At 39 I had a total knee replacement of my right knee. As of this blog post I am 9 weeks post op and while a long ways from 100%, I feel I can provide enough detail to be of help to someone else. Mainly I hope to help someone as young as me, someone searching for answers because to be honest, all of my research left me with articles and videos geared towards the typical audience, those in their golden years. There was no real data about when I could return to my active lifestyle or what recovery would look like in your 30’s. Hopefully, my unbiased opinion will help someone make a decision or prepare them for the decision they have already made.

First, some background. Prior to surgery I was in the gym 6 days a week; CrossFit junkie. I was squatting 275 and cleaning 155- most definitely the strongest I have ever been. My knee however; was not. Years of sports, while good for the heart, left my knee demolished. Leading up to my first doctors appointment in June of 2021 I was killing it in the gym morning sessions and then suffering after with debilitating knee pain. Ice, pain meds, sleep, repeat was the regimen. By summer, pain was present in all facets of life, just going to the grocery store left me walking stiff legged for 24 hours.

When I finally made my appointment with an ortho, I expected to be put on an exhausting course of temporary solutions. Injections, therapy, ICE, but I was very surprised. That first appointment included a set of X-rays and a doctor advising “you have an 80 year old knee and it needs replaced. All other options may work for a few weeks, but I am not even confident of that.” So, after a multitude of questions, mainly surrounding how long I would be down and what degree of activity I could return to, I scheduled a total knee replacement for July 28th.

The weeks between scheduling surgery and surgery day were spent doing countless hours of research. I wanted to know first hand what this procedure looked like, how bad it was going to hurt and the stages of healing. All of my searches for “total knee replacement young female athlete” returned void. I modified these key words every way I knew how and NADA. This is when I realized the database for information was grossly ill supplied. And I decided I would share my story. Please keep in mind this is my experience and I only hope to bring clarity to expectations after a total knee replacement for a young female athlete.

Let’s start with the pain.

I know that no matter how much I attempt to explain the amount of pain I experienced, it will NEVER make anyone FULLY understand. I know that my doctor did a very poor job conveying the amount of pain I would go through and the amount of time it would take me to recover. I know that I have had 12 surgeries, 9 orthopedic and 3 c-sections and NOTHING has come close to the pain from this. I know that everyone deals with pain differently and up until this surgery I thought I had a high tolerance. Apparently not lol.

Prior to being wheeled back for surgery I was given 3 nerve blocks. One in my back, hip and knee. Awaking up from surgery I remember screaming and convulsing in pain, I was immediately given Fentanyl and then not long after that Morphine. Once taken to my room I was started on oral pain and nerve meds. Within 3 hours of recovery, I was up walking and because of the amount of drugs I was on, this was easy. By the next morning though, the nerve blocks had worn off and the IV drugs were long gone. Walking was no longer exciting. Little did I know, this would be the start of me chasing pain for weeks. Not the ideal situation.

Surgery was on Thursday, July 28th at 7 am and by Friday, July 29th at 12 I was leaving the hospital. Despite running fevers and battling low pressure for the previous 24 hours they were booting me out the door. Now, if you’ve ever spent the night in a hospital, you understand it is not the most conducive environment to get sleep, so I will only complain briefly about being evicted.

For 5 days after surgery I was on Morphine and Oxycodone. The morphine was no longer available on day 5 as addiction starts on day 6. The oxycodone continued every 4 hours for 2.5 weeks, alternating between that, Motrin and Tylenol to get me to the next 4 hour slot. At the end of week 1, I was in so much pain that I was taken back to the doctor where they gave me a pain shot and additional meds. Eventually I weaned off of the drugs during the day and only took one at night and then eventually off all together. I was also sent home with an ice machine which is a MUST! This machine allows you to keep ice on your knee constantly, which helps reduce the swelling faster. Swelling causes more pain so of course it is important to get that gone. I used this ice machine daily for 6 weeks. Keep in mind my knee is still not the normal size and is still hot. My doctor and therapist advised this heat is caused by the extra blood the body sends to the knee to promote healing.

Therapy began 3 days after surgery. It was slow at first but actually a welcomed break in the perpetual scenery at home from my recliner. My therapy is still happening, even at 9 weeks out. I go 3 days a week for roughly 1.5 hours a day. If you have never had knee surgery, you need to know that your quad muscle shuts down completely. For some, it takes only days to awaken from the slumber but for others (me), at week 9, it is still quite groggy (like it was out too late with the gals). Frustrating to say the least. Without this muscle firing you can’t lift your leg properly and thus cannot get out of therapy. It is this issue that prevented driving for so many weeks (discuss that failed expectation below).

