Given how common it is for people to hurt their knees in sport, meniscal tears are one of the more common injuries you see as a doctor. Many cyclists who tear their meniscus will be concerned not only about their knee, but how quickly it will be before they can start cycling again. As a doctor and keen cyclist, I thought I would take a look into this question in a bit more detail. So, can you ride a bike with a torn meniscus?
You should not be cycling on a torn meniscus for the first 1 to 2 weeks following the injury. However, in mild tears, you may be advised that you can do some cycling as part of your physiotherapy between weeks 2 to 6 of your recovery. A doctor or physiotherapist must sign you off before you ride a bike.
So, we’ve established that you may be able to cycle following a meniscal tear. But what impacts whether or not this is the case? And if you are planning to cycle, what is the best way to do it? I take a look at this as well as the benefits of cycling following a meniscal tear in the rest of the article.
Can you bike with a torn meniscus?
First things first. While I am a qualified doctor, it is important for me to remind you that I have not been able to properly assess you before giving this advice. This page has general guidance and if you are concerned about a torn meniscus then you should ensure you are seeking formal medical attention.
This article is a resource that can help once you have already been fully assessed and are seeking further clarification. For further advice on when to seek medical attention, please see this link from Patient UK.
Whether or not you are able to ride a bike with a torn meniscus will depend on multiple different factors including how severe the tear is, how long it has been since you injured your knee, as well as the advice from your doctor.
What is a meniscal tear?
The meniscus is a piece of cartilage in your knee (in fact you have 2 in each knee). Meniscus are designed to act as shock absorbers for the knee, keeping it stable, lubricated, and limiting the damage you take if you have a fall.
The most common cause of a tear to your meniscus will depend on your age. In younger people, a tear is often caused by sporting activities such as football or skiing. Normally from a sharp twisting motion that causes the meniscus to tear.
In older people, meniscal tears can occur for less traumatic reasons, this is because the ongoing wear and tear in our knees as we get older can rub down at the meniscus and damage them without any specific injury.
Type of tear
Whether or not you are able to cycle after you have torn your meniscus will depend on the type of tear you have. Some tears can be quite mild and heal within 6 weeks, on the other hand, some can be much more severe and require surgery.
When you get diagnosed with your tear, your doctor will be able to give you some indication of the severity of the damage you have done, and this can be helpful to estimate how long before you can start cycling again.
Some types of tears will actually heal better if you cycle as part of your physiotherapy. This is because cycling helps to keep the knee joint mobile while building up the muscles around the knee so that they can support than damaged meniscus. However, this should be guided by a physiotherapist or doctor.
Have you been suitably treating the injury?
Whether or not you can cycle with your meniscal tear will also depend on how well you initially managed the tear.
When you first injure your knee, it is important to properly look after the area, this reduces further damage and helps the healing process.
The aim for the first 72 hours is to protect the knee from any further damage, while also reducing inflammation and pain.
As with most sporting injuries, the steps you will want to use follow the acronym PRICE.
|Protect||Make sure to protect the knee, ensuring it has no more damage done to it|
|Rest||Rest the ankle, try to keep weight off of your knee, limit the activity you need to do|
|Ice||Use regular ice packs on the knee to reduce inflammation and swelling|
|Compression||Use compression on the knee to help limit swelling|
|Elevation||Keep the knee lifted above the height of your heart, for example lying down with your knee on a pillow.|
After the first few days of managing your injury, the treatment will be dependent on the type of injury you have sustained. Often this will include either a prolonged period of careful physiotherapy and gradually building up the muscles around your knee. However, it can also include a referral to an orthopedic surgeon who may need to perform keyhole surgery.
If you are going to be treated with physiotherapy, your doctor may sign you off to take part in physiotherapy after a week or two, provided your pain is manageable, the swelling has reduced and the bruising has gone away.
