28 Apr Progressive Cycling Rehab Programme

Cycle rehabilitation Programme

This is a graduated rehabilitation programme with a key focus on knee and other lower limb injuries. The goal of the programme is to slowly re-introduce load through an injured limb and depending on how the injured area reacts to this new load determines the progression/regression through the programme.
The programme can be commenced under the guidance of your Kingsland Physiotherapy team when clinical criteria is achieved for eg. Minimal to no pain, adequate wound healing, appropriate range of motion, swelling etc.

Adverse reactions to load that must be looked out during all phases are:
-Pain: *not to be confused with DOMS (delayed onset of muscle soreness)
An increase in pain while cycling that stops after performing the activity
An increase in pain after cycling or anything that presents up to 24 hours after performing that activity
-Loss of range (stiffness):
An increase in stiffness that comes on after cycling or the following morning
-Swelling
An increase in swelling immediately after or up to the next 24 hours after performing the activity

If you experience any of the above reactions reduce your training by dropping back a level in your programme. Ensure to treat with RICE (rest, ice, compression, elevation) if your symptoms don’t settle please contact your physiotherapist.

While there are many graduated cycling programme resources available to you online, we particularly like the one our friends at Axis sports medicine have created as we feel it respects the time the body requires to adapt to changes in load. We have made some modifications to the programme below.
https://www.axissportsmedicine.co.nz/patient-information/cycle-rehab-program/

Starting Level:
• Seat a little higher than normal (above hip height) – your leg should be straight at the bottom of the stroke when the forefoot is on the pedal
• If you are unable to fully extend your knee (because of your injury) you may need to have your seat lower than normal
• Resistance as low as possible – Some resistance is actually better than no resistance at all
• High cadence – spin as close as possible to 80 rpm
• Start with 10 minutes each training day

Progression:
• Increase by 5 minutes on every third training day if there are no adverse reactions
• Gradually build up to 30 minutes per session
• When you can cycle for 30 minutes without pain, stiffness or swelling lower the seat height to normal – saddle at hip height
• If you develop pain, stiffness or swelling reduce the load by 5 minutes per session until it settles then gradually build back up to 30 minutes
• When you can do 30 minutes at this seat height without problems gradually increase the resistance
• Keep building up until you can do a heavy workout for 30 minutes without any problems – at this stage you are ready to gradually return to weight-bearing exercise under the guidance of your physiotherapist.

If you have any further questions or would like to adapt this programme into your training schedule feel free to speak to the any of Kingsland Physiotherapy Team at any stage.