Muscle recruitment for cycling: recovering from a knee replacement

I saw this neat little diagram that perfectly illustrated for me where my weaknesses still lie in this TKR leg when it comes to trying to get back to the cycling pace I once had.

The physio talked about the different phases of the pedal stroke and what it meant when I first paid to go and see Joel from Accelerate physio when I needed another perspective from someone who actually believed in my goals.

Now, I know that the Left and right legs still are not equal in power, because the left fatigues and develops DOMS whereas the right doesn’t (because in many ways, it is still on holiday – and that is more than just muscle power).

Many of the issues related to rehab from a knee replacement is FIXING all the things you had either consciously or unconsciously changed before the operation. These little subtleties are causing me more issues than anything else.

There is no reason why I should be using more force through my left leg when pedalling, the right leg does not hurt any more. Has anyone told my brain that yet? It doesn’t seem so! So where I was walking around with the following mantra to even up the stride, I need to develop something similar for riding because the force through the pedals cannot be seen from the outside so is not quite as obvious till later on in the ride.

When I was trying to lose my limp after my knee replacement my walking mantra as I took a step was ‘fat leg, thin leg’ to remind me that they felt different.

Melanie Ryding

Comparing the two legs physically: almost 10 months post op

  • Left quadricep muscle has still got more mass than the right.
  • Left Hamstring is still stronger than the right
  • Left glute is still stronger than the right (most obvious in single leg balance)
  • Right calf is still more swollen than the left and always has been since the op: I am convinced it is due to a lymph edema but they have checked my circulation and say its fine (rubbish!!).
  • Left knee has more flexion than the right (I still cannot ‘sit on my feet’. I am not sure I will ever be able to).

My progress: compared to the ‘norm’

In the normal world, (whatever that is!!) I would be classed as ‘fully recovered’ now from the TKR. But, in the world of an athlete, there are still many many discrepancies that are blindingly obvious to me.

What I have encountered from rehab is once I was able to do ‘normal person’ things… like walking, shopping, bla bla bla… it was considered a success and there was nothing more to be done.

The trouble is my level of expectation is quite simply on a totally different plain than your average 70 something knee replacement patient. I am not sure why rehab is so ageist… I recently read a 71 year old woman just set the world record for running a marathon (for her age).. 3 hours 23 mins. That is a bloody good time, regardless of how old she is, only amplified by the fact that she is 71! So why should there be a one size fits all approach to knee replacement rehab? IMO there shouldn’t be and it frustrates the life out of me.


Am I fully recovered? I would still argue no. I still have not got the right and left legs back to equal power. That is when I would consider this knee to be fully recovered. Will that ever happen? I have no idea. Will I give up trying? Hell no!


5 Comments on “Muscle recruitment for cycling: recovering from a knee replacement

  1. Great diagram, thanks so much. After my first knee replacement it took over a year for my VMO to resemble the mass of the good leg but not sure it ever returned to the same strength. Now I have two replacements, I don’t know if I will be able to do the same fitness instructor activities.

  2. Great info! In your opinion, after how many weeks can a start light trail running? I started a running at 8 weeks and told to wait from my PT.

    • I’d say 4-6 months. It takes that long for the cement to set fully and the bone to knit to the implant. Until then, you run a high risk of dislodging it, which would definitely not be ideal!

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