The hip is a strong and complex joint, yet not immune to injury or dysfunction. Arthroscopic hip surgery, also known as a hip scope, is used to diagnose or treat non-arthritic issues at this joint.
Returning to cycling after a hip scope can easily be beneficial and successful. Though just because it is a minimally invasive procedure doesn’t mean that rehabilitation isn’t necessary!
Let this guide inform your return to cycling after an arthroscopic hip surgery. Read below to learn more about hip scopes and general rehab plans.
Types of Arhroscopic Hip Surgeries
A hip scope is a minimally invasive procedure with a quick recovery period and a great success rate. It’s used to treat and diagnose various issues, such as labral tears, impingement, and removal of loose or damaged cartilage.
Typically an outpatient procedure, this surgery takes around two hours to complete, and rehabilitation will take several months. Patients are usually able to walk with crutches and partial weight-bearing immediately following the surgery. Physical therapy starts soon after and will continue until proper recovery is achieved.
Recovery Timeline
Most recreational and competitive cyclists can return to sport in about 4.5 months after hip arthroscopy. Following the guidance of a Physical Therapist can ensure your rehabilitation is successful!
Post Operative Protective Phase
The initial stages of rehab will include several weeks of crutch use and weight-bearing restrictions. The patient is advised to avoid pivoting on their leg, lifting their leg independently, and crossing the legs.
From the very first day post-op, you may be riding the stationary bicycle! This cyclic motion will help lubricate the joint and gently stretch soft tissues. The first few weeks are all about letting the hip heal and recovery after surgery with easy exercises and rest.
Activity Progression
After the protective phase of rehabilitation, your physical therapist will add in more strengthening exercises, and you may begin to advance your time on the stationary bike.
The goal for the first 2 months of rehab is to regain independence with daily activities. You will be able to walk further, carry weights, and perform activities as usual throughout your day.
Return to sport
Here comes the fun part: Returning to cycling! The focus of the final phase of recovery will be building up strength and endurance specific to your sport.
This phase takes place 3-4 months after surgery. See the tips below to make sure you’re ready to return to outdoor cycling.
A Few Helpful Tips
You are ready to return to cycling if:
- You have rebuilt adequate hip strength in all planes of motion
- You can perform all of your exercises without pain
- You can cycle for at least 30 minutes on a stationary bike without pain
You are NOT ready to return to cycling if:
- Your therapist observes you making compensatory motions during exercise. In other words: you can’t maintain proper form.
- You feel pain while cycling.
- You feel pinching in the hip when sitting on the bike
How to Return to Cycling After Hip Surgery
Discuss your desire to return to cycling with your provider. Besides the standard post-op rehab for a hip scope, you can add in cycling-specific exercises to better prepare you for the bike.
A Gradual Plan
Week 6 After Surgery:
- Progress to the elliptical
- Continue stationary bike – practice pedaling in smooth and even circles
- Work core stabilization exercises
- Single-leg balance
Weeks 8-10:
- Add in single-leg strengthening (single leg press, step-ups, squat progression)
- Continue to work cardiovascular fitness on a stationary bike, elliptical, or aquatics.
Week 10:
- Begin outdoor cycling in a more upright position (avoiding drop and aero bars)
- Return to clip-in pedals, if desired
- Continue to progress biking time to build endurance
- Work sit to stand drills while cycling (ensure this is pain-free)
- Add agility drills to work core strengthening and single-leg stability further
- Add resistance to single-leg activities (deadlifts, lunges, etc.)
Week 12:
- Progress to drop-bar positioning on the bike, if desired
- Work single-leg pedal drills
- Begin to incorporate climbs and descents
Remember to work with your physical therapist to design the best rehab program for you. Take time after your exercise to include any stretching or cool-down methods you’ve been advised to conduct.
If you feel pain, it’s time to backspin and take a pause. Discomfort is one thing, but the pain is a signal that you’re likely setting yourself up for further injury if you push further.
