Hi everyone,
I’m a 33-year-old male, and I’ve had persistent knee pain for the past three years. It first started during a multi-day cycling trip—my first of the season—where I was untrained and riding about 100 km per day. The pain began on day two, and although I pushed through, by the final day my right knee was extremely painful, and I also felt discomfort in my left knee.
Looking back, this happened during a stressful period in my life. Two years earlier, my mother had passed away (my father died eight years before that), and I was about to move across the world with my partner to live in her home city after spending two years in the Netherlands. My family was sad about me leaving, and I was under a lot of emotional pressure—even if I didn’t fully realise it at the time.
After the trip, I saw a physio who gave me the standard VMO exercises. I could still walk fine then, so I switched from cycling to walking to work, since cycling would immediately trigger the pain again. Things improved a little, but I never got back to pain-free cycling. (In hindsight, I also had a very poorly fitted city bike, which probably didn’t help.)
A few months later, I went hiking in the mountains. I was definitely worried about my knees going in. On day three, my knee became swollen and painful, and I had to abandon the hike. I tried icing and rest, and after about two weeks, I could walk again—with knee braces, which helped a lot. With the braces, I could dance, hike, even cycle again.
I saw another physio who focused on hip mobility and trigger point work. Over time, the pain kept improving, and I gradually returned to most of my normal activities.
For about two years, things were manageable. I still used braces for long hikes or intense activities but was able to hike the full GR20 in France last summer without major issues.
Then, about six months ago, I decided to return to longer cycling trips. I did three 40 km rides in one week, which triggered a major flare-up. I saw an exercise physio who gave me squats and strength work, but my pain only worsened. After two months, I could barely walk more than five minutes without pain. I also developed back pain and RSI symptoms, which I thought were from being too inactive. Strangely, during my back flare-up, my knee pain improved—possibly because I was lying down and resting more.
Later, I went on a relaxing holiday with my sister, and both my back and knee improved. I was even able to go on two-hour hikes. But once I got home, the pain slowly returned, and I blamed it on too much sitting.
Recently, I read The Way Out and The Mindbody Prescription, and the TMS concept really resonates. The emotional link makes sense given everything going on in my life. Still, the fact that the pain always seemed activity-related gives me some doubt.
One thing that stands out: being careful and hypervigilant always made the pain worse. I followed Doug Kelsey’s approach for a while, but it seemed to backfire because I was constantly monitoring my knee. Two weeks ago, I went to a wedding and danced for five hours (I was drunk), and strangely, my knees felt better that night than they had in weeks.
So there's definitely some hope—and some clear signs pointing toward TMS. I’m still working on fully accepting the diagnosis, but I feel like I’m on the right path.
I’m a 33-year-old male, and I’ve had persistent knee pain for the past three years. It first started during a multi-day cycling trip—my first of the season—where I was untrained and riding about 100 km per day. The pain began on day two, and although I pushed through, by the final day my right knee was extremely painful, and I also felt discomfort in my left knee.
Looking back, this happened during a stressful period in my life. Two years earlier, my mother had passed away (my father died eight years before that), and I was about to move across the world with my partner to live in her home city after spending two years in the Netherlands. My family was sad about me leaving, and I was under a lot of emotional pressure—even if I didn’t fully realise it at the time.
After the trip, I saw a physio who gave me the standard VMO exercises. I could still walk fine then, so I switched from cycling to walking to work, since cycling would immediately trigger the pain again. Things improved a little, but I never got back to pain-free cycling. (In hindsight, I also had a very poorly fitted city bike, which probably didn’t help.)
A few months later, I went hiking in the mountains. I was definitely worried about my knees going in. On day three, my knee became swollen and painful, and I had to abandon the hike. I tried icing and rest, and after about two weeks, I could walk again—with knee braces, which helped a lot. With the braces, I could dance, hike, even cycle again.
I saw another physio who focused on hip mobility and trigger point work. Over time, the pain kept improving, and I gradually returned to most of my normal activities.
For about two years, things were manageable. I still used braces for long hikes or intense activities but was able to hike the full GR20 in France last summer without major issues.
Then, about six months ago, I decided to return to longer cycling trips. I did three 40 km rides in one week, which triggered a major flare-up. I saw an exercise physio who gave me squats and strength work, but my pain only worsened. After two months, I could barely walk more than five minutes without pain. I also developed back pain and RSI symptoms, which I thought were from being too inactive. Strangely, during my back flare-up, my knee pain improved—possibly because I was lying down and resting more.
Later, I went on a relaxing holiday with my sister, and both my back and knee improved. I was even able to go on two-hour hikes. But once I got home, the pain slowly returned, and I blamed it on too much sitting.
Recently, I read The Way Out and The Mindbody Prescription, and the TMS concept really resonates. The emotional link makes sense given everything going on in my life. Still, the fact that the pain always seemed activity-related gives me some doubt.
One thing that stands out: being careful and hypervigilant always made the pain worse. I followed Doug Kelsey’s approach for a while, but it seemed to backfire because I was constantly monitoring my knee. Two weeks ago, I went to a wedding and danced for five hours (I was drunk), and strangely, my knees felt better that night than they had in weeks.
So there's definitely some hope—and some clear signs pointing toward TMS. I’m still working on fully accepting the diagnosis, but I feel like I’m on the right path.
