Dynamic Stretching Below 60 Flexion: The Science of a Cycling Alternative for Knee Arthrofibrosis

Knee arthrofibrosis can make it impossible to pedal a standard recumbent or upright stationary bike.

But when the pedal crank length is adapted to the knee’s current range of motion, cycling therapy becomes an alternative to conventional static stretching for knee arthrofibrosis rehabilitation.

This is the first of three posts (Post 2 here and Post 3 here) introducing:

Short- and variable-length pedal cranks can help patients start cycling at less than 60° flexion. They allow incremental, patient-controlled motion that supports progress in knee rehabilitation for arthrofibrosis.

Let me start with an observation from thirteen years of developing OrthoBike and seeing it applied in the clinics and in homes by thousands of patients, including people with mild to severe knee arthrofibrosis:

People who could not pedal a conventional stationary bike rehabilitated their knees
to normal flexion and extension by cycling with OrthoBike, some starting at < 60° flexion.

What this suggests is happening in the knee

What is the logical conclusion based on this experience?

Cycling with short- and variable-length pedal cranks apparently

1. lengthened the soft tissues surrounding their knees and
2. remodeled the scar tissue inside the joint.

This is the essence of arthrofibrosis knee rehabilitation, right?

What the research says

Is there any science that might explain this observation and conclusion? Yes and no.

First, yes: Short- and variable-length pedal cranks on stationary bikes have been studied and reported in the orthopedic therapy research literature since the early 1990s. The authors showed that short-crank bikes were helpful to people who could not pedal a conventional bike and for starting cycling therapy earlier in rehab. (see the white paper →: short-variable-whitepaper.pdf).

But the specially designed one-off bikes they built for their research could not be used in the home or orthopedic/sports medicine clinics. They were useful for research to prove the concept but not commercializable for everyday use in clinics and by patients at home.

Why you don’t see this in the physical therapy literature

What I’ve described here comes from real-world use and repeated observation.

Second, no: So why doesn’t rehabilitation of severe arthrofibrotic knees by cycling appear in the physical therapy and orthopedic literature? There is no question that the need for effective rehabilitation tools and processes is great.

The answer is typical of progress in science and technology: until the tool becomes available, it is impossible to ask the questions and do the research.

The classic example is the telescope. Jupiter was just a bright dot in the sky until Galileo invented the telescope and was able to see it as a planet with moons. His equipment changed everything.

Until OrthoBike was developed, no commercial bike existed that was equipped with very short and easily adjustable cranks and a step-by-step roadmap delineating rehabilitation of knee arthrofibrosis at home.

That’s the gap: it’s not the science of cycling therapy, but the lack of a tool and protocol designed for this condition in the 60-90° range of flexion.

OrthoBike proven useful in the clinics and can be used independently at home 

OrthoBike has been in clinics and homes for 13 years with its

• patented short- and variable-length pedal cranks that are easy to adjust, 
• its integrated adjustable seat, and
• the knowledge of how to apply it to incrementally increase flexion and extension.

It has been proven to be the “BETTER MOUSETRAP” that makes it possible for patients and therapists to solve arthrofibrosis problems that neither surgical intervention nor standard PT could.

What this means for knee arthrofibrosis rehab

It apparently unlocks the door to systematic cycling therapy for knees with limited range of motion. 

How? I propose that it permanently stretches the knee in small, controlled increments via dynamic stretching.

1. Pain-free
2. At home
3. Under the patient’s control
4. Incremental flexion and extension improvement (learn exactly how this improvement happens. → Pain-free, stepwise approach to regaining ROM)

OrthoBike appears to give patients and medical providers an alternative to static stretching devices and techniques for treating arthrofibrosis.

Bottom line: You have an alternative

Let me repeat it for emphasis:

⭐️ OrthoBike appears to give patients and medical providers an alternative to static stretching devices and techniques for treating this condition.⭐️

The key word I want you to take away: alternative. You have a choice.

Contact us to learn more about OrthoBike HERO or to reserve one for home use →

Click here for a technical review of the science behind OrthoBike.

Nothing in these posts is intended as medical advice or as a guarantee of any level or kind of outcome. The science of cycling in therapy and high- and low-intensity stretching is established. The physiological and psychological conditions of people vary. Consult with your medical care team.