If you are on the road to recovery from a knee injury, then you may well have been advised by an exercise professional to use a bicycle to aid in your knee rehabilitation.
There are a range of reasons why this is the case, one of which is the fact that cycling prevents the knees suffering the impact caused from other forms of exercise, such as running.
With this in mind, we are going to adopt a comprehensive set of goals that most knee rehabilitation programmes are always looking to take into account. They are as follows:
- To decrease, alleviate, or eliminate pain
- To prevent current injury returning
- To improve and/or restore range of movement in the knee joint
- To increase or return stability in knee joint
- To increase or re-establish muscle strength around the knee
As we touched on previously, cycling ranks among the best activities in terms of being ‘kind on the knee’ as far as assisting in the improvement of knee joint mobility and stability.
Cycling is habitually prescribed in conjunction with rehabilitation programmes following knee injury or surgery, additionally, it is a mainstay of chronic degenerative condition management, osteoarthritis for example.
For those wondering what essential benefits cycling has and why it is so widely-used, there are nine main motives:
- Low impact
- Ideal for remaining in a stable position
- Recurring movement assists to nurture joint cartilage
- Utilises a range of motion that’s required for most daily living activities
- Applies controlled movement
- Variable resistance can be introduced
- Offers an effective closed kinetic chain exercise
- Efficient cardiovascular exercise
Explaining the functions and benefits
When cycling is undertaken, all of the major muscles of the legs are, at one point, brought into play, however, the most influential muscles used for creating power are those that make up the quadriceps group. During a stroke rotation, the quadriceps work predominantly as you push the pedal down and straighten your leg, whilst the hamstrings are activated at the back of your thigh to allow for the knee to bend. Those who use a regular flat pedal will have a less engaged hamstring, whereas people who are using toe clips or clipless pedals (specially-designed shoes that are clipped into pedals) will have more engaged hamstrings, as they work more so to pull the pedal up. Cycling within the rehabilitation program gives the quadriceps the ideal activity to be strengthened at the same time as controlling the severity of stresses applied to the knee.
Furthermore, articular cartilages gain the benefits of this motion on the bike due to the alleviation of disproportionate forces. These cartilages serve to cover the ends of your bones, and when cycling they are nurtured idyllically.
A common injury that is rather wide-spread among a host of sports and activities is the dreaded anterior cruciate ligament (ACL) injury. Regardless of severity, reconstruction of this particular injury means cycling is a proven rehabilitation option due to the low amount of strain applied, rendering it a safe preference.
By having a correctly set up bike, one complete turn of the pedal gives your knee anything between 30 to 110 degrees of flexion. It is important to know that you should have the ability to perform at least 100 degrees of flexion before you add cycling into your rehab programme, simply because you need this minimum to complete a full turn of the pedals, and anything less could amount to added/prolonged injury.
Backward pedalling on a stationary bike
If you have access to a turbo trainer or stationary bike, then by altering the direction of pedalling can change the how much influence different muscles have on the pedal stroke. It’s not simply a case of the same, but in reverse!
The backwards pedalling motion engages the quadriceps even more so in relation to how much the hamstrings are. Unlike the forward pedal action, when the leg is at its straightest point the ACL has reduced levels of protection while pedalling backward compared to forward pedalling so this should be avoided if this is an injury you are suffering. Also, this increased quadriceps activity puts even greater stress on the patellofemoral joint, therefore, anyone looking to recover from patellofemoral joint problems should not attempt to incorporate a backwards pedal motion.
However, where backward pedalling is beneficial and effective is for those enduring meniscal problems or tibiofemoral osteoarthritis. Backward pedalling acts to reduce the pressure on the tibiofemoral joint so using backward pedalling on a bike connected to a turbo trainer, or a stationary bike can be added to a safe rehabilitation programme.
It is important to consider adding stretches into your rehabilitation exercises, as, after exercise muscles proceed to tighten, resulting in a reduced range of movement, lessened mobility, and in some cases, discomfort and irritation.
When you have a program put together for you, or if you are piecing one together for yourself, then aim to allow for 10-15 mins of stretching either side of your rehabilitation. Prior to exercise, dynamic (moving) stretches should be adopted as they prevent the risks of tears and pulls that static stretches can cause when the muscles are cold. Once you have finished your exercise, static stretches can be used. Look to hold each movement for 15-30 seconds to reap the benefits. We suggest seeking advice on which exercises to use as they can depend on your injury.
Other aides can be introduced, including exercise bands, exercise balls and foam rollers.
Physicool also offer a range of products that can be added to programs and for general injury prevention, such as IT band pain relief, for example. So, if you are looking to stay as fit and as strong as possible, we are on hand to help you along the way!