Healthy Biking Hints, by Jennifer Gloystein, DPT
I am frequently asked by patients what they can do aerobically to maintain physical fitness when beginning a Postural Restoration physical therapy program, and I traditionally encourage either use of a stationary bicycle or elliptical trainer during the initial stages of a PRI program. During lunch not long ago, Ron Hruska and I began discussing recumbent bikes and their benefits with a PRI program. Since then, I have taken some time to investigate different stationary bikes, specifically upright vs. recumbent models.
Recumbent stationary bikes have become more popular recently, as they are traditionally more comfortable for the rider. They can be used with a variety of age groups (including elderly and those with balance deficits) and are favored by patients with back pain. Recumbent bikes feature a bucket type seat design (similar to a tractor seat), with an upright back support. This is compared to a smaller, slimmer, saddle-like seat of a traditional upright bicycle, which can lead to soreness in the buttock or groin region while exercising. In the world of PRI, we are concerned with keeping the pelvis neutral bilaterally, and many times on a small upright bicycle seat, the patient’s pelvis is not stable and will rock up and down throughout the work-out. This pelvic motion is not allowed with the larger, bucker-seat design of a recumbent bike.
When positioning yourself on the recumbent bike, you want to be sure your knees are at or above hip level. Most recumbent bikes will have the seat tube angle adjustment either 1) horizontally or 2) more at a 45° angle (see photos 1 & 2 for example). I would recommend looking at bikes where the seat adjustment is at more of an angle, as this will allow you to engage the gluteal musculature (hip extensor muscles) more effectively. A fully recumbent position where the seat adjustment runs horizontal may have the hips below the pedals of the bike and will not allow as much hip extensor activation secondary to the length-tension relationship of the muscle. Upright stationary bikes have seat adjustment on a vertically positioned post. This will be more inclined to position you forward on the seat and increase the likelihood for increased lumbar lordosis (deep backward curve in the low back, which is not ideal – as in photo #3). To help measure the appropriate distance from the pedals, I recommended that you maintain a slight knee bend (10-15°) when your foot is at the furthest distance from the body (bottom of the pedal stroke). At the top of the pedal stroke your knee should bend to allow 90° of hip flexion (your knee is at or slightly above hip level). If the seat is too far away from the pedals you will have to reach near the bottom of the pedal stroke and your pelvis will rock either up and down (on upright stationary bike) or forwards and backwards (recumbent stationary bike) on the seat.
The upright back support on a recumbent bike helps encourage thoracic and lumbar flexion, rather than the forwardly tipped pelvis and accompanying increased lordosis posture that you often see in upright stationary bike riders (photo #3). The bucket-type seat is also ideal to help maintain a zone of apposition (ZOA) throughout the patient’s aerobic workout session (see photo #4). Maintaining a ZOA means that you have adequate abdominal opposition to the diaphragm (the major muscle for breathing), and your anterior ribs are not elevated or flared causing you to arch/extend your low back. Most recumbent bikes have handlebars in front and at the side of the seat, which allow you to flex (forwardly bend the spine) which assist you to engage the abdominal muscles as you ride.
Many feel that a recumbent bike provides a less intense workout and does not allow you to burn as many calories; however that has not been proven when investigated. Many recumbent stationary bikes allow you to adjust the resistance to participate in a more intense workout. Another difference in the recumbent bicycle is that you cannot stand up and pedal (such as you would when you go uphill while riding a traditional bicycle). When standing up on a bike, you have the tendency to shift you center of gravity forward, push through your forefoot/toes and increase the activity of the plantarflexors, hip flexors and back extensors. However, in the PRI world, this is undesired sagittal plane strengthening, as these muscles are typically very strong and over-worked among our patient population. Meanwhile, a recumbent bike position helps to engage the hamstrings, gluteals, and abdominals which are ideal to decrease low back pain. So, in short, I would recommend use of a recumbent stationary bike for the majority of my patient population!
If you or your patient population is interested in purchasing a stationary bicycle, I would consider these differences when comparing stationary upright vs. recumbent bicycles. There is a wide range in prices for stationary bikes, ranging from approximately $200 to $2500. Many of the inexpensive bikes are perfectly adequate for aerobic exercise purpose; however they do not feature advanced options such as computer programming screen (allowing you to choose a variety of pre-programmed work-outs) or heart rate sensors. Click on the pictures below for more information on each bike.
#1 Recumbent Bike with Horizontal Seat Adjustment.
Hruska Clinic Restorative Physical Therapy Services
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