 20454005)
Sounds as if you need to talk with your ortho doc about the possible causes of the pain, could be lots of things. My ortho doc advised that I never get out of the saddle to pedal because, in his words, that places about a 100 times more load on the knee than sitting while climbing." Now, maybe his numbers are off, but the general message was that standing to climb is likely to wear more quickly the polyethelyne component of the prothesis.

I do get out of the saddle to take a positioning break and I sometimes get out on a hard climb, but I then use the easiest gear I have and limit revolutions and how many times overall I do that during a ride. I would ask your doc about the potential consequences for your prothesis if you stand while climbing, assuming you get the pain issues resolved.

metalheart. Thanks for the reply. I am glad to know the info about your ortho doc warning you against it. We changed insurance a year after my surgery and the ortho guy I saw at the new clinic basically blew off my concerns and said “it’s mever going to be like your original knee.” ..... duh! He was irritating.

I will I’ll just be satisfied with sittOmg and spinning up those hills.

TCR Rider 07-24-18 05:21 PM

One possible cause of your problem could be a muscle imbalance or weakness in the muscles around the knee.Many times the Vastus Medialis, which is the portion of the quad on the medial side of the knee. If you sit on the floor and extend the leg you can find the vastus medialis by flexing the leg and look for a teardrop shaped muscle just above the knee on the inside part of the leg. It can be overpowered by the larger quad on the lateral side of the leg. When that happens it can cause the knee to track incorrectly. I'm not saying that's your problem but it's something to consider and it's an easy fix.
I had a TKR last September and I can get out of the saddle to pedal without issue. MY knee is fine my back....well that's another story.

DaveQ24 08-03-18 08:55 PM

Hi guys ... just dropping in to read this because total knee replacement is in my future. Almost total bone on bone in my left knee. For now, not painful but it “catches” at times and doesn’t bend well. I hope I can put off surgery for 6-8-10 years, right now a cortisone injection 2-3 times a year gives about 75% of “normal”.

I wasn’t aware that standing in the pedals is out after TKR - yikes! Makes sense but a little discouraging.

So, I’ll just throw this out there - e-bikes- maybe a good option after TKR, at least if you ride in hill country or mountains. I ride an ebike part of the time, and it is great for assisting on hills. The one I’ve been riding has 5 levels of assist plus throttle on demand. The rider can choose how much assistance he/she wants. I would like to dispell the mistaken belief that it’s “cheating” to ride an e-bike - I’ve found that it’s still a good cardio and muscle workout as long as you aren’t riding the entire time at maximum assist or throttle-only. When I ride at 1 or 2 of 5 levels of pedal-assist, the lowest levels, the reduced workload on my body gained by the assist seems to be compensated by the fact I can ride longer and faster. To me at least, I’m pretty tired when I get home after a 40-50 mile human-powered ride, and just as tired after a 50-60 mile e-bike ride (an FYI, I bought a spare battery and bring it along in a backpack or rear rack case, because I want to be able to ride 50-60-70 miles, and one battery won’t do that). Finally, keep in mind that most e-bikes are in the 50-65 pound range (mine is 62 lbs plus another 5 for the 2nd battery). The non-motorized hybrid I ride most often is a carbon frame, about 18 lbs, maybe 22-23-24 lbs with a trunk pack loaded with some tools/emwrgency repair parts and 2 or 3 or even 4 if it’s really hot extra 16-24 ounce bottles of water. That 40 plus pound weight differential definitely adds work load for the rider which isn’t necessarily negated by the motor at the low assist levels.

Finally, for a real workout, try being 30 miles from home and discovering battery #2 isn’t charged - 30 miles of no assist on a 70 lb bike is a lot.

Even if you do ride with high assist levels, as long as you aren’t throttle-only, you are still pedaling, and fast - I think that would help with range of motion and flexibility no matter the workload on the muscles.

I wanted to bring this up because I have seen a lot of anti-e-bike sentiment on BF and other cycling forums, and usually an attitude like “it’s cheating”. I had a pretty good crash on my hybrid almost a year ago - 355 days ago to be exact, and the experience of being temporarily disabled made me appreciate just how hard many things are when you are physically challenged. I say anything that helps someone compensate so they can continue to function to their highest potential is great.

So, I’m just trying to plant the seed in someone’s mind that an e-bike might be a good workaround for certain physical limitations or conditions. The first time I rode one, about a 20 minute test ride, I quickly disavowed myself of the “is it cheating?” question ... it was a pretty intense ride and I came back drenched in sweat on a 50 degree late October morning. Yes, it “could be” cheating if your express goal is exercise, and you use highest assist or throttle-only the whole ride - but as adults, we should know enough to realize a little candy is ok, a steady diet of just candy makes us sick.

At any rate, e-bikes are a growing trend, more of them coming to market, and all of the big names are jumping in, so they will become more common, more accepted, and less expensive - not to mention more diverse types, better tech, and lighter. I would encourage anyone who is strugglimg to ride because of knee (or any) health problems to consider one.

McBTC 08-04-18 09:48 AM


Originally Posted by Morango (Post 20451660)
I’m 55. Got my first road bike at 45, and total knee replacement at 52. Right knee was degenerative and bone on bone from four knee surgeries in my 20s (basketball). I am now biking more than ever before because I took a new job and can now commute by bike (8-12 miles each way depending on the day). Hoping to start a discussion among those of us with joint replacements.

My replaced knee will never be like a normal knee but in general it works fine. I can do 60 mile road rides on weekends, plus the commute, etc. The only issue I am having is I cannot pedal up out of the saddle. Some weird twist/torque thing happens on the top of the stroke with my right leg, and it hurts like heck. My wife thinks I am just scared and if I keep trying I’ll get it. She might be right.....

Anyway I miss being able to climb up out of the saddle and power up a hill sometimes.

is anyone else biking with a tkr? Anyone else having issues like this?

As a member of the club, the only pain issue I know something about that may be 'normal' in that there's probably not much you can do about it, is possible if you have a stem going down tibia-- it's called end of stem pain and usually some kind of radiographic evidence is necessary to confirm that the pain isn't being caused by something else.

metalheart44 08-05-18 04:05 PM

I don't see anything discouraging about limiting how much you are out of the saddle when climbing. I stand every so often while climbing, but most of the time I climb seated and I climb a reasonable amount,10k or so a week. I just don't think it is a big deal to stay seated to minimize wear and tear on the prosthesis.

zjrog 08-20-18 12:41 PM

I have a thread in Clydsdales. Had my left knee replaced at 47, was back on the bike and getting in shape when I crashed and broke my back, neck, some ribs.... Ever since, I seem to injure other parts of me, keeping me off my bikes. And they are non-bike related injuries. As for my knee, I have excellent ROM, rarely think about it. It is part of me. And I kneel on it, crawl around chasing my grandkids and such. It is nearly 8 years old. But, My right knee is failing, and I won't wait nearly as long. In fact, probably this Dec...


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