Really Struggling with Knee Pain

Hi everyone - I am really struggling with some knee pain that is being resistant to my TMS/Sarno treatment so far.

For some context, I've eradicated chronic pain around other areas before (post-hip-surgery, then later related to overuse "injuries" in my foot & shin) so I'm familiar with the program but this knee pain is being particularly stubborn.

I'm a very active endurance athlete (trail running and cycling) and started having issues with this knee going back to 2017. It's diagnosed as "runner's knee" or patellofemoral pain syndrome (PFPS) but after years of trying to manage it conservatively (PT & stretching and NSAIDs) I relented and had some new xrays and an MRI performed. The Xray revealed some slight mal-tracking of the patella (a common blame for runner's knee) and the MRI showed some arthritis on the back of the patella/kneecap.

So I double-downed on my conservative treatment of PT and actually made a little progress with the pain backing off, but I also cut down on my running/cycling tremendously during this time as well.

It wasn't until a few weeks ago that it occurred to me it could be TMS. I know this sounds like I was blind given my prior experience with TMS but I actually had given some thought to it being TMS-derived previously but discounted it for a number of reasons. Now, some new evidence had me rethinking it (basically the big clue was when the pain dramatically shifted over to my "good" knee).

When I started applying what has worked for me (revisiting Sarno's 12 reminders, listening to TMS podcasts, visiting this site - all that + fully believing/accepting there is nothing structurally wrong), the pain backed off quite a bit. In fact, over last weekend I was able to do some things (certain movements where the knee is loaded) without any pain at all! I was stoked and pretty excited that I might put this thing behind me.

However, the last couple of days it has come back with a vengeance and I am finding it difficult to allay the fears that I overdid it and caused some damage that brought all the pain back again. It's extremely hard getting the imagery out of my head of the knee being damaged, which I know is a key component of TMS treatment (not obsessing on that imagery).

Anyway, this site has been so helpful in the past and I'm hoping if nothing else that writing all this out will help me get back on track again with recovery from this.

Here's a link I found last week where someone else solved their similar knee issues with Sarno work, reading this really helped me and I'm hoping to go down the same path as the author:

https://inscape489664645.wordpress.com/2018/07/24/my-knee-pain-success-story-a-surprising-road-from-despair-to-joy/ (My Knee Pain Success Story: A Surprising Road from Despair to Joy)

 

My Knee was one of the first TMS things that 'got me', meaning I first treated it as 'real' and only after that did it dawn on me that It was TMS.
I was in the doctors office when the cognitive dissonance of structural mythology gave me the 'aha' moment.

But it wasn't just ignoring and saying the reminders. I had to look at a very painful situation in my marriage (which ended up failing) I was happily whistling in the dark about the shallowness of it and the kabuki theater it had become.

when I looked at that , saw why I needed the distraction, the pain left immediately. It tried to come back some months down the road during my divorce, but I just kept writing, reading and fighting it... The reminders and challenging it are a part of TMS therapy, but they are still secondary to where the problem really is...in my life and in my mind.

 

Wow, how true is that. With "runner's knee" (or PFPS or chondromalacia etc) there is no real consensus on what should be done to fix the issue but lots of speculation (one brutally honest PT basically laughed and told me I was F'ed) and theories. That kind of "structural mythology" should be a red flag right there that it's TMS but yet I was still blind to it and find myself doing all kinds of weird stretches and odd strengthening exercises before I too had my a-ha moment.

Thanks for the reminder, there is no doubt you are total MVP around this site and I appreciate your input on everyone's behalf.

I have some work to do I guess. Because it's not an easy fix (recognizing it's TMS sometimes resolves it for me but this one is stubborn) I am going to try to get to the bottom of it. We humans are lazy though, and we particularly hate re-doing work that we've already one before (i.e. TMS/sarno methodology), or at least *I* do but it seems to be necessary again.

 

One thing I've noticed when I work through TMS "issues" (i.e. do the mining to try to find those emotional triggers and their roots), I feel exhausted afterwards. It's an odd sensation to not do anything I would consider physically taxing but to feel that crushing fatigue nonetheless.

