Lindsey Vonn held up her hands with fingers extended when asked how many surgeries she’s had.

"It’s more than two hands," said Vonn, 38, the downhill skier who won an Olympic gold medal, two Olympic bronze medals and four World Cup overall championships before injuries prompted her to retire in 2019. "I just had a surgery three weeks ago.

"Yeah, my right knee is in a constant state of pain pretty much, so I’m just trying to manage that. I definitely paid a heavy price for the success I had in my skiing career. But I have no regrets."

Vonn talked about a variety of subjects during a recent Zoom interview while in Los Angeles for business purposes. The conversation included the ongoing impact of countless crashes on the ski slopes.

In a few months, Vonn said, she will undergo knee replacement surgery − which says as much about her hopes for the future as her past.

"My goal is for that to allow me to ski with my kids one day," she said.

The kids she hopes to have.

Vonn, who famously dated Tiger Woods and retired NHL defenseman P.K. Subban, has been dating tequila founder Diego Osorio since 2021. She has avoided talking publicly about the relationship, but she discussed with USA TODAY Sports her desire to be a mother.

"I’m the oldest of five kids," she said. "The youngest three were triplets, and I changed a lot of diapers and I took them to school and I made them lunches.

"I think my parents did a really great job. I’d love to add things that I’ve learned in my life kind of in that process of raising a child."

How multiple surgeries have affected Lindsey Vonn

In 2013, Vonn said, her first knee surgery left more than scars. It also coincided with the onset of insomnia.

"I really started to struggle with my sleep and it became this downward spiral where I just had a lot of anxiety and it just kept getting worse and worse," she said. "And obviously I’ve had my share of surgeries in my life. So the compounding effect of all those things really was not helpful for me and my sleep patterns."

She said the problem lingered nine more years before she consulted her doctor. According to Vonn, her doctor prescribed QUVIVIQ, a drug used to treat insomnia.

"I don’t know if I look like I’ve been sleeping better," Vonn said, with a self-deprecating smile. It "has been such a game changer for me. I’m finally getting the sleep that I so desperately needed."

Vonn said she has partnered with Idorsia, the Swiss pharmaceutical research company that makes the drug.

Challenges Lindsey Vonn faced beyond insomnia

The problems Vonn said she faced after retirement at 34 went beyond insomnia. They surfaced when she was writing a draft of her memoir, “Rise: My Story,’’ according to Vonn.

"I was still very upset and I think resentful that I had to retire because I didn’t want to," she said. "I had to because of my injuries. So I rewrote it and I think was in a much better place the second time around."

In addition to what she described as the therapeutic process of writing the book, Vonn also credits her work with Armando Gonzalez, a therapist who has worked with professional athletes and Olympians.

One approach Gonzalez uses is brainspotting, a psychotherapy that involves identifying how a patient’s body responds when they’re describing a traumatic event, according to a paper co-authored by brainspotting’s founder, David Grand.

Vonn said it’s helped her figure out “who I am and what makes me tick."

"It’s not skiing, it’s what skiing made me feel," she said. "And so kind of figuring out how I can find that same emotion in my life now, which again, I don’t have the adrenaline as much anymore obviously. But I have no shortage of adventure as I am always trying new things and I enjoy the feeling of setting my mind to something to do it. And I don’t always succeed but I think for me it’s that challenge that really excites me and makes me feel similarly to when I was racing."

Lindsey Vonn reflects on her mental health journey

Vonn said her current state of mind is a departure from what she felt during her career.

"Being on the road when I was skiing was really difficult for me," she said. "I’ve struggled with depression also since I was a teenager.

"Journaling has been something that really has helped me. Now mental health is something that everyone talks about. But when I was racing it was absolutely not and it was a sign of weakness if you were struggling with something.

"Talking to someone was not an option. So for me I just kind of internalized it, I wrote it down in my journal and that was my way of coping."

Journaling no longer was enough and so she sought therapy, Vonn said.

She credits athletes such as Michael Phelps, Kevin Love, Naomi Osaka and Simone Biles for being “really important players in that conversation’’ and also noted she addressed it publicly in 2012.

"Because it was something that I was weighing on me for a long time," he said. "I felt like I needed to share that part of myself to kind of get the weight off my back and it definitely did help me a lot in my journey."