The exercises you are doing in the first few weeks will be very simple and it is unlikely that you will be fit to start cycling at this stage. However, between weeks 2 and 6, you will likely progress to more complicated exercises such as step-ups. When you start doing these more complicated exercises you may want to ask your physiotherapist if they feel that cycling would be beneficial or suitable in your case.
In general, if you have a tear with symptoms that are ongoing for a prolonged period of time or where there is any locking of the knee, you are more likely to be seen by a specialist, and therefore you will be less likely to be cycling with them.
It is very important that you do not start cycling on your knee until it has been cleared by your doctor or physiotherapist. Jumping back into the saddle too early can set back your recovery or worsen the damage.
Are there any benefits of cycling with a torn meniscus?
So, we’ve established that you should not be cycling on your injured knee until you are signed off by your doctor. But once you have been given the all-clear, is there a benefit to cycling?
Strengthening of muscles
Cycling actually is used as part of physiotherapy following a meniscal injury. This is because cycling can help to strengthen the other muscles around your knee, which can help to carry some of the extra weight while your knee recovers.
When cycling to aid recovery of your meniscal tear, it is important to talk to your physiotherapist about the best seat and pedal positions as you cycle. Different positions of these can help to take weight off the damaged area.
Speeding up recovery from surgery
Cycling is not only beneficial in patients who are undergoing a physiotherapy-based treatment, but also in knees that require surgery. In fact, cycling after surgery has been shown to increase muscle strength and overall recovery time.
Reducing symptoms of arthritis
Finally, cycling has also been shown to help out with symptoms of osteoarthritis, a common complication of meniscal tear repair surgery.
How to cycle with a torn meniscus?
So, you’ve been signed off by your doctor that you can go back to cycling. But what is the best way to start cycling again?
Use an exercise bike
First of all, consider starting out on an exercise bike. This is a nice safe way to get back onto a bike as you have far less risk of having to suddenly put a foot down and you can much more easily control the environment you are cycling in.
Stationary bikes also have the benefit of having very low resistance as you cycle, and you are positioned in such as way that you put a very even spread of weight onto the knee area.
If you would like to cycle outside, some people also suggest using an electric bike. This again helps to aid you and take weight off of your knee.
Get a proper bike fitting
If you plan to use your own bike rather than an exercise bike, make sure that you have had a proper bike fitting. Cycling with the wrong posture can put excess strain on your knees, and end up doing more damage than good.
When getting a bike fitting for this reason, you want to pay specific attention to the saddle height, saddle angle, and handlebar position.
Try flat pedals
Try swapping out your clip-in pedals for platform pedals. Clipping and unclipping your foot from a pedal require a twisting motion than can hurt your meniscus.
By moving over to flat pedals, you not only reduce the risk of this hurting your knee, but also reduce the small risk of you falling over while unclipping which could seriously hurt your injured leg.
Cycle with a high cadence
When you progress to a normal bike, make sure you are cycling at a high cadence. This means that your pedals are moving around the bike quickly with little resistance. The high cadence does a good job of building up your muscles while limiting the pressure you put on your meniscus.
For the same reason, you should avoid cycling a route with a lot of inclines as climbing will put more strain on your knee, as will bike racing or cycling in a high gear.
If it hurts, stop
If your knee starts to hurt as you are cycling, make sure to give it a break. If the pain continues after you have stopped then you need to get in touch with your doctor. Once they have checked you over, try returning to cycling at a slower pace and increasing things more gradually.
Can cycling cause a torn meniscus?
Given that many people suffer from meniscal tears, some of you will be wondering if cycling itself can cause a meniscal tear.
The answer is that cycling is very unlikely to cause a tear. This is because cycling is a very low-impact sport that does not put much strain on your knee.
Meniscal tears most commonly occur after a trauma, typically in sports such as football or skiing.
As you can see, whether or not you can cycle following a meniscal tear will be dependent on how severe your tear is, how long ago it was, and whether or not you have been signed off by your doctor.