• Alan has completed the new Pain Recovery Program. To read or share it, use this updated link: https://www.tmswiki.org/forum/painrecovery/
  • Welcome to the new TMS Wiki server! Things aren't finished yet: email is not set up, so notification and password-reset emails don't go out, and new registrations are paused until email is installed. Details and updates are in this thread (click here). Locked out? Email tmswikisignups@gmail.com from the address where you receive TMS Wiki notifications.

Day 1 Could My Knee Pain Be TMS?

little frog

New Member
Hello everyone,

I am a 34 year old woman, and I have come to this forum after 4 years of knee pain.

When it first began in my right knee, after a day of long hiking, it only showed up when I tried to run or cycle. I went to see an orthopedist after 2 months who diagnosed me with chondromalacia patella and suggested that I use RICE (rest-ice-elevation-compression). In the days following that visit my pain became much worse. He told me to only go up and down stairs leading with my good (left) knee and while stairs had previously been painless, I found within days of receiving this instruction that taking stairs in a normal way had become quite painful. I got an MRI done that revealed Grade II chondromalcia (softening and defects in the cartilage beneath the knee cap) - a later orthopedist evaluated the same image to show something more like Grade I. I began to feel a sharp pain in my right knee when I put on shoes or tried to lift my knee onto the gas pedal of the car.

The first PT I went to said I was not responding to treatment as expected (my knee remained very reactive and inflamed despite strengthening and conditioning). A second PT was able to help me improve things such that I could function pretty normally though I still felt knee pain when I danced or did certain kinds of squats and I could not run or play sports.

A year ago pain began in my left knee as well. I began seeing a highly specialized PT who only works with knee arthritis and chondromalcia who expressed confidence that she could see me through to a complete restoration in function. Her program involved carefully guarding against overload (meaning giving up hiking and dancing and many things that bought joy and meaning to my life) and careful tracking in a spreadsheet of how many steps I took a day and how many rounds of exercise I completed. It has required a lot of discipline, which has been hard and taxing. She told me not to stand for too long, and now standing which had never been a problem before is such an issue that it makes it hard for me to attend parties or museums or to do chores around my house. I used to get some mild pain when I danced, but now 10 minutes of dancing at a wedding leads to days of pain and mild swelling. A year later my PT has determined that her program does not seem to be working for me. "I cannot think of a reason why you should not recover from this, but we are seeing no evidence to the contrary." She suggests my progress may be impeded by my autoimmune disorder (Hashimoto's), but I have explored that angle (going gluten free, taking supplements, etc.) in the past with no perceived effect on my knee.

I am a psychotherapist currently training in Somatic Experiencing and another practitioner at my recent training recommended John Sarno's books to me. There are things that give me hope I could be suffering from TMS. For example, the instances in which activities (walking, standing, dancing) became much more painful after an expert told me they were bad for my knee (this had always been suspicious to me and I wondered how my anxiety was playing a role in things). When I first got the diagnosis of chondromalacia I was so anxious and freaked out - the idea that there was an irreversible defect in my body that might have been my fault (overuse etc.) was intolerably distressing. (I have always been unusually distressed about things like scars or stains). I am a perfectionist and a goodist. And my life on paper isn't that stressful but I always feel very overwhelmed. I feel very stuck moving forward in life between my disoraganization and ADHD on the one hand and my need to have things done to a very high standard on the other.

Reading about TMS, I feel hope at times, but also a lot of fear and dread. I am so afraid of trying something else to find that it doesn't work for me and running out of hope. And it is hard to accept a diagnosis I have given myself. I worry that to believe my issues aren't fundamentally driven by structural damage and to believe that there could be an expedient way back to a full life is simply wishful thinking. Because of course I would long to believe that! I have often struggled with faith and doubt.

I am grateful for resources like this program and this forum! It offers hope to hear about other's success, and it feels a little less lonely to witness other people on this journey with pain (at whatever point they may be).
 