 

I think the exhaustion is a form of resistance. You have mined and are getting to close for comfort...if you are too tired to do more, you stop, right?

 

Interesting, so basically the symptom imperative. "Hey, I'm so tired let me focus on that a bit."

 

Yeah, think its like an even more “immediate” thing. For example, now when I try and journal My mind quickly jumps to future tasks or the feeling I must attend to something else immediately or that my mind totally spaces meditating... I think its so subtle yet ‘loud’ as a distraction. Constantly thinking psychologically helps catch these things. I try and look at everything from different perspectives to suss stuff like this out. TMS is a sneak.

 

Great insight, I've noticed the same when I try to focus on these things - it feels like there is a mental block preventing it from happening. For example, I have a mantra I use when I experience insomnia due to overly ruminating over things. It's a very simple phrase yet my mind often blocks me from remembering the phrase in that moment and I have to really concentrate to remember it.

 

General update to the thread topic: Last night waking up from sleeping (a classic time for TMS symptoms to pop up for me), my right hip spasmed and ached for the first time in ages. This is the "original" TMS site for me and the hip that had surgery performed on it in 2018 and the first chronic pain area I fixed using TMS techniques.

I take this as a sign I have things "on the run" for it to resort to such a played-out cry for attention such as this.

 

I'm going to try to post here as I make new discoveries about this current issue. The great irony is that these are all "discoveries" that I've made with previous TMS issues, I'm just too darn dumb to remember these things despite reading and re-reading Sarno/TMS stuff and having these "a ha" moments repeatedly.

Conditioned responses!

One of the frustrating thing about this knee issue is that it frequently hurts "under load" a term used by doctors/PTs to indicate when force is applied to the knee joint. For example, when bending, squatting, or ascending/descending stairs. Only rarely are my knees ever achey when I'm just sitting (which is the way it was with previous TMS areas). Instead, my knees hurt when I'm using them, that has to be structural right!? At least that's how it made sense in my mind.

But in re-reading some Sarno stuff (in this case an article about how he helped a reporter), I came across the part about "conditioned responses" where we have come to expect pains in some instances and voila, we feel pain in those instances.

I'm constantly "testing out" my knee with flexion or bending to see if I get the sensation - sometimes, especially lately, I am delighted when there is no sensation at all - but usually I am downtrodden when I feel that familiar ache at a certain flexion point. Thus, reflexively I feel fear and a strong desire to do my old PT exercises.

Hopefully recognizing this (again for the umpteenth time), I can move past this aspect.

 

One thing that I have learned about this insidious knee pain is related to how misguided (maybe even deluded) I have been previously in how I see this "injury." My perspective on the pain was driven previously by structural means. "I have a misaligned patella and therefore it gets aggravated by the activities I regularly do (& love). Because I can't resist doing these activities, this is what I get. Pain."

Usually, I get pain at the start of the activity (be it running or cycling) and then it "mellows out" and goes away for the rest of the activity, sometimes even hours later.

My previous perspective on the cause of this is that I got "warmed up" and as the tendons/ligaments got cold/stiff the pain would return. Or I would "pay" for my exercise transgression later or the next day with soreness/pain.

Now, I'm beginning to see that these are conditioned responses. The fact the pain goes away during the activity is the same reason all TMS pain goes away with activity, it's "given up." The reason it comes back later is that I am conditioned to fully believe it will come back later.

 

I'm doing the Educational Program here at the site, and thought I might use this thread to comment and even to add the required exercises. Today's item (I'm a little bit behind) is to write about the "most disheartening thing a Doctor has told you about your condition." I'll flex a little on that one and extend it to a PT in lieu of a Dr. Here goes:

When I was going through Physical Therapy to recover from the Hip Labral Tear repear arthroscopic surgery in 2018, I was doing a ton of leg strengthening exercises under the supervision of a dedicated PT. This guy was really great through that whole process, providing easily as much mental support as physical. I came to really look forward to our twice a week sessions for that reason. I got to the point where I was doing some single leg strength work, specifically some single-leg bulgarian squats. BAM, knee pain that I had previously had hit me on those where the knee was flexed/loaded for the first time in 6 months of "rest" prior. It didn't get any better and since I was there anyway for the PT work I figured I would bring it up and ask about it during one of our sessions. This knee issue is called PFPS or "runner's knee" and when he realized that's what it was, he scoffed and said "You're screwed" (or something to that effect). The clear indication was that this was a mysterious injury that nobody really knew how to fix (in hindsight, classic TMS). But this was particularly disheartening to hear at the time as he had become such a trusted figure in my life. That's probably one of the reasons I went 2-3 years of just enduring it before finally getting serious about a fix.

 

Right now, my knee is 95%+ healed. I still get a tweak from certain movements but I keep telling myself those are conditioned responses. I've said it before, I've experienced it before...but every time that TMS treatment works for me, I am AMAZED. It really is like magic.

Of course, my TMS is now barking up a few other trees trying to get a response...my right (operated) hip, a bunion on my foot. I'm waiting for the earache to come back, that's been a common site.

 

That is when I know I have 'won' and it's nearly over. At that point in my recovery is when I might say OUT loud (I live alone)..."Wow..is that the best you can do? I really don't need your help anymore". When I just flushed out a mystery hip issue around September, the 'victory' day was when it went into BOTH wrists.

Sarno said catching it early is the most important thing. I was climbing up into a really tall truck bed two days ago and my other hip spasmed. I immediately walked off to the side and had a discussion with my brain....and then got in and out of the truck focusing on my anxiety and perfectionism about the job I was doing.

Be careful about 'expecting' that ear thing. Most things we 'expect' end up showing up. That's why Sarno said this is preventative.. I now expect to be fine and when stuff does show , I try to escort it to the door immediately

 

I hear you. "Be careful what you wish for."

I'm actually dealing with a bit of a setback today...that 95% I was proud of yesterday is back down to about 50%. But that's been the nature of this, I've seen longer and longer time periods of no pain, followed by shorter and shorter periods of relapse.

 

A week later and I have another setback. I weathered the one posted about above but have had some significant pain today again. I am doing my best to diminish its importance and instead just looking at it askance and thinking "that's curious." Reading this forum, reminding myself of the 12 dailies from Sarno, listening to TMS podcasts, all those seem to help but I am struggling finding the deep subconscious issue(s) that must be at play.

I am getting some other, very random, symptoms though. Last night at a sporting event for my son, I noticed my left thumb start to twitch involuntarily. I immediately thought back to prior to that happening and it occurred to me I had gotten annoyed at something my wife did/said.

 

Certainly as bad now as this situation has ever been. I guess the only avenue is to keep hammering away at it with what has worked in the past. I do have Alan Gordon's book "The way out" on order from Amazon. I haven't read anything new on TMS since Steve Ozanich's "Pain Deception" (I re-read alot of my Sarno's books though), so looking forward to seeing Gordon's take in this book.

Otherwise, I am just plowing forward with whatever activity I feel like doing.

 

Week later update - Things are looking up. I was a little frustrated with some persistant pain over the week but I tried to double down on my mindfulness and gave a read of a somatic tracking worksheet and saw some significant improvement. In fact, last night I was 100% pain free. I need to keep reminding myself that that these periods of pain-free sensation are clear signs this is TMS at work.

I have been continuing to do activities with impunity - including cycling and leg strengthening - which are two activities I avoided previously thinking I was damaging myself. Hopefully by continuing this mindset I can get the message through to my thick skull/subconscious.

Interestingly I did have a bout with other symptoms popping up in the last week - including a back "crick" (like a crick in the neck but in my back) that I noticed but didn't obsess over. Sure enough, it was gone in a few days altogether.

 

thank you for all these updates~ i was just reading through them and my goodness all your stories and anecdotes all add up to a very clear case of TMS! keep up the inner work~ i’m also dealing with some insidious and difficult to shake TMS symptoms of arm weakness and tingling… but i have seen success from doing the work. i’m inspired by your saga. keep us updated!

 

Thank you for your comments!