Have you been diagnosed with osteoarthritis of the knee, or do you have knee pain, and you are wondering if it is good to ride a bike?
Does cycling reduce knee pain, can it aggravate osteoarthritis or damage the knee cartilage more?
Maybe you can not even ride a bike anymore because of your osteoarthritis. In that case, what can you do?
For this article I base on in-depth documentary research in scientific publications referenced at the end of this article.
Happy reading?😀
▶️What do we know about the benefits of cycling for knee osteoarthritis?
Is cycling beneficial to knee osteoarthritis? The answer is YES.
Cycling is great for knee arthritis because it puts much less strain on your body than running or contact sports.
Cycling both indoors and outdoors is beneficial for your condition as it keeps your knee joints moving without putting too much pressure on them.
Hypothetical benefits of cycling for osteoarthritis.
In theory cycling can have a positive effect on knee pain, stiffness and osteoarthritis. Here are the main hypothetical benefits.
🟠Cycling helps to strengthen your muscles around your knee pain.
🟠Cycling helps to improve mobility of the knee joints promoting better lubrication.
🟠Cycling helps you maintain a healthy weight; this puts less pressure on your joints
🟠Cycling helps to improve your knee joint function and stiffness.
🟠Enhancing your balance
🟠Boosting your range of motion in the knee joint
🟠Improving your mood – exercise releases endorphins which can help make you feel happy
There are several consistent ways to suggest that cycling is good for knee osteoarthritis.
▶️Advantages of cycling observed in people with knee arthritis
Cycling to relieve knee pain
Yes, cycling is known to help improve knee pain. The movement of your legs pushing on the pedals works certain joints, which can help reduce pain or stiffness.
Cycling can also improve range of motion in your knees, so if you suffer from both pain and stiffness, your bicycle may help loosen things up and reduce pain.
High‐quality evidence suggests that:
Pain on a scale of 0 to 100 points (lower scores mean reduced pain).
• People who completed an exercise programme rated their pain at 12 (10 to 15) points lower at the end of treatment (12% absolute improvement) compared with people who did not exercise.
• People who completed an exercise programme rated their pain at 32 points.
• People who did not exercise rated their pain at 44 points.
{Fransen 2015}
It’s noted that people with osteoarthritis who exercise (cycling) in general report less pain on average than those who do not exercise, or significantly less pain.
▶️Cycling to limit knee cartilage wear?
What is knee cartilage
Knee cartilage is a flexible connective tissue that acts as a shock absorber at the ends of the knee bones that helps to reduce friction by preventing them from rubbing together when we move.
Because the cartilage does not have a blood supply it can not repair itself the same way other body parts do.
Movement is essential in maintaining a healthy cartilage and cycling has been seen as a good sport for limiting knee cartilage because of the following reasons.
Pedalling bends and stretches the joint to ease movement and build strength and muscle around the knee.
This kind of movement allows the cartilage to receive nutrients that are needed for healthy thick cartilage.
Cartilage thickness did not change after short bends exercises but longer duration exercises such as cycling led to increases in cartilage thickness after 5 minutes from the completion of the exercise (Rodrigo 2020)
This may also explain why rates of knee pain increase as people grow older because they’re moving less.
Cycling can also be bad for knee cartilage if you do not avoid the following:
♦️You can avoid poor posture and try not to train in too high a gear if you feel discomfort in the joints.
♦️ Overtraining or overdoing it on the mileage can also create knee pain.
▶️Is an electric bike good for knee arthritis?
No matter how severe your knee arthritis is, you can find a type of cycling that suits you.
Yes, electric cycling is one of the activities you can do if you have severe knee osteoarthritis
Evidence shows that stationary cycling can reduce knee pain and improve aerobic capacity, self-reported physical functioning and gait.
(Mangione 1999}
For example, electric bikes and battery pedal-assisted bikes can work well if your condition is more severe, as minimal strain is put on your joints and the bike will support your knees as you cycle.
An electric bicycle can be especially beneficial because the electric motor helps you pedal, allowing you to control how hard and how often you must push and how much stress you put on your knees as a result.
▶️How can you ride a stationary bike with bad knees?
You need to find an electric bike that does not cause significant pain every time you ride it.
For example, city bikes, mountain bikes, exercise bikes and racing bikes, these are less of a problem in case of knee osteoarthritis.
🔵Try to adjust the saddle height properly so that it is comfortable for your knee when pedalling.
🔵Adjust the seat so that it’s roughly hip height and you can comfortably reach the handlebars.
🔵While pedalling, keep a slight bend in the knee to avoid overextending it.
🔵Strap your shoes into the pedals or consider clip-in bike shoes. “In a full revolution, you want to push down and pull up,”
▶️Are there any negative effects associated with cycling with knee osteoarthritis and pain?
🔴Yes, in some people cycling can increase pain in the knee, while padding or in the hours or days that follow.
🔴It can also cause further damage to the cartilage and surrounding areas of the knee joint.
You must evaluate whether in your own case the potential benefits outweigh the potential risks.
