On July 2, 2012 I received a bi-lateral knee replacement … on August 16, 2014 I became the first person ever to ascend Mt. Washington by bicycle with double knee replacements. From July 2013 through July 2014 I have ridden over 7000 miles and climbed over 300,000′ on my bicycle. The full story can be found at www.tek-kneescycling.com.
My treatment and recovery
Rehabilitation and Cycling With Knee Replacements
By Greg Bullock © 2014
I’ve been cycling with bilateral knee replacements for nearly two years. When I decided to undergo my surgery I could barely walk, and had not cycled in nearly two years, I had no intention of stopping or even slowing down my cycling career, but I had to. Post surgery, to date I have been able to not only fulfill my expectations, but I have been able to exceed the level I had previously attained as a distance cyclist. My journey is still underway, and I’m not sure I will ever be able to say I’m “back” to what I was before my knee joints were replaced. I mean, I don’t have my original knees, I have knee replacements, which pose some mild restrictions to the activities I can choose to engage in. I now have limitations, and I have had to pay more attention to what my knees tell me during my training rides. The biggest element I have noticed is that it’s a new beginning for me. I ride differently now, and pay attention to the details. The important thing is that I ride.
The morning after my surgery I was greeted by two very pleasant physical therapists. They came into my room and very happily informed me it was time to get out of bed. To my surprise, I did. With help I was able to stand on my own two legs. I took one step forward, and one step back, then back into bed. The next day I met the same two gentlemen bright and early in the morning, and this time I took three steps out and three steps back. On the third morning I was informed I was going to take a “walk around the island”. I was helped out of bed. I got out one side, walked around the foot of the bed and to the other side, where I got back into bed. I was excited and happy I made the trip. It wasn’t easy, but I knew my rehabilitation had begun the day after the surgery. The medical staff wasted no time getting me back on my feet.
I was soon moved to an inpatient rehabilitation facility, which is a requirement for a double knee replacement. I was very limited in my mobility at this point. Which meant the need for a team of experienced staff, who had the responsibility of getting me to a point where I was reasonably functional in my own home, without putting a serious burden on my family and friends when I returned home. I saw a physical therapist twice daily and an occupational therapist once daily. They assisted me with re-building muscle strength, developing range of motion, and teaching me how to do basic tasks like dressing myself, climbing stairs, using the bathroom and taking a shower. All as I worked my way back to being self sufficient. I was instructed in doing exercises on my own, and how to use a machine twice daily to extend my range of motion. It is important to do this. The biggest factor in failing to gain range of motion or getting muscle strength back is you. It is important that at the beginning stages of rehabilitation you do what you have been instructed to do, both during your daily therapy sessions, as well as, on your own time.
I was not cycling yet, but I was well on my way. Once I was released from the rehabilitation facility I was able to walk on my own with a walker, navigate the front steps of our house, climb a set of stairs to our second level bedroom, and take care of my hygiene on my own. I would take daily walks outside, each day adding to the previous days distance. Within a week at home I began to use a cane to walk and help myself maneuver around the house. By my second week home I was ready to ditch the walker all together, and began outpatient rehabilitation. It was about this time I decided to sit on the stationary bike in my living room and see what I could do. I could not do a full rotation, but I could move the pedals back and forth, nearly going all the way around. It was now about six weeks past my surgery, and I was encouraged with where I was in my rehabilitation. Within another week I was riding the stationary bike for 10 minutes … very slowly and carefully. Two weeks later I took to the street on my road bike … I rode about a mile that day. My wife has the video of me wiggling my way down the street in front of our home. On Labor Day I rode 7 miles on a multi-use trail with my son. Now, I was cycling again! You may not have the same experience as I did, as I had been a cyclist for decades prior to my surgery. As an example, what I have been able to do should give you an idea of what is possible, as long as you are diligent about following the rehabilitation program you are given by your physical therapist.
Having been cycling for more than a year since my surgery, I have discovered several things I can pass along to those who want to cycle with double knee replacements. More than anything, be patient. If you have been a cyclist in the past, don’t expect to go out and hammer the miles like you used to. I tried it, and it didn’t go well. My knees ached quite a lot the next day. The muscles of your legs may be willing to go the distance hard and fast, but the bones where the prosthesis attach need time to heal, and get used to the new parts you are now carrying around. Learn to spin your cadence. Ride lower gears … stay off the big chain ring. You’re not in a hurry. The road will always be there for you. Take your time getting back into condition for cycling the way you once did. If you are just now taking up cycling as part of the maintenance of your new knees, work your way into cycling slowly. Another lesson l took away from this experience was to take days off the bike. I used to ride at least six days a week. Now I take days off … no set pattern, I rest my legs based on the weather, the miles I have accumulated for the week, or listening to what my knees have to say. Sometimes my knees just tell me to stay off the bike by the way they are feeling. So, I don’t ride that day. The longer I have been riding the less I feel I need to rest my knees, but in the first six months, I didn’t push beyond my comfort zone. If my knees ached, I took a break. Nowadays, I still ride only 4 – 5 days a week, but my rides are much longer and I give my legs a good day or two to recover after an extensive ride … usually for rides over 100 miles. Everyone will find they’re own comfort zone. If you can comfortably ride 20 miles, and do it 3 – 4 days a week, that is awesome, you should be proud of your accomplishment. Just a year or two ago you could barely walk, let alone ride a bike or climb stairs for that matter. Way to go.
Cycling is a great way to keep your new knees strong and healthy. Second only to swimming in benefits verses impact. Not everyone wants to ride insane mileage like I do. For those who just want to enjoy the new life you were given with your knee replacements, cycling can be a large part of your maintenance plan. Just because you have new knees, doesn’t mean you can ignore them now. It is important that you exercise them regularly. You need to mobilize them as much as possible, but with low impact. Playing basketball, or going skiing may not be good choices.Take walks, go swimming at a local pool, and cycle. The better you maintain your knees, the better your quality of life will be after the knee replacements. Now that you have a second chance at having an active lifestyle, take advantage of the technology you are now the recipient of … get out and ride! Your knees will love you for it.