Who is biking shortly after surgery?

[MattFL]

Who is is biking shortly after surgery, and how is it going?  I'm 12 weeks out and have been biking a little bit on-road for the past 2 weeks or so.  My doctor told me OK to ride around but "not for exercise", however if feels really good so it's difficult not to want to push a bit.  I've so far resisted the urge to go off-road, which is the ultimate goal.  My cardio is shot LOL, but biking feels like it helps the muscles quite a lot.  What is everyone else's experience with biking after surgery? 

[petemeads]

Hi Matt,

I had to look back through my Garmin records since my surgeries were 10 and 7 years ago, and it was interesting to see the contrast between the two.
After my BHR it was 8 weeks before I got on my bike, indoors on a cheap flywheel attachment, and I rode up to 30 minutes several times in the next month - but really disliked the whole process. At 4 months the weather got good enough to venture outside, in month 5 I did at total of 100 miles and in month 7 managed a 66 mile long ride in unusually hot weather.

After my THR, I was ready to recover indoors using a Wattbike, much more like a real bike, and was using this from 2 weeks and racked up 85 miles within the month of surgery. One week later I hit the road at week 6 and rode 90 miles in the rest of June, and in July rode 270 miles with a longest ride of 58 miles, at a good pace. Much quicker recovery than the first time, but a better time of the year for weather etc.

[MattFL]

Thanks for the reply.  Interesting that you were back on the bike so much faster with the THR!  Out of curiosity, were your muscles not as wrecked after the THR as after the BHR?  Also what were your joint conditions prior to surgery? 

[petemeads]

Second operation was a failed BHR, femoral head broke off, THR fitted instead so the same amount of muscle manipulation/damage/incision length, and for the first week or so more pain during recovery.

The big difference was the BHR had to be treated carefully, partial weight-bearing for a couple of weeks because the bone was sub-optimal. THR came with my surgeon's guarantee that I would not break it!

Both joints were in the same state of arthritic damage at the time of repair, my surgeon used a lateral incision (Hardinge method) that spares the glute muscle damage but requires detaching/reattaching a chip of bone with a tendon attached, and it leaves a very long scar which is still just visible after all these years.

[MattFL]

What did you do to break the femur, and how long after surgery did it break?  Interesting they chipped the bone instead of disconnecting the soft tissue.. that actually sounds kind of better, I bet the bone heals better than soft tissue. 

[petemeads]

Femoral head snapped off during the cementing of the cap. McMinn says to "push hard and tap lightly" but you do only get 60 seconds before the cement sets... Bone was thin, age was outside the BHR envelope, but my surgeon was prepared to give it a try. The THR alternative has been excellent, and I don't have to worry about my femoral head breaking off whilst out in the mountains!
Just had 10 year follow-up for my BHR, looks perfect on xray, waiting for blood test results and will publish here when received.

[MattFL]

Thanks for the info, very cool that the doctor was willing to give it a try, and glad to hear you're doing well!  I was curious about the blood test, but my doctor said he does not test for a single BHR.  They know the levels will be elevated over a non-BHR person and if there's no symptoms there's no reason to do surgery anyway, so wait for symptoms.  If they do a second BHR they will test in-between in case one goes bad they will know which one it is.  I hope things keep going well for you! 

[MarvinB]

Dr. Gross’s protocol prohibits biking until 6 months due to falls possibly causing femoral neck fractures.  Looking forward to a warm day here at post six to go for a ride!

[MattFL]

Fear of falls breaking something sounds like a valid concern.  My official post-surgery paper says "Bike is OK with minimal resistance", which is pretty vague.  When you're allowed, I find that it really seems to help everything, and actually makes my walking better too.  Hopefully you will find the same. :) 

[MarvinB]

Stationary bike after 6 weeks was allowed, with minimal resistance.  Wonder if anyone has fallen off a stationary bike and ruined their repair?  Yikes!

[MattFL]

Checking in; I'm 13 weeks post-op, had a longer than planned ride today, all gravel/dirt/shellrock roads, except the last 5 miles were mostly paved.  Got back to the truck and the battery was dead so I had to ride the bike home from the trail.  20 miles total, felt great the whole way.  A couple weeks ago I did only 14 miles and part way through whatever muscle is on the outside of the hip was letting me know that it's not fully healed yet, not pain just awareness that things are still off a bit, but today I had none of that, felt great.  Progress!

[fakelord99]

Cardio takes time to bounce back (mine was trash too), but biking really does help the muscles.

[BilateralRecerf]

Generally speaking, indoor cycling is used on rehab starting ~ 1 week after surgery, 10-15min per day and increasing time 5min per week or so. No resistance for few weeks. We started it in the hospital rehab center in belgium where hydrotherapy was also used. Continued then both at home

But outside cycling not that early  :)

Cycling makes the joint move which is good for the rehab. Walking is still more important.

[fakelord99]

I got back to biking around 10 weeks after surgery, mostly just easy road rides. Honestly, it felt so good to move again, but yeah, keeping it chill is hard. My cardio was trash at firstâ€"like zero staminaâ€"but biking helped wake up the muscles and get things going again.

Off-road is tempting as hell, but I’ve been holding off too. The doc said the same thing about not pushing it, but man, it’s tough when you feel like you’re ready.

[MattFL]

I'm right about 15 weeks post-op now and had a 20 mile ride on mostly gravel last week, about 12 just now mostly pavement at a pace my doctor probably would not approve of, but it does feel good.  Especially the sprints through the grass and across highways when the sidewalk ends (I'm in S. FL, it's horrible here for pedestrians/bikes).  BUT it feels fantastic while on the bike, but gets a little bit stiff pretty quickly after I stop. It loosens right back up when I start moving again.  Does anyone else get this?  It feels like riding the bike really helps with everything, including making it easier to walk standing strait up and reduces the limp that I still have when I'm not paying attention.  I've managed to limit myself to nothing more off-road than gravel and dirt roads so far, I'm trying to be good! 

[HipGiz]

After one week I was back on the stationary bike without resistance. I did this for 6 weeks. Following that I added a resistance of around 100 Watts. During 8 days I was back at 160 Watts for around 45 Minutes. Beginning of week 8 I was back on my bike outside. First week on my Gravelbike. The Hip ankle was around 100 degrees. Beginning of week 9 I was back on my Racebike ( I am a Roadbike Racer). Hip Ankle around 110-120 degrees. End of this week I was back to nearly normal daily Training including Intervals of 300 Watts. Normal Training is around 3 hours. Hip feels good and the muscles are responding positively. I am now at the End of Week 11.

[MattFL]

You are definitely pushing faster than I did!  I'm at 7.5 months, doing 1.5-2 hour rides at this point, pushing pretty hard with some very short sprints but just on gravel roads (I'm resisting the urge to go off-road due to doctor saying nothing high impact for 1 year).  Great to hear you're doing well, makes me think I can push harder. :)