FAQ About Riding a Bike After Hip a Scope
When can I Start Riding a Stationary Bike?
The good news about recovering from a hip scope is that you often get to start on a stationary bike sometime between the first and third week after surgery.
The stationary bike helps improve the range of motion and reduce stiffness in the hip joint. You’ll start with no resistance and work to restore a normal pedal motion. In this surgical protocol, patients are allowed to start on the stationary bike after their 3rd week.
Do I Need to Adjust my Bike Seat After Hip Surgery?
You likely won’t need to adjust your bike seat after hip surgery but we do recommend making sure it is properly fitted to you. If you haven’t been to a bike shop or had a professional bike fit session, it’s a good idea to avoid any issues.
In some instances, patients have had to raise their seat very slightly to make it more comfortable on the front of the hip.
When Can I Start Mountain Biking After Hip Scope Surgery?
Mountain biking is actually a much easier position on the hip than road biking. The main concern with mountain biking is getting on and off or having to do a quick release from the pedals to catch yourself.
You can begin easy to moderate mountain biking 3-4 months after surgery as long as you’ve progressed through your strengthening exercises and return to sport program.
Can I Ride in the Arrow Position or on the Downbars?
It’s not uncommon for people to still feel uncomfortable in the arrow position. This position puts the hip and pelvis in the tightest position it can be in. You can start riding on the down bars at around 3-months after surgery and gradually increase your time and resistance in that position.
Mild soreness does not mean you are doing any damage but avoid any sharp pains or pinching sensations, especially if it occurs on each pedal stroke.
How Long Should I Warm-Up Before Cycling?
The best practices include a 10-minute warm-up before performing any intense exercise. This helps reduce re-injury rates. A great warm-up should include hip flexor stretching, light hip activation and strengthening exercises, and dynamic movements to prepare the body and hip tissues to work.
When Can I Elliptical After Hip Arthroscopy?
You can start to elliptical 6 weeks after surgery. The elliptical is a great way to gradually return to normal walking mechanics and practice getting equal weight-bearing in the surgical and non-surgical legs. Start off with no resistance and if you can elliptical for 20 minutes pain-free you can gradually increase the resistance each week.
Should I Use Flat or Clipless Pedals After Hip Surgery?
We recommend starting with flat pedals as your return to cycling, especially if the hip that was operated on is the side that you typically clip out of first. The hip may not like the rotational movement to clip out each time. Within a few weeks of cycling, you can return back to clipless pedals.
It is best to practice clipping in and out multiple times before going on a ride to make sure that the hip can tolerate it.
Conclusion
Cycling is an excellent alternative to weight-bearing sports. You’ll likely be able to return to recreational or competitive cycling after your hip scope. Follow the advice of your Physical Therapist, and you’ll be spinning your way to cycle-bliss in no time!
Works Referenced:
Edelstein J, Ranawat A, Enseki KR, Yun RJ, Draovitch P. Post-operative guidelines following hip arthroscopy. Current Review of Musculoskeletal Medicine. 2012; 5(1): 15-23.
Enseki K, Harris-Hayes M, White DM, Cibulka MT, Woehrle J, Fagerson TL, Clohisy JC. Clinical practice guidelines: nonarthritic hip joint pain. Journal of Orthopaedic & Sports Physical Therapy. 2014.
Frank RM. Ukwuani G, Clapp I, Chahla J, No SJ. High rate of return to cycling after hip arthroscopy for femoroacetabular impingement syndrome. Sports Health. 2017.; 10(3): 259-265.
Author Information: Lisa Woolridge, DPT
After graduating from the University of Texas Health Science Center at San Antonio, Lisa served as a physical therapist in the Army. She treated orthopedic injuries in soldiers and family members, ran fitness testing clinics, and conducted wellness classes. Lisa left the military when she became a mother and remains involved in the medical field through freelance science writing and consulting.
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Disclaimer: The information provided in this post is for educational purposes only. This is not a substitute for a medical appointment. Please refer to your physician before starting any exercise program.
