On e-bikes and double knee replacement surgery

I played racquetball regularly for a few years. Jeff, a friend from those days, played well but was clearly limited by his arthritic knees. The time came when he finally decided to do what he knew needed to be done: new robo-knees.

[I have my big takeaways itemized below if you want to skip the narrative and get right to the good stuff. Scroll down to the next picture...]

He chose to do both at once, which seemed insane right after the surgery, but definitely made sense after he was back on his feet (after the pain of recovery, I don't think he'd have gone back for the second surgery).

I kept checking in on him post-surgery and, knowing I had switched from rball to cycling, he asked me for some guidance in picking some form of pedal-powered vehicle to help him regain strength and flexibility. He had tried some direct-drive trike (kind of like a Big Wheel for grownups) and hated it. They are garbage, for this purpose at least, because it's easy for the thing to get away from you going downhill (remember taking your feet off the pedals of your Big Wheel and just letting it fly?) and it's really hard to get uphill. 

I suggested an adult tricycle, adult training wheels, a low step-through bikes (i.e. "girls' frame"), or a folding bike. I went to Bicycle Sport Shop, Austin's bike retail behemoth, to get their thoughts. They pretty much cut down my ideas and really pushed me toward a Specialized Como ebike. 

I told him about the recommendation, but at nearly $3k, I had my doubts that Jeff would go for it. He read up on the topic, though, and realized that it was probably the way to go. So we went into BSS and tried it out on a trainer.

It did not look good to either me or the BSS saleslady. He could barely get a pedal stroke going but he said was having a bad knee day, he said. Regardless, he put down the card and soon was toting home his new toy. 

I was not there for his first excursion/attempt. It did not go well. He hadn't ridden in decades and forgot to put it in a low gear.  He was also afraid it'd get away from him so he thought it'd be better to try going uphill. He also forgot how to use bike brakes. All this meant he ended up in a ditch less than 30 feet from his driveway. Inauspicious...

So, being the noble friend that I am, I went over to check out the bike and to see if I could help him get going. I took it for a spin and, I have to say, it put a smile on my face. The experience is kind of like stepping on a moving sidewalk in an airport--you're still walking (presumably) but you're suddenly moving much faster. And if you want to let the moving sidewalk do all the work, you can do that; you just have to "soft pedal;" no actual force, just keep the feet going around. 

The Como has four settings: no power, 20% power, 50% power and 100% power. I took it up the biggest hill in his neighborhood, cranked that puppy up to 100% and--damn!--it was like going up an escalator! If you stop pedaling, you get no power, regardless of the power setting so it really can't run away from you like a motorcycle can do. The more power you put in, the more power it puts out, so you really do get some actual exercise. 

Knowing how the thing felt and worked now, Jeff and I decided to go to a little park where there was some an open field--he was afraid of falling again but, dang, he was determined to make that thing work for him. 

I did what a dad does when teaching a kid to ride: placed my legs on either side of the back wheel while he got on, held the seat, gave a push. He was scared the thing would run away from him if he used the power but I convinced him that was the secret of getting rolling. 

Much to my surprise, Jeff had that thing going around the park like a champ within 30 minutes. I won't quote his gleeful exclamations because they involve exuberant swearing but, man, it was hilarious and delightful to see him taking laps around the park. He was as gleeful as a kid, maybe more so.

Soon he was on the pavement and we did a lap around his neighborhood. "The wind on my face!!" he kept saying. He'd basically been stuck in his house for five months and he suddenly had mobility and the experience of flying down the road on two wheels that is so very addictive. Another disciple in the Church of MAMIL...

Jeff's been riding nearly every day the weather permits and has "seen the light" when it comes to cycling. He's usually on 20% power, so he's building strength as well as mobility. He even plans to get back on the racquetball court next week. 

So here are my takeaways on e-bikes for those recovering from major knee surgery: 

1. First, e-bikes are damn awesome. I cannot believe how easily Jeff, who had had double knee replacement surgery just five months before, took to his Specialized Como. Having the 100% power setting allowed him to know that he would not get stuck at the bottom of a hill. He was quite skeptical that the thing would have enough battery power for a good ride but he's learned that he can actually go on a couple of rides without needing to recharge. 
2. E-bikes also allow a lot more people to experience the joys of cycling, which means fewer motorists telling us to get off "their" roads, less pollution, and more fitness. Yes, I'm a purist and "don't need no stinkin' motor," but I can definitely see the place of e-bikes. There are many of my ilk that will mutter and roll their eyes about this growing phenomenon. Screw 'em...  
3. The low step-through thing was a very important factor in Jeff's success here. A "men's frame," with that high top tube means you have to swing one leg up high and support all your weight with the other leg. That was just not going to happen for Jeff so the low step-through was critical. 
4. A TIP: It was actually pretty hard for Jeff to get his leg over the low bar at first so I had him lay the bike down on the ground, step over it, and then pull the bike up underneath him. A pretty nifty trick, if I do say so myself, but he graduated past that quickly. Still, it's something that might make more of a difference for others.
5. I suggested Jeff get a trainer which, yes, CAN be used with an ebike, so he could build some confidence, strength, and flexibility without risk of falling before his first excursion. He demurred but I definitely think it's something to consider. It would also allow you to ride when the weather is bad.
6. Jeff's main fear was falling and injuring his knees and setting himself back. This is a legitimate concern to be sure. I highly recommend some of the knee and elbow pads made for mountain biking. Yes, it will protect those expensive knees directly and it will indirectly protect the knees because the elbow pads allow you to stick out your elbows and catch yourself (kind of like ski poles) with a much-reduced risk of injury. Again, Jeff declined but he'd have saved himself some pain if he'd worn pads; he's taken more than a couple of spills. 
7. I think this goes without saying but, just to be sure, you do NOT want to use clip-in pedals if you've had major knee surgery. These are indispensable for serious cyclists and your local shop might recommend them, but you have to twist your feet out of them, which is hard on the knee, and they just make it much more likely that you'll fall over when you're coming to a stop. 

I'm not a doctor, physical therapist or in any related field. All I can speak to is my experience helping my friend get out on a bike so you need to talk to your medical/recovery team about whether an e-bike is a safe option for you (covering my legal butt here). But Jeff's experience was remarkable and it's given him a fun way to recover his strength/flexibility and get his mobility back. He has shown amazing determination, commitment and, yes, bravery and he's been rewarded with a new way to spend some time outdoors, meet new people and rehabilitate.