My Knee Replacement Started Hurting Again from Cycling

Quick Take: After 5,000 miles this year (and ~8,000 since July 2024), my 11-year-old knee replacement started hurting again. I was scared the implant had come loose. Bone scan says it didn’t: it’s soft tissue. I took four days off (which I hate), and I’m starting softwave therapy. I’m not quitting—just riding smarter, especially on hills.

Last updated: October 17, 2025

Older cyclist resting beside his bicycle with a hand on his knee after pain during a ride

I’ve been pain-free on this artificial knee for 10 years. They told me it would last 10–15 years. I nodded like a good patient and then did what I always do—ride my bike a lot. Since January 1st, I’ve put down 5,000+ miles. Since July of 2024, about 8,000. That’s lovely… until this year, when the knee started barking again.

When you’ve got a replacement and pain shows up out of nowhere, your brain goes to the worst corner: “It’s loose. The clock ran out.” I went for a bone scan. The result I didn’t dare hope for: the implant is fine. No loosening. The pain is soft tissue. Relief washed over me, followed by a groan because you don’t fix soft tissue with a new bolt—you fix it with rest and smarter habits. And I hate rest like I hate 30-mph headwinds.

What Actually Happened When the Pain Came Back

Pain crept in after weeks of steady miles, then flared after some climbs. I can muscle through a hill; my tissue apparently files a complaint afterwards.
I took four days off. I do not like being off the bike more than one day. Day three, I’m pacing the house like a caged dog. Day four, I’m Googling “patience for cyclists” and coming up empty.
Bone scan: not loose. The best two words I’ve heard this year.
Diagnosis: soft tissue. Translation: calm down, heal the overworked stuff, then ride smarter.

I’m Almost 70. Recovery Isn’t the Same—But I’m Still Riding.

I’ll be 70 in a month. Recovery used to be: sleep, a sandwich, and I’m good. Now it’s: sleep, a sandwich, two mobility drills, a compression session, and a reminder that I’m not 35. Some days I wonder if my “hearts” are wearing out—all four of them. But I’m not done riding. I just need to pick smarter fights.

What I’m Changing So I Can Keep Riding

Respect the hills. Sit sooner, spin lighter, and stop trying to prove I can grind a 12% grade on pride alone. Pride doesn’t lubricate tendons.
Shorten the stubborn days. If the knee whispers, I end the ride while it’s a whisper—not after it’s shouting.
Weekly mobility + glute work. Five minutes counts. Ten is better. The knee likes when the hips do their job.
Cadence > torque. I’m biasing toward spin. It’s not as heroic as mashing, but it keeps me on the bike.
Recovery is part of training. Compression, gentle massage, and a little heat before rides. Ice + elevation if it’s grumpy after.

Chiropractor, Decompression, and Now Softwave Therapy

I see a chiropractor every two weeks and do a monthly neck decompression. It keeps the system aligned well enough that the rides feel smooth. Because this pain is soft tissue, I’m starting softwave therapy on Monday. Plain English: it’s a handheld device that sends high-energy pulses into the tissue to help kick-start healing in grumpy tendons and fascia. I’m not a doctor; I’m a cyclist who wants to ride. If it helps, I’ll report back. If it doesn’t, I’ll roast it here and move on.

I had my first softwave therapy and it was quite an experience. I can already tell that it will help as I likely have tendonitis and the waves are doing some work. It will take about 3 months and 10 treatments.

I had my second treatment 3 days later and have now had 4 rides equaling 100 miles and my pain is almost gone. There is a small amount of pain when I start to push it or climb a hill but it is so much better than it was. The amazing thing is that I don't swell up after my ride now.

I have 8 more treatments to go. I understand these first 2 probably were most effective at breaking up the inflammation I was dealing with and that is why I had such immediate relief. These next 8 treatments will work on the healing. Here is what the literature says it does:

"Softwave therapy helps stem cells by stimulating dormant stem cells to migrate to injured areas and activate them, promoting natural healing and tissue regeneration. The shockwaves trigger a cascade of biological responses, including increased blood flow and the release of growth factors, which support the activation of these stem cells to repair damaged muscles, tendons, ligaments, and joints."

The Hardest Part Wasn’t the Pain. It Was the Four Days Off.

I ride for fitness, yes—but also for sanity. Take away my bike and I become… let’s call it “less charming.” Four days off felt like serving a sentence. But here’s the truth I don’t like: those four days probably saved me four weeks. Sometimes the bravest thing an older cyclist does is stop before something tears.

Gear That Helps Me Recover (No Hype, Just What I Use)

Disclosure: As an Amazon Associate I earn from qualifying purchases. If you buy through these links, I may earn a small commission at no extra cost to you.

Compression Knee Sleeve — light support on days the knee is opinionated.
Percussion Massage Gun — gentle setting on quads/IT band after hills.
Knee Ice Wrap — easy on/off while I grumble on the couch.
Electrolyte Drops — fewer cramps = less weird strain patterns.

A Simple Checklist I’m Following for the Next 4–6 Weeks

Warm-up 10 minutes easy before touching a hill.
Spin 85–95 rpm on flats; don’t grind at 60 rpm because I feel “tough.”
Cap climbs at a talkable effort for now. Ego can wait.
Mobility 5–10 minutes after rides: hips, calves, quads.
If pain > 3/10 during a ride, dial it back or end it. Tomorrow’s ride matters more.

FAQs

Can you keep cycling if your knee replacement starts hurting again?

Sometimes, yes—if the implant is fine and the pain is soft tissue. That’s my case. I’m dialing back hills, spinning more, and starting softwave therapy. Pain during a ride is my cue to back off.

What is shockwave therapy for cyclists?

It’s a clinic treatment that uses high-energy pulses on stubborn soft-tissue trouble spots (tendons/fascia). I start Monday. If it helps, I’ll say so. If it doesn’t, you’ll hear that too.

How long should I rest if knee pain flares?

I lasted four days and it helped—more than I wanted to admit. The point isn’t a magic number; it’s resting soon enough that you don’t turn a flare into an injury.

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