Rehab question--pedal type?

[skinimini]

I'm recovering (and healing quite nicely) from 3 lower leg fractures and a severe high ankle sprain. In a little less than two weeks, I will finally be free from my aircast.

My orthopedist and physical therapist say, at that point, I can start cycling again on the trainer. But, I'm unsure about the pedal type. My PT says to talk with a fitter, the fitter I've used in the past says pedal type needs to be recommended by the PT or orthopedist. But neither are cyclists. The PT seems to think the Look pedals are OK. However, a student PT (who is a cyclist) seems to think I should start with flat pedals. I'm trying to plan ahead to get the LBS to change out pedals if necessary. I also have SPD pedals that I could use. What about toe clips with athletic shoes?

Any thoughts about my dilemma? Has anyone ever been in this situation? I think I seem to be obsessing about this.

[DebW]

Would the force or motion of clipping in or out cause stress on your leg? That might be the primary consideration as you first get back on the bike. I'd assume any pedal would be fine for pedaling as long as your foot is in it's proper neutral position.

[Andrea]

When I had a severely sprained ankle, I used speedplay pedals, which allowed me to be basically pain-free. Though, I did have to ride with my right foot clipped in the entire time and take my foot out of my shoe with the shoe still clipped on when I got home.
I'm wondering the same thing as Deb- my problem was that my foot needed to float freely, and I could not torque it to unclip, so the speedplay/never unclip strategy worked for me.

[KnottedYet]

If you were my patient (and you're not, so take this with a grain of salt) I'd be telling you to use BMX pedals.

Huge contact area, very non-slip, nothing to fight.

Don't forget you've also got some muscle inhibition reflex arcs to counteract, along with the bony changes. I would stay away from any sort of retention system until all the muscles are back up to speed and the inhibition is completely gone. (your PT can tell you when that is) You've got a lot of muscles to wake up. They've been on vacation in that cast!

My concern with plain platform pedals is that the cheaper plastic ones can be slippery, and while you are working on regaining stabilization and corrective responses (the small muscle contractions and larger co-contractions that keep everything lined up) you do not want your feet slipping out from under you. If your LBS has some good grippy platforms of any type, that's what I'd be going for on the trainer. BMX pedals can run around $50, grippy platforms around $15.

[skinimini]

Thanks guys for your suggestions. This helps tremendously. I'm a little concerned about the torque, but that's just probably fear based as it was incredible torque from the look pedals that got me in this mess in the first place. However, my PT places lots of torque on my ankle right now in therapy, so maybe I shouldn't worry so much.

Knotted, so with BMX pedals you don't clip in? Do you use athletic shoes, or perhaps some sort of a stiffer shoe?

[Pedal Wench]

I used the plain $15 platform pedals that came with my first road bike for when I do the Breast Cancer walks, since there's so much starting/stopping and general slow-speed riding. I wear Keen sneakers or hiking boots (for rainy days) on the walk and the metal platforms have some ridges that keep my feet from slipping.

[skinimini]

thanks guys for all your suggestions! I'm now a week and a half post air cast and I'm doing great. I still have some stiffness and swelling, but that's normal. My orthopod gave me a smallish, ankle support sleeve, but it was so uncomfortable, my PT thought it OK to do without.

I bought the BMX pedals, but haven't tried them yet (out of town all week). I audibly gasped when I saw them, they are sooo huge! I have small feet, and couldn't imagine how they would work. But the fitter concurred with your suggestions, so voila! Once in PT, I biked a few minutes on a stationary recumbent (flat pedals) and another time on a spinning bike (toe clips) at my gym. No problems whatsoever, but I've only done a few minutes each time. I hope to get the trainer set up this afternoon, and start getting some real time back on the bike. Perhaps in another month, I'll be ready to do some short, flat rides outside and build from there. I think more than anything, I need to build my confidence. I'm really OK with baby steps. I wanna be ready when Meidei comes to Atlanta.

[Kathi]

When I was recovering from acl surgery my ortho, also a cyclist, wanted me to use flat pedals without grippiness. He said he wanted me to get my prioproception back before I went to clipless. Even regular flat pedals were too grippy and did not allow my foot to sit comfortably on the pedal. I use speedplay X pedals and they have a flat pedal that attaches over the pedal. They allowed my foot to align properly on the pedal. I think spd's also have a similiar type pedal. I did have the slippery problem, especially when my shoes got wet and my foot would fly off the pedal when I hit a bump.

I tried my regular tie shoes but they weren't supportive like cycling shoes and several times the laces came loose and almost got caught in the chain ring. I found a cheap pair of Specialized mtn bike shoes that I could use without cleats.

Hope this helps, I've not heard of any other ortho who was as picky as mine was.

[skinimini]

prioproception

It's amazing the words you learn while injured. I'm working on that word (above). I never thought one would have to balance with eyes closed.

[OakLeaf]

I never thought one would have to balance with eyes closed.

I make my classes do it at least every couple of weeks! (And we do eyes-open balancing just about every class, usually combined with strength moves.) It's so important as we get older.

[shootingstar]

There are some simple standing exercises for balancing on l ft. for a min. or so with eyes closed that would benefit you skinmini, when your leg is better. Some come from the yoga world.

Useful to ask physiotherapist about this since you have access to the person's expertise now.

I find it helpful and it looks deceptively simple. But requires calm focus, etc.