Returning to Cycling After Total Knee Replacement

By Peg Labiuk | 08/28/12
Returning to Cycling After Total Knee Replacement

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We’ve teamed up with Marilyn Trout, certified USA Cycling Elite Coach to answer Voler Newsletter List members’ training questions. You can view her coach profile at Send your cycling inquiries to Marilyn, and for a limited time, if yours is selected to be answered in our Training column, Voler will send you a $20 gift certificate that can be used towards any purchase from the Voler Store at To submit your inquiry, e-mail her at, and type “Voler Training Question” in the subject line of the e-mail.

The following question was answered by Peg Labiuk (nee Peggy Maass), a colleague of Marilyn Trout, and a certified NCCP level 3 coach with a career in international road and track racing. She is a World Championship medalist, World Record holder, U.S. Olympic Team member, former British national team coach and Kreb's Cycle co-founder (British Columbia, Canada).

Returning to Cycling After Total Knee Replacement


Last August I had TKR (Total Knee Replacement Surgery).  Both  at the same time... the best way to go!
I am 73 years old, a retired physical therapist.  I've returned to playing senior basketball.  I ride our stationary bike.  I want very much to return to bike riding. I know I could go with an adult tricycle, but would prefer 2 wheels.  Have checked web sites for low step in/thru bikes. Do you have any suggestions?  (I'm 5ft. 8in.)  I won't ski or roller blade anymore... but cycling should be safe.

Thank you, 
Geri B.

Dear Geri,

Total Knee Replacement in both knees is major surgery.  Congratulations on your recovery and return to basketball and cycling.  I can understand wanting to get moving on the bike outdoors instead of  staying stationary indoors, though.

Your idea of a step-thru frame is a good one. Schwinn does offer Urban bikes like their City and Cream lines and their Cruiser bikes have the coaster brakes you are looking for. Let me also suggest taking a look at the “crank-forward” style of bike.  Crank-forward means the frame geometry is different.  The cranks are actually placed in front of the seat tube.  The diagram to the right from the Electra Bike website illustrates the concept. 

The result is a much more relaxed riding position, one where you can stay seated and are always able to put a foot down, as shown in the image at the top of this article.  Electra’s “Townie” bikes are known for their comfort.  Crank-forward models are also made by Fuji, Giant, K2, Trek, Sun, RANS, and KHSiPed.

The most important thing for you is to avoid falling, so whatever bike you choose, I’d suggest riding alone on a paved or rubberized running track (or a velodrome!) until you build up strength, speed, and confidence.  It would also be wise to practice your mounts and dismounts on the soft grass.  You’ll also need to be careful about stressing your knees as you transition onto the road.  You should select flat routes and introduce climbing gradually.  I’m sure you know all that being a physical therapist yourself!

If you get the bug to return to a road bike, consider:

  • Riding a road bike on an indoor trainer first.
  • Non-round chain rings like Rotor’s Q-Rings or Osymetrics.
  • Compact cranks.

Make sure you have help checking your bike position.  It’s been my experience that people with TKRs and problem knees can avoid pain with a more forward seat position and a higher seat height.

Coach Peg


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