Knee Replacement For Athletes (What To Expect)

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I am an athlete, albeit a sixty-eight-year-old one.  I have always considered myself an athlete and I plan to be a competitor until the day I die.

I love physical activity, testing my body and breaking a good sweat. As a youngster, I thrived on competition.

I still enjoy competing against others of my own ability but I no longer enjoy the cutthroat competition. I am more careful when pushing my body to the limits so that I avoid injury.

Healing seems to take longer as I age.

I enjoyed playing basketball twice a week, softball on a regular basis and running a mile 3 times a week until I reached my 50’s. As time went by I began favoring my leg more and more and eventually developed an obvious limp.

Pain as the result of old college athletic injuries to my knee finally became so unmanageable that I had to adjust the activities that I could enjoy and participate in with the least amount of pain. I quit running, playing basketball and softball and substituted non-competitive activities such as swimming, hiking and bicycling.

In my mid-sixties I discovered pickleball.

For the next few years, I put off knee replacement, figuring that I had to live with the pain and minimize it by adjusting my physical activity.

Tough Decision For Athletes

I tried to put off knee replacement for as long as possible. I figured once they cut off parts of my bone and inserted an artificial joint that my playing days would be over.

Little did I know then, that this was not true.

When you are an athlete, you expect to play with some degree of pain. As time went on for me the pain gradually increased and I just learned to live with it. I never thought the pain would ever go away completely.

I figured that as long as I could swim, bike, golf and play pickleball (limping during play) at some level it was better than having a knee replacement.

It was a tough decision for me until the pain became so severe that I finally gave up and decided to have TKR. I was surprised to learn from my surgeon that I would be able to continue with all the activities that I presently participate in without pain.

He even said I would be able to jog and play basketball even though he did not recommend either. In hindsight, I wish that I had had TKR years earlier.

Knee Replacement As An Athlete – Weighing The Pros and Cons

If you are a young athlete in your 30’s or 40’s I hope that TKR isn’t something you need to consider. Surgeons can repair knees with outstanding results and can put NFL players back into action after severe knee injuries.

However, I have never heard of a professional player returning to any major sport after a complete knee replacement. Hopefully, if you are young and experiencing knee pain in your 30’s and 40’s like I was, you can play through the pain and put off TKR as long as possible.

I know in my case and at my age, I would not resume running or playing basketball. I am content to be able to participate in the more senior activities that I choose now.

Even though I have a “new” knee I have a 68-year-old body and it no longer functions the way it did when I was 30 or 40.

If you are a younger patient, it’s important to know that you likely won’t be able to participate at a high level of sport. You might lose a step or two, but if TKR goes well, your knee will be pain-free.

After Knee Surgery Can You Still Be An Athlete

Remember this saying: “Once an athlete, always an athlete”? Expect to modify your choice of sports and activities as well as modify your intensity of play.

Believe it or not, you can enjoy sports and activities that allow you to compete at a high level against good competition.

As far as I know, athletes don’t get “special” knee replacements. But I do think that athletes understand the benefits of hard work and that they will have a distinct advantage when rehabbing their knee.

An athlete will remember all those training sessions and time spent in the weight room that paid dividends when they were younger.

I have a friend my age that has had two knee replacements and he still plays basketball 2 times a week.  Another acquaintance who has had two TKR surgeries plays 100 games a year of softball on a 65-years and older team.

I prefer to continue to swim, bike, and hike, play golf and pickleball (read more about my swim workout for knee replacement). I prefer to watch the younger generation compete with more strenuous competition like running, football, basketball, soccer, and baseball.

In the Gym

Don’t expect to be a powerlifter, don’t expect to record “personal bests”, but do expect to workout with 100% effort.

Before TKR surgery I was unable to use most of the leg machines in my gym. I used mostly upper body and ab machines.

If I used the leg press, leg lift or leg pull machine my knee would crack and crunch. I was limited to just using the stationary bike (read my article on 15 exercises to prepare for TKR)

Now, post TKR I use all of the leg machines without any pain or crunching and I have been able to build up the muscles around my knee.

I’ve experienced gains in leg strength but I also pay close attention to the joint to make sure I don’t overdo it.

Water Sports and Athletes

Will you be able to participate in water sports? You bet!

In fact, water sports might be your best option after TKR surgery. If you’re a swimmer you should be able to use all the strokes (back, butterfly, freestyle, and breaststroke).

Water therapy is great for the leg because very little pressure is placed on the joint. It helps with strength and stretching.

Athletes can expect to swim laps, snorkel, scuba dive, play water polo, water aerobics, and dive. Other sports like wakeboarding and water skiing put much more pressure on the legs and should be discussed with your doctor.

After TKR I’m able to kick with or without a kickboard pain-free and, like the leg machines in the gym, I can feel the burn in my muscles around the knee.

Before TKR I was able to paddleboard in the bay near my house but I could not stand for long periods of time. Now I am more comfortable standing longer and I am able to spend more time paddle boarding.

The same is true for snorkeling and bogey boarding. Before TKR I was unable to use fins on my right knee because of the pain and crunching. Now I snorkel and swim using fins with no problem.

I have a friend who still surfs after having TKR on both knees (He is 80 years old). However, I don’t think I could pop up to a standing position anymore so surfing is no longer on my list of activities.

Getting up on the paddleboard takes some work but I can do that slowly. 

Will A Knee Replacement Wear Out Faster As An Athlete

Knee replacements don’t last forever even though I hope mine lasts my lifetime. Like anything the more stress you put on the knee the sooner it will wear out.

The lifetime of your TKR will depend on a number of things:

  • Quality of the knee replacement
  • Success of the initial surgery
  • Pain you experience after surgery
  • Sports you participate in

As you can imagine, running three times a week will wear out a knee replacement much faster than swimming three times a week.

My doctor told me I could jog and play basketball if I wanted to but that he would not recommend either. Pre-surgery my doctor said that there were no definitive studies yet but that my knee replacement should last at least 20 years.


I put off TKR surgery for several years because I was afraid of the unknown. Yes I have had to modify the sports and activities that I engage in now.

I also have to modify the intensity level I play at to avoid injury to all parts of my body. Post TKR I can play a competitive game of pickleball without pain and I can definitely move quicker and play better than I did before surgery.

If you are an athlete and are considering TKR, know that you can still be an athlete post TKR surgery. In my case and probably in your case you will be a better athlete than you have been before TKR.

You can always play with some pain but when the pain becomes severe it is time to seriously consider TKR. The rehab process is both tough and important.

If you have been an athlete and remember the benefits of hard work on the practice field and in the weight room you will have an advantage for a successful recovery and rehabilitation from total knee replacement.