Riding Toward Recovery: Rafael Returns to Cycling After Two Knee Replacements

Rafael Elvira’s journey with Brooks Rehabilitation began in 2022 following his first knee replacement. Just days after the procedure, Rafael arrived for his first physical therapy appointment at the Brooks Rehabilitation Outpatient Clinic – Riverside Healthy Living Center. There, he met Brendan Bak, PT, DPT.

“The first time I met Brendan, he was doing his assessment, and out of nowhere I started crying,” Rafael recalled. “And I never cry.”

Brendan reassured Rafael that what he was experiencing was normal. Recovering after surgery would take time, but was possible. If Rafael committed to therapy and continued putting in the work at home, he could return to the activities he enjoyed with less pain.

That first conversation laid the foundation for a relationship that would continue for years.

“When I first met Rafael, he was overwhelmed by everything that came with his surgery and recovery,” Brendan said. “My goal was to meet him where he was, reassure him that what he was feeling was normal and help make the recovery process feel manageable. We focused on taking things one step at a time, setting realistic short- and long-term goals and building his confidence as he progressed.”

Bonding over a shared interest

During Rafael’s twice-weekly sessions, he and Brendan’s conversations extended to topics beyond therapy. Brendan asked what he was most looking forward to doing again.

The answer was cycling.

Rafael rode BMX bikes as a child. During the COVID-19 pandemic, he and his wife purchased bicycles, giving him an opportunity to rediscover something he enjoyed. But his worsening knee pain made riding increasingly difficult.

As an avid cycler himself, Brendan and Rafael began exchanging stories. “We had this bond. I didn’t feel like I was talking to my therapist, I felt like I was talking to my friend,” Rafael said.

Another setback

Rafael completed his initial rehabilitation, but his time with Brendan wasn’t over.

In 2023, Rafael underwent a left shoulder replacement due to arthritis. About 10 months after completing his first round of rehabilitation, he returned to Brooks—and specifically requested Brendan as his physical therapist.

“I knew that if I had to go through this again, I needed Brendan by my side,” Rafael said.

For Rafael, Brendan had found the right balance between challenging him and giving him ownership of his recovery.

“He’s pushing your limits in what you’re supposed to be doing, but you feel like you’re doing this on your own,” Rafael said. “That’s how I felt. Like he was inside my head encouraging me.”

For another three months, the two worked together as Rafael recovered. By then, Brendan already knew the type of patient Rafael was—determined, motivated and ready to put in the work.

“Rafael is very intrinsically motivated, so it took little motivation from me to help him on his road to recovery after his shoulder replacement,” Brendan said.

Approaching recovery differently

In 2025, Rafael learned he would need another knee replacement. This time, however, he was prepared.

Rather than waiting until after surgery to begin thinking about rehabilitation, Rafael reached out to Brendan. Together, they discussed exercises he could perform before surgery to prepare his body for what was ahead. He was able to approach this next recovery with a new level of confidence and determination.

Cycling once again became an important part of his life. Rafael returned to his bike, gradually increased his mileage and even began participating in cycling events.

After years of bonding over their shared interest in cycling, Rafael invited Brendan to join him for a ride. Brendan was more than happy to say yes.

Their first ride marked a full-circle moment. What had once been a goal discussed during physical therapy was now something they could enjoy side by side.

Since that first ride, Rafael and Brendan have cycled together more than a dozen times.

“Seeing Rafael out cycling, you would never know he had two knee replacements,” Brendan said. “He continues to impress me with his strength, speed and endurance. Watching him push himself and seeing how far he has come since we first started working together is incredibly gratifying. It’s a reminder of how rewarding it is to be a physical therapist.”

More than getting back to where he started

For Rafael, rehabilitation became about more than recovering from surgery. It was about returning to the activities he loved, building confidence and creating a life no longer defined by pain or physical limitations.

“There should be no reason for you to do half of life and be in pain,” Rafael said.

Today, Rafael continues to push himself, adding more miles and setting new goals along the way. And the physical therapist who once helped him take those first steps toward recovery is still there beside him.