Sleep is difficult. For the first 3 weeks I slept in 2-3 hour increments, as the pain would allow. This was often drug induced sleep which isn’t at all restorative. I had a reclining bed which helped tremendously in getting comfortable but again, it was only for brief periods of time and then I was readjusting. Back sleeping is difficult and unfortunately is the only option at first. Around weeks 4-5 I began trying to sleep on my sides. Yikes at first! Be prepared for lots of arranging and rearranging pillows around, under and between your knee. By week 7, I was getting a full nights sleep.

Nighttime showers became my saving grace. I would sit on a bench and let the hot water pierce my skin. It was the only time for the first month, I felt true pain relief. After 5 weeks I was able to start taking baths and OMG, yes. I would soak every night with epsom and still do at 9 weeks out.

The incision is big. It is bloody, I expected that. What I did not expect was the bruising. I had severe bruising on both sides of my ankle and foot. Apparently this was due to them manipulating the knee during surgery with such force it caused contusions. Also, a tourniquet is applied on the upper thigh during surgery to prevent blood loss. This caused extreme, deep, bruising in the entire quad. Bruising in this portion of the leg made laying on the side to sleep extremely difficult. While the ankle bruising dissipated 2 weeks after surgery, the thigh remains tender even today. I had glue steri-strips on the incision that I was able to remove after 4.5 weeks. These strips did cause scars that you can see in my post op pictures. 6 weeks into healing, I had extreme nerve pain on the inside of my knee. This pain was so severe, I couldn’t even tolerate a blanket touching it. During the day I ran a paint brush over the skin in an attempt to desensitize it. This pain stayed from weeks 6-7. At night I found wearing my compression sleeve (more on that below) especially at night helped tremendously.

Crying became a common occurrence during healing. I cried. A lot. I cried from the pain. I cried from the frustration. Sometimes I cried and didn’t even know why. Most of my showers mentioned above involved me crying and sometimes wailing from the pain. Eventually the crying stopped, but be prepared. I was also very short nerved with my family. Most nights I went to my room early because I didn’t want to take my frustration out on them. This had a lot to do with not being able to do things for myself and not liking to ask for help. Get humble, really quick.

The days out of surgery I began losing my appetite. Most likely due to the drugs. I jokingly advised I was on the “Crumbl Cookie Diet” because for several weeks, this is all I ate. I absolutely could not fathom eating meat. Other than cookies, I lived on toast, crackers, ice cream and Coke Zero. 7 weeks after surgery I finally stepped on a scale and realized I had lost 15 lbs, or 7% of my body weight. I can say that mentally it was a battle watching my muscle dwindle away. Being a daily CrossFit athlete I had significant amount of muscle prior to surgery and it was shocking how quickly I lost it. Even today my right leg (calve, quad, hamstring and butt) is 35-40% smaller than my left. My entire body tires quickly on walks, chores, biking.

Mobility happens quickly but not easily. Like I said earlier, after 3 hours I was up walking. By 6 hours after surgery I was taking laps around the hospital floor. For the first 5 weeks I used a walker. At week 5 and 1 day I was able to move to a cane (leopard btw). By week 6 1/2 I was walking without all devices entirely. I was not aware that the compression sleeve provided in the hospital is something that stays with you for 6 weeks. My daughter generously fancied mine up once I realized this fact.

Looking back on this entire process, I realize that the biggest issue for me has been the failed pre-surgery expectations. The pain, healing process and limitations explained before surgery were nowhere close to what I actually experienced. The lack of being mentally prepared made this entire experience difficult. Being told I would be driving after 2 weeks, when reality was almost 6, made life with kids and schedules stressful. Being told “you’re young, you’ll heal quickly” and at 9 weeks I get tired after walking a mile, causes extreme feelings of failure/inadequacy. Full intentions were to be back in the gym after 2 weeks, at least riding a bike, reality is therapy wears me out, even today. The most honest thing I have told in the past 9 weeks was from my therapist 5 days after surgery, “please consider that what you have been through is same as a leg amputation.” Bingo. Had I been told this before surgery, maybe I would’ve been better mentally prepared.

Here is what reality looks like 9 weeks post op. I can barely walk today due to being sore from normal daily house duties. 2 days ago I was bending my knee to 120 degrees and today I am at 109… just because. Walking a mile causes every muscle in your body to be sore. My back, my shoulders, my hips, are all working overtime helping my body balance. Reality is also that my knee doesn’t creek anymore and while I have pain from surgery, I do not have pain from bone rubbing bone. I try to remember daily the amount of pain I was in before surgery, so that I don’t get discouraged. I repeat often, this is a marathon, not a sprint, 2 steps forward, 1 step back is still progress.