It is often a question of knowing the quantity, amount and intensity of cycling you need to help with your knee pain.
However, in general most medical publications report a positive effect in staying active with any sports not specifically cycling, because it can be good for your health.
A you tube video showing a Stationary Bicycling Program for Osteoarthritis (Practical Session)
Recommendations from scientific publications on how to practise cycling properly with knee arthritis.
Here are some ideas
🔴Keep a sustained pace when pedalling, that only cause you to get a little out of breath.
🔴Start with 30 minutes to an hour engaging how far you can sustain it.
🔴If you think cycling is not possible consider other activities like walking, swimming and water walking.
▶️Is cycling the best sport for knee osteoarthritis and pain?
Moderate physical activity is recommended for people already suffering from OA with the goal of increasing muscle-strength, reducing pain and preserving the range of movement in the affected joints.
I do not think cycling is the best sport for everyone who has osteoarthritis and knee pain.
The best sport in my own opinion, if you have osteoarthritis will be ideally meeting these 3 criteria.
1️⃣You must enjoy it enough and it is easy for you to do it consistently with less effort.
2️⃣When you are doing it, it does not give you too much stress and body weight on the knee.
3️⃣It allows you to practise it by sufficiently strengthening your muscles and allows controlled breathing.
In theory cycling is one of the best sports for knee osteoarthritis. Stop these exercises if they make your symptoms worse, or if they cause new pain.
▶️If you can no longer ride your bike because of knee osteoarthritis: what can you do?
Opinions of professionals and experts.
🟩Knee replacement surgery is often an option offered when nothing works anymore.
🟩You can try other activities like swimming and walking if you do not want to go through surgery.
🟩Some people try nature treatments for knee osteoarthritis which sometimes must go hand in hand with physical activities.
Some medical studies outline the benefits of surgery for those who accept knee replacement to ease pain of knee osteoarthritis.
After surgery, a total number of 70% patients successfully return to sporting and recreational activities, such as cycling, hiking, dancing and swimming (Ventura 2022)
out of 97 people followed knee replacement surgery (average age 70 years), 12% were cycling before the operation, and 14% after. So, some resumed cycling after the operation (Ventura 2022).
85.5% of people who undergo total knee replacement surgery before the age of 50 are satisfied or very satisfied with the operation.
Types of sports practised before after surgery.
| Sports practised | No of patients participating before surgery (%) | No of patients participating after surgery (%) | Differences(%) |
| Cycling Swimming Hiking, log walks Jogging Skiing Dancing | 12 11 15 17 4 9 | 14 13 17 9 0 6 | +16 +18 +13 -35 -100 -33 |
This table shows that among the people followed in this study, 12% practised cycling before the knee replacement for osteoarthritis. After the operation, 14%: therefore, some people were able to resume cycling after the knee replacement. Source: Ventura 2022.
The present study showed that a significant percentage of patients were able to return to regular physical activities following Total knee replacement.
And subjective and objective clinical improvement at a mean follow-up time of 4 years after surgery was confirmed.
In summary, patients with knee OA, who cannot bear exercises because of pain.
Total knee replacement provides a high rate of return to sport postoperatively and confirms improved subjective results and reduced pain compared to preoperative status.
However, most patients returned to low-impact activities, while a significant decrease was reported for mid- and high-impact sports.
We have come to the end of this article, let’s meet in the comments section for any questions.
Wishing you a quick recovery.🙋
📚Sources:
Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL. Exercise for osteoarthritis of the knee. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD004376. DOI: 10.1002/14651858.CD004376.pub3. Accessed 13 September 2024.
Zeller L, Sukenik S. [The association between sports activity and knee osteoarthritis]. Harefuah. 2008 Apr;147(4):315-9, 374. Hebrew. PMID: 18686813.
Rodrigo Rico Bini, Alice Flores Bini,Effects of exercise mode in knee cartilage thickness,Journal of Bodywork and Movement Therapies,Volume 24, Issue 4,2020,Pages 490-495,ISSN 1360-8592,https://doi.org/10.1016/j.jbmt.2020.05.006.
Rewald S, Mesters I, Lenssen AF, Emans PJ, Wijnen W, de Bie RA. Effect of aqua-cycling on pain and physical functioning compared with usual care in patients with knee osteoarthritis: study protocol of a randomised controlled trial. BMC Musculoskelet Disord. 2016 Feb 18;17:88. doi: 10.1186/s12891-016-0939-5. PMID: 26887576; PMCID: PMC4758142.
Mangione KK, McCully K, Gloviak A, Lefebvre I, Hofmann M, Craik R. The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. J Gerontol A Biol Sci Med Sci. 1999 Apr;54(4):M184-90. doi: 10.1093/gerona/54.4.m184. PMID: 10219009.
Ventura A, Macchi V, Borgo E, Legnani C. Shift to low-impact sports and recreational activities following total knee replacement. Int J Artif Organs. 2022 Nov;45(11):952-956. doi: 10.1177/03913988221119524. Epub 2022 Aug 22. PMID: 35993237; PMCID: PMC9580033.