Let’s first start by saying that any recommendations are always superseded by doctors instruction. While we would like to think sports like cycling and swimming are very low impact, it is quite possible to damage knees with improper fit and techniques. So, while there are some recommendations in the following article, please follow your doctors advice in using bikes for knee rehab! The best exercise bike for knee replacement rehab is indoor type and we recommend the Joroto Belt Drive.
If applied properly, I think a bike is one of the best ways to rehabilitate from many leg injuries. Pressure on joints can be alleviated and compensated for quite easily. I even have customers riding eBikes that I built for them, where they use the motor if they get into trouble, fatigued, or start feeling pain.
In my decades of cycling experience, my first recommendation would be for the use of two things: a standard bicycle and an indoor trainer. If you are at the start of your rehab journey, indoor riding is a good way to start. If there are issues, or adjustments necessary, you can be easily accommodated. At first pedaling can in small increments, and as strength is increased, ride times lengthened, gear ratios changed, and trainer resistance increased.
As you improve, the use of a bike with indoor trainer can progress to outdoor riding on flat ground, then with hills. The overall utility of using a standard bike and indoor trainer is incredible and very flexible in setup and use. I also would recommend a road style bike over a hybrid or mountain bike. I will explain why down below.
Indoor exercise and spin bikes have made significant improvements over the last few years. The quality, adjustability, functionality, and comfort has drawn many fitness oriented people to their use. These dedicated indoor bikes can be a valid approach to rehab as well.
We will explore these two paths, and map out the good and bad. It is important to evaluate your needs, environment and budget in considering how to proceed. My bias is toward overall longterm utility.
Exclusively Indoor Bikes
There are hundreds of brands and models of indoor bikes out on the market. Some brands you may heard of, and others that look the same. What we will focus on here is overall utility as it is difficult to characterize by just the names involved.
Some indoor bikes are quite expensive, potentially costing thousands of dollars. That doesnt necessarily make them better. Take the Joroto Belt Drive Indoor Exercise Bike.
The Joroto has many good features that are beneficial for someone doing rehabilitation. The first thing I was looking for is a hyper adjustable seat. This is the number one thing that needs to be focused upon.
When considering any bikes for knee rehab, saddle position is key. The Joroto is what I would call hyper adjustable. That means there is significant height, front to back, and tilt adjustability available. A key failure for many bike owners is the lack of diligence in properly adjusting the seat to their bio-mechanical needs. One or two adjustments may not be enough, it can take me dozens of tries over multiple days to get my position just right.
I would easily recommend the bars on the Joroto as well. A basic straight bar makes changing your hand position difficult as there are few choices for supporting your body. The various hand positions with this bar can help you adjust your body weight so you can endure more time in the saddle.
The Joroto also benefits from a book rack that could easily hold a tablet. If you want to read great! But, using a tablet could have some great benefits. You can watch basic programming videos, but there are some very cool cycling videos that you can go on tours with. Or, you can join and follow a spin class for instance.
Outdoor Bikes -Indoors
While some would argue that the handlebars are too low and that other bikes would have an upright position, I would offer that a good shop, or a plan would include a way to raise the bars at first. For a bit over $30 a Delta stem riser could be installed that can raise the bars almost 4 inches. The road bike bars offer almost a dozen different hand positions, and that can be crucial to staying comfortable riding indoors.
Another key for in road bikes for knee rehab is that the seat tube of the frame is more upright. I think the ideal is at the beginning of the rehab is to have the saddle positioned over the cranks as much as possible to create a more simple up and down movement. As the seat moves further backwards pressure increases on the Posterior Cruciate Ligament.
A cool way to go would be using something like an Elite Direto 2 trainer. When used with a laptop or tablet, it is interactive, and can provide different workout types. While this is an expensive solution, there are many basic trainers for less than $100 to put a road or hybrid bike onto.
Choosing a bike like the Diamondback Century 1 has benefits. The frame design has a larger head tube size which naturally raises the bars. The geometry is fairly relaxed, so it would be easier to get a reasonable fit position.
Like I had mentioned, I have several customers that use eBikes as a safety precaution. Part of their routine is to ride the bike without any motor assistance. If pain, discomfort or fatigue becomes too much, they turn the motor system on, and use it to return home.
Additionally, an eBike can help in other situations. Hills are difficult on tender knees. So if you live in an area that is hilly, an eBike can be a safety net for those situations. The same goes for the wind.
A bike like the DJ Mountain Bike 750W could be an economical choice. It features a 750w motor that is sufficient to get up most hills, even for heavier riders.
So, you have to wonder why bicycle geometry has not significantly changed in over a century. Largely, every bicycle, and even indoor bikes have a diamond based design. I doubt the term ergonomics was widely used prior to the year 1900, but a reality exists about human dimensions fitting onto a bike.
For most humans, the proportion of the lower leg to the upper leg is very close to being equal. This relates to a bicycle in this way: the geometry of a bike is based on a relationship of the hip, knee and ankle to the crankset. If the seat is excessively forward or back, the ability to pedal properly is diminished.
Based on this approximate position we find several things about overall pedaling position:
- When a rider is seated significantly behind the cranks, such as a recumbent, or pedal forward design, the stress on the Posterior Cruciate Ligament is significantly higher
- If the saddle height is set very low, as the rider pedals and reaches the top of the pedal stroke, stress on the ACL is significantly higher
- If the saddle is excessively high, the rider will be forced to overly point their toes, and will see-saw across the saddle creating discomfort
- When the bars are set excessively high, hip angle is diminished, reducing pedal force
The biomechanics of bicycles is more complicated than we realize and can be very precise. For some riders, just 1mm of saddle height can change their heart rate. Imagine significant issues in how the bike fits you. When choosing bikes for knee rehab, work with professionals, it goes a long way to your progress and comfort.
Accessories for Success
No matter the bike type you choose, there are a few things that can help with your indoor training needs. One is a rubber mat. It serves two purposes, to cut down vibration noise, the other is to protect your floor from sweat.
Another is what is called a sweat cover. These stretch between the bars and the seat and deflect sweat off the bike or trainer, so that less damage occurs. It is possible for a bike to fully corrode to failure due to sweat.
Dont forget things like towels and hydration. I like to use two towels, a large bath towel on my handlebars, which catches sweat, keeps the bars dry and can act like padding. The other is a hand towel or similar to wipe sweat off.
Bikes for knee rehab can both be good and bad. If you are not careful, you can do damage and slow down your rehabilitation process. Some doctors may even recommend not using a bike, unless it was setup properly.
The great thing about bikes is it is difficult to do damage quickly. Most injuries to the knees and hips are from repetitive use. Crashes withstanding.
Our main recommendation is based on utility. Using a road bike, like the Diamondback Century, with an indoor trainer is a great place to start. Road bikes are more precise in their fit. You can take yours to a local bike shop and they can help you with adjustments, many professionals are trained and have knowledge of common injuries and can work accordingly.
Once released to ride outdoors, the bike can be taken off the trainer and used the way it was originally intended. When winter or bad weather occurs, break the trainer back out to continue with your progress.