Recovery after knee surgery

fastcat

Just over a year ago I had surgery to my left knee to sort out some torn cartilege. Operation was successful - knee is in much better shape than before.

Recovery of the leg muscles was slow, in particular the ability of the quads to properly control the leg going down stairs for example.

But, all that said, it's now working well. And, after a low year last year in terms of milage and training intensity I am now building back up to previous levels of intensity, if not yet power, though hopefully that will come back.

Issue: the muscle mass on the left leg is still noticeably less than the right - perhaps an inch or two smaller circumference round the lower parts of the quads.

I'm not doing anything special to address this. I don't like doing leg-weights - both because of the stress on the joints but also because I'd rather use the time/energy for cycling.

I don't notice it whilst cycling so my instict is to ignore it and just pedal.


Question is:
a) does a size (or rather the potential strength) imbalance between right / left leg matter ?
b) if the answer to a) is 'yes' should I be doing anything special to built the left leg up to the same size/strength as the right ? (e.g. weights; one legged cycling drills etc)

Thanks for any thoughts

Ken (Some background for context: Age 42; prior high FTP: 275 watts; 75 kg; limited training time due to family & work commitments)

djaeggi

I think the biggest issue for you is not directly the L vs R difference in muscle mass (although maybe this might cause issue in the future? Doesn't sound optimal anyway!) but the lack of stability of you right knee joint. If you've had knee problems such as a cartilage tear, then this probably means your knee was twisted in some way it didn't like at some point in the past. You *really* want to avoid this happening again, and the best way to do this is build up the muscles surrounding that knee such that they help stabilise the joint. This will involve some strength training. Actually the "stress on the joints" concern you have with this is a bit of a myth - done properly, while of course loading your muscles and joints, weight training does not place undue stress on the joints, and the physical adaptations that take place (increased muscle mass, bone density, stronger connective tissues) help reduce the stress on the joint from other activities, placing you at less risk from further injury.

I'd go an find a decent sports physio with a keen interest in physical training, and let him/her put together a program for you.

Good luck!

pbracing

IME you don't need to do weights, your own leg/ body weight is enough for what you want to do. I don't think it's worth the risk, but it's a personal choice.
The post op exercises you were given (straight leg lifts etc) are enough if you do them consistently, plus leg bend etc (standing on bottom stair, good leg off ground, bend bad leg gently (dip) and straighten. Do sets of these).
Also an amazing thing is standing on your weaker leg with your eyes closed trying to keep your balance. You won't believe how much harder it is than on the good leg. Apparently it gets all the little nerve sensors around the knee working again, crucial in stabilising the joint.

Strange thing is even though my right leg is still a bit smaller, it's my left leg which doesn't have as much power :? :?:

fastcat

Thanks for the thoughts guys. Tried the balancing and wobbled on both legs !

rgarner

Would have to second the physio advice. If you can afford it, just two or three sessions along with some exercises you'll be given will sort you right out (if you do the work!)

I've got one leg about half an inch shorter than the other and I have been told that this does make a massive difference to wear patterns on your knees. After physio advice I'm now wearing one orthotic insole on the "shorter" side and doing pilates-style exercises aiming at firming up one buttock It really helps, and the imbalance correction stops me re-injuring so easily with simple wear.

Go find physio!

lochindaal

I had both my knees operated on for cartiledge in October. After the usual physio exercises to get things going I bought a turbo in December. Fortunately I got a great deal on a Tacx basic on Gumtree so have power output.

When I first got on the bike I could manage 30W. I did this for a couple of weeks spinning really easily to get things going. It sounds like you are well past this.

I have just completed the 7 week intermediate training program from the LA Performance Program book. As part of the program you need to do a fitness test to determine your zones. In my first week my maximum power output was 145W. On a restest in week 4 it was 186W and last week at the end was 254W.

For me therefore it is a turbo trainer and focus on a program. The LA one requires being on the bike/turbo 6 days a week for seven weeks. If I was away a night on business I always found a local gym and did the days session.

I did a 60 miler on Saturday for the first time since last year and already feel stronger on the bike. Just the rest of my body ached from the time in the saddle.