I get asked a lot from patients whether or not they should be using the bike at the gym, and specifically, whether they should use the recumbent bike, which is the bike that has the back rest and you're kind of in a long sitting position versus the upright bike. The more stationary bikes you see in the gym where you're more upright, no back support. Things that almost mimic the outside.
And it's a real simple answer, the upright bike is better. The recumbent bike is often recommended, really just for your older population or your patients who might have a balance disorder, so they're worried about falling off the bike. They're worried about being so high up that they get a little scared and they need that back support, maybe and the hand support to stay on and not be too concerned. The upright bike on the other hand, really for a number of reasons is the way to go.
In the presence of knee pain, it's going to allow the knee to bend and extend more consistently at a better angle, which is great for nourishment for the knee. And it's also going to allow the quads to work more optimally, as well as the hamstrings. And lastly, you're also going to be using your core, so as you're doing your rehab at the gym or rehab in a physical therapy clinic, just strengthening your core as a secondary assignment is great for later on, when you're doing functional activities like squats and lunges.
The key thing with the upright bike though, is the setup. Too many people are setting up the bike where it's setup a little too low. It's not allowing the knee to bend enough and extend enough. Plus, they're not getting the proper nourishment inside the knee or the proper workout for your quad and hamstrings.
The general rule is you want to have your knee in a down position or when your foot's in a down position to be at about 25 degrees of flexion, which is not a lot. It's almost full extension. Every repetition they're getting to that spot. It's much better for the knee, so in general it's the upright exercise bike, way before the recumbent.