An Active Approach to Cycling Injuries: Total Knee Replacement

An Active Approach to Cycling Injuries: Total Knee Replacement

Recent data shows that as many as 47% of people surveyed have delayed seeking relief from their joint pain due to concerns with the post-operative process.  Although I have no definitive proof, my guess is that a greater percentage of cyclists avoid surgical intervention despite the significant limitations of joint deterioration for fear of the inability to regain their active cycling lifestyle.  

With advances in medical technology and post-operative rehabilitative care this need not be the case.  By asking the right questions and making educated decisions you can return to cycling after Total Knee Replacement, and likely at a higher performance level and with greater enjoyment than prior to surgery!

In a recent installment of this series, it was suggested that not all knee injuries require a hiatus from riding and most can be managed while maintaining some level of cycling fitness.  But when all conservative modalities have been exhausted, knee joint deterioration has progressed to severe, and the pain and loss of function leaves you with the inability to perform daily activities (let alone ride a bike), Total Knee Replacement may be the only available option.

Seron Eaton

With the help of Zwifter Seron Eaton (see his ZwiftPower and Strava profiles) who has successfully returned to cycling after undergoing Total Knee Replacement surgery, this article will explain the questions to consider.  With Seron’s experienced-based answers and informative research, you can gain the knowledge required to make an educated decision when considering Total Knee Replacement as a cyclist.

With Seron’s consent, the answers to many of your Total Knee Replacement questions can be found below.

How long did you suffer with knee pain and did you delay surgery because it would interfere with your cycling lifestyle? 

I had knee trouble and arthritis for the good part of 20 years, and after trying all other therapies (bracing, cortisone injections, platelet rich plasma), it was on to the replacement.  I put it off as long as I could and riding was definitely a factor.   

When did you know it was time to undergo total knee replacement surgery?

The level of discomfort from arthritis was debilitating.  I couldn’t stand for 15 minutes, walk in the grocery store, or do the dishes without severe pain.  The level of disability works into your head and the growing depression is real.  When I wouldn’t want to do chores, run around with the kids, or pedal my bike, I knew it was time.

How important was the ability to return to an active cycling lifestyle in the decision to undergo surgery?

Being able to ride comfortably and with the same ability was paramount.

Was finding a surgeon who could provide you a level of confidence that you would return to cycling important and was it difficult to find?

I’d been going to the same Orthopedic clinic for many years and felt confident in the reputation of their knee specialist who had performed at least 12,000 replacements.  The doc was sure I would return to a full cycling life with little loss of ability.

Did you require a specialized surgical procedure or implant?


When were you able to resume cycling post-surgery?

I was able to begin pedaling a bike within weeks after the surgery and started to ride outdoors at three months out.  With three months of Zwift I felt pretty strong and well on my way to riding without worry.

Did you have to change your Zwift setup?

Nope.  The knee took to it like riding a bike.

Did you receive Physical Therapy treatment and for how long?

I did home PT for about a month, and continued to progressively work at home and on the bike for another 6 months with PT consultations to keep things moving forward (see the Brigham and Women’s Hospital Total Knee Arthroplasty Protocol).

When was your surgery and at what level are you cycling now compared to pre-surgery?

My surgery was in January of 2019 and I was riding well within 6 months.  My volume is now higher than before surgery and my cardio is the best it has been in 20 years.  I can pedal and sprint to my heart’s content.  Now I don’t even think about my knee.

Are you pleased with your decision to undergo Total Knee Replacement surgery?

I’m ecstatic!  It’s fantastic!  In many ways, I feel reborn, able to chase the kids, do chores, and ride.  I’m forever grateful to my surgeon’s skilled hands, awesome technology, and Zwift, otherwise the pack would have left me to the wolves before too long. 

Do the Research to Best Make This Very Difficult Decision

While the decision to undergo Total Knee Replacement surgery is not one you should make without considerable thought, research, and preparation, it need not be avoided purely for the fear of never being able to ride again.  Knee replacement is a major surgery and the rehabilitation is extensive and demanding, but when all other options have been explored, it quite possibly may be the best decision you could make.  It was for Seron.  Ride on!

Was it the correct decision for you?

Have you undergone Total Knee Replacement and returned to an active cycling lifestyle?  Tell your fellow Zwifters about it. Comment below!


About The Author

Christopher Schwenker

Chris is a semi-retired physical therapist who, following more than 25 years in solo private practice, considers himself blessed to combine a passion for cycling and creative writing in pursuit of his next life goal. He lives on the North Fork of Long Island with his beautiful wife and two university student children.

Notify of
newest most voted
Inline Feedbacks
View all comments
Jason Bretz
Jason Bretz (@jasonbretz)
4 months ago

I just had knee replacement this week. I wanted to put it off until the end of the summer, but the pain became overwhelming, so I moved it to early June. The initial pain after surgery was excruciating, but is now more manageable. I’m hopeful to be back cycling in a couple of months. Thanks for the article!

Marsha Wartell
Marsha Wartell
4 months ago

I was diagnosed with psoriatic arthritis several months before I shredded my medial meniscus on a 4 mi run in 2012. In October 2012 I had arthroscopy and medial meniscus removed. I still had pain which only worsened over the years even with the injections however I had been training for a 500 mi ride across Texas raising money for a Veterans group and I was determined to go. I told myself those men suffered for my freedom and I will make it happen; I did. Then I could no longer work 12 hr shifts or even go to the… Read more »

Deke Botsford
Deke Botsford
4 months ago

Ortho surgeon here – enjoyed the article, and agree with all that was said. Cyclists actually make the best patients!

Jim Callaghan
Jim Callaghan
4 months ago

Had my TKR three years ago. Was on the bike after 12 weeks . Done 13000 Km since. All good. Even done some racing.

Shellie Martin
Shellie Martin
4 months ago

Had a total knee replacement 8 weeks ago. On week 6, I put my seat up one inch to bike on the trainer. It is still up about a half inch because flexing is slowly coming. I velcro my foot to the pedal for the first couple miles then I can clip in. Cadence was really slow at beginning in the 50’s and is finally creeping toward 70’s. Every knee is different and it was my third surgery on that knee. I was unable to bike January – April so I will be happy when more cardio conditioning takes place.… Read more »

Joe Kuchta
Joe Kuchta
3 months ago

In 1968 I had 3 surgeries to remove torn meniscus from both knees. At the time removal was the only option. I was inpatient for nearly a week. The pain was severe. When able, I returned to playing hockey, casual cycling and jogging. Jogging evolved into marathons,10k and other races. For more than 30 years, I was fine, but as I approached 60, the pain became more severe. I was in Boston like Chris and consulted 3 surgeons. Any would have been a good choice. My history was with Mass General Hospital so I went there. I had bilateral replacements… Read more »

Roger Lister
Roger Lister
2 months ago

Total knee replacement can be a game changer for anyone that is ready for it. I had my left knee replaced in Nov 2010. And it got me back on my bikes again. Which was bittersweet, as I crashed 9 months later breaking my back (T9 burst fracture, 6 level fusion required). I had put it off a lot longer than I should have out of fear. So when my right knee was toast last year, I didn’t put it off and that was a much better decision and outcome. Oct of 2020 was my right TKR. And I was… Read more »

Free Zwift Trial

Newsletter Subscription

Would love your thoughts, please comment.x