This sounds very recognizable, I think I almost went to the same specialized PT as you went to. But I noticed that more I became hyper vigilant with my knee the worse it got, and she really seems to encourage hyper vigilance. Surely the fact that it only got worse after being so careful is a hint that suggest TMS?
 
Yes, Knee pain is a normal TMS response. I had it when I was going through my divorce. I only treated it as 'real' for a short time . Then when I was at a Sports medicine palce and they showed me the amount of fluid that was allegedly keeping me from walking, I Instantly knew I'd been had...

I had to work hard to figure out the sinisterly obvious emotional problems and anger I was going through that necessitated the symptom
 
Thank you both for sharing with me about your experiences! It gives me encouragement me to continue trying to apply this way of looking at it.

Something odd happened yesterday, which made me think of TMS. In all these doctor's appointments over years I have often been asked "does your knee get red?" "does your knee get hot?" and that answer has always been "no, it doesn't although it does swell a tiny bit" (I can notice by pinching the skin above the knee and feeling a little more chub). I'd been at a conference this weekend and my knees seemed to be regressing even further - I was elevating them through every workshop and session and icing them 4x a day and taking 1000 mg of Aleve a day, which didn't seem to touch the inflammation. Yesterday at lunch with my friend, who trained as a naturopath before becoming a therapist, she said "does your knee get red? does it get hot?" and again I said no. She said "I'm just thinking it's really strange because when there's inflammation that's usually indicated by redness and heat and visible swelling....and you are having all this pain but you couldn't tell by looking at you." Tonight I got home and for the first time I can ever remember my knees felt hot to the touch and looked visibly red. Seems like such very strange timing....that a new undeniably physical symptom would begin just after I was confronted about it's absence....

Jlucas - I read your post and it sounds like our experiences have a lot of overlap (and that we are both referencing the same PT)!

I'm finding the hyper-vigilance is a really really hard mental habit for me to unlearn - even in the face of more evidence for TMS. I welcome any tips that folks may have about letting go of that monitoring. I am trying to practice redirecting myself to check in instead with the tone of my nervous system (am I stressed and activated, or feeling safe and at ease?), but it's easier said than done. I find even in the middle of the night I am braced to notice if my knee will click and pop as I readjust in bed.
 
Look up "stress and inflammation" to discover that inflammation (heat and redness) is naturally manifested by the stress response of our immune systems. It's supposed to do that. You want to calm this down when you know rationally that it's not necessary - because it's actually not healthy to keep allowing this to happen long-term. You want to engage your stress response only when it's really needed!
 
Yeah that seems super strange indeed! Definitely seems like more evidence pointing towards TMS. I also had the same experience with anti inflammatory pain killers not really helping with the pain at all, which seems to suggests that maybe there is no inflammation? To me that pointed more in the direction of TMS. I took Voltaren for 4 days, and the pain only got worse.

Might be nice to make a list of evidence pointing towards the pain being non structural, for me that helps a lot towards convincing myself that moving the knee is not bad for me. (non dangerous), which helps make it less painful.

This video I also found super useful! Even the medical community is pointing towards more movement is better!
 
Hello everyone,

I am a 34 year old woman, and I have come to this forum after 4 years of knee pain.

When it first began in my right knee, after a day of long hiking, it only showed up when I tried to run or cycle. I went to see an orthopedist after 2 months who diagnosed me with chondromalacia patella and suggested that I use RICE (rest-ice-elevation-compression). In the days following that visit my pain became much worse. He told me to only go up and down stairs leading with my good (left) knee and while stairs had previously been painless, I found within days of receiving this instruction that taking stairs in a normal way had become quite painful. I got an MRI done that revealed Grade II chondromalcia (softening and defects in the cartilage beneath the knee cap) - a later orthopedist evaluated the same image to show something more like Grade I. I began to feel a sharp pain in my right knee when I put on shoes or tried to lift my knee onto the gas pedal of the car.

