Why cycling for rehabilitation is not a good idea

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Many rehabilitation practitioners from surgeons to physios advocate stationary cycling as an integral part of the rehabilitation process for many injuries and in particular for knee injuries such as ACL (cruciate ligament injuries). There has been many discussions as to whether open (able to move through) or closed chain exercise (has to move against) is the best form of exercise to improve function. But is cycling and spinning counter-productive for improving (real) functional outcomes in post injury and operative situations?

What are the advantages of cycling for rehabilitation?

  1. Low load on the injured area.
  2. Localised conditioning
  3. Maintains localised fitness or allegedly maintains cardiovascular health

In a nutshell, cycling supposedly provides a low impact form of exercise that maintains some element of CV fitness and may give limited localised strength to quadriceps. In some cases of cruciate ligament injuries, people fail to increase adequate quadriceps strength. In which case, cycling and particularly spinning will be of little benefit to the rehabilitation process. In fact, an over reliance on the calf muscles with activities such as cycling can inhibit not only the quadriceps but the hip flexors, glutes and many other muscles, increasing subsequent dysfunction and future pain. Many clients that I have seen who either teach spinning or take part on it have often suffered from plantar fascia issues and over developed calf muscles that have often inhibited the thigh muscles.

Take a look at the picture above and this will give you an idea of why cycling can be detrimental to those seeking to improve functional strength. Here are some potential reasons.

  •  Inability to train functional slings such as the lateral, posterior oblique, deep longitudinal and anterior oblique sling.
  • Train the muscles into poor posture, note that with the picture above there is an approximate angle of 60 plus degrees of the thoracic spine.
  • Due to the angle of the pelvis, there is poor muscular recruitment between the knee and hip, flexors and extensors. In many cases the gastrocnemius of the calf has the potential to disrupt optimal mechanics of many of the muscles need to provide stability for the kne
  • Many people mistake the fitness associated with cycling as strength but in fact, training this way, serves to decrease optimal muscular recruitment and increase dysfunction.

Muscular slings in all their forms, whether it is from Vleeming or Myers, suggest optimal muscular recruitment via the use of slings, optimal use of fascia and a framework for tensegrity models. Take the posterior oblique sling, as pictured below. Its function during gait is documented and just one method for optimising support for all structures involving gait and performance. Any rehab methodologies should integrate these systems for optimal alignment, support and movement for injured or compromised structures. Sitting on a cycle provides insufficient training stimulus for structures that provide the most effective forms of joint stability and motor control.

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Individuals deserve the most time efficient and effective forms of therapy and exercise. Outcomes such as improved mobility, stability and enhanced motor control should be the goal and sitting on a bike may give a false positive as to enhanced function but it does not carry over to real world gains.  Spinning in particular continues to create dysfunction and disrupt optimal biomechanics. The fitness industry continues to use modalities that whilst make people, hot, sweaty and  increased  whoop factor and appear that they have done some good, actually creates injury after injury. Instead of telling people to get on your bike, we should be telling people to get off and use your legs properly.