They have to yank on the muscle and pull it out of the way a lot more than just cutting it. She has a high pain tolerance and that surgery was the most I have ever seen her react to pain. She was a trooper through the shoulder replacement and her first knee replacement. But there were a lot of tears on the micro knee surgery. I felt super bad for her. There was nothing I could do to help her except keep bringing ice to reduce the swelling and numb it down.