The first PT I went to said I was not responding to treatment as expected (my knee remained very reactive and inflamed despite strengthening and conditioning). A second PT was able to help me improve things such that I could function pretty normally though I still felt knee pain when I danced or did certain kinds of squats and I could not run or play sports.

A year ago pain began in my left knee as well. I began seeing a highly specialized PT who only works with knee arthritis and chondromalcia who expressed confidence that she could see me through to a complete restoration in function. Her program involved carefully guarding against overload (meaning giving up hiking and dancing and many things that bought joy and meaning to my life) and careful tracking in a spreadsheet of how many steps I took a day and how many rounds of exercise I completed. It has required a lot of discipline, which has been hard and taxing. She told me not to stand for too long, and now standing which had never been a problem before is such an issue that it makes it hard for me to attend parties or museums or to do chores around my house. I used to get some mild pain when I danced, but now 10 minutes of dancing at a wedding leads to days of pain and mild swelling. A year later my PT has determined that her program does not seem to be working for me. "I cannot think of a reason why you should not recover from this, but we are seeing no evidence to the contrary." She suggests my progress may be impeded by my autoimmune disorder (Hashimoto's), but I have explored that angle (going gluten free, taking supplements, etc.) in the past with no perceived effect on my knee.

I am a psychotherapist currently training in Somatic Experiencing and another practitioner at my recent training recommended John Sarno's books to me. There are things that give me hope I could be suffering from TMS. For example, the instances in which activities (walking, standing, dancing) became much more painful after an expert told me they were bad for my knee (this had always been suspicious to me and I wondered how my anxiety was playing a role in things). When I first got the diagnosis of chondromalacia I was so anxious and freaked out - the idea that there was an irreversible defect in my body that might have been my fault (overuse etc.) was intolerably distressing. (I have always been unusually distressed about things like scars or stains). I am a perfectionist and a goodist. And my life on paper isn't that stressful but I always feel very overwhelmed. I feel very stuck moving forward in life between my disoraganization and ADHD on the one hand and my need to have things done to a very high standard on the other.

Reading about TMS, I feel hope at times, but also a lot of fear and dread. I am so afraid of trying something else to find that it doesn't work for me and running out of hope. And it is hard to accept a diagnosis I have given myself. I worry that to believe my issues aren't fundamentally driven by structural damage and to believe that there could be an expedient way back to a full life is simply wishful thinking. Because of course I would long to believe that! I have often struggled with faith and doubt.

I am grateful for resources like this program and this forum! It offers hope to hear about other's success, and it feels a little less lonely to witness other people on this journey with pain (at whatever point they may be).
Many people on the forum find it inappropriate to discuss symptoms. And that's partly true because doing so means seeking reassurance.
However, it's also right to have some parameters. It would seem truly strange that redness, heat, creaking, and instability could be caused by TMS.
In reality, that's exactly how it is, and I myself have overcome pain in both knees several times, when I least expected it, when I managed to live my life without thinking about my knees 10, 20, 100, or 500 times a day.
I'll just say that if I think about my knees with fear and lie down on the bed, they become very hot. If I don't think about them or if I'm at my desk, this doesn't happen.
You describe your knee pain with the typical characteristics of someone with TMS!!!
Tell us more about the pain in your left knee. Doesn't it seem strange? How likely is it that your other knee is hurting? Did the pain in your left knee arise out of nowhere?
 
Last edited:
Yes, Knee pain is a normal TMS response. I had it when I was going through my divorce. I only treated it as 'real' for a short time . Then when I was at a Sports medicine palce and they showed me the amount of fluid that was allegedly keeping me from walking, I Instantly knew I'd been had...

I had to work hard to figure out the sinisterly obvious emotional problems and anger I was going through that necessitated the symptom
I didn't understand your answer. Was there too little fluid? Is that why you knew it was TMS?
 
Back
Top