Knee problem: my inspiring story

Before I begin, I would like to thank JanAtheCPA.

I'm 38 years old. Back in 2010, when I was about 23, I underwent arthroscopic surgery on my left knee performed by a surgeon who claimed that I had torn my cruciate ligament. However, that diagnosis turned out to be incorrect—there was no such injury. About a month after the operation, I started experiencing some discomfort. It wasn’t anything major, but I became afraid to go back to running, and my leg has felt a bit weak ever since (I used to have the quads of a footballer). I was devastated—it was a clear case of medical malpractice. I also felt guilty for not seeking a second opinion, and I was angry with my mother for not supporting me more during that time.

For years, I was afraid to push myself. It wasn’t until 2018, after experiencing new pain, that I finally saw a physiotherapist. He encouraged me to start running again. I preferred to run slowly, a sort of fast walk. Things went really well. That summer, I even cycled 40 km in one day without any patellar instability. A month later, I returned to running but overdid it—three sessions of 8 km each. That led to pain in both knees and an 8-month recovery period.

During that time, I did a lot of light physiotherapy and walked frequently in sea water over the summer. My right knee improved significantly (about 80%), and my left knee gradually got better over the years (from 50% to around 90%).

Since then, I haven’t returned to running or heavy workouts out of fear of overloading my knees. Still, I’ve enjoyed trips where I walked 20 km a day, climbed lots of stairs, swam, and stayed active—I love to travel. Between 2019 and 2024, my condition tended to worsen in winter and improve during the summer. I attributed this to humidity, a sedentary lifestyle, and spending too much time with bent knees at a desk. But whenever I resumed walking regularly, I felt noticeably better. However the pain has never been as bad as in 2018 (and today, in 2025)

In May 2024, I experienced a wonderful period: the birth of my first child. I also spent 15 days away from home, near one of the most renowned hospitals in my region.

In June 2024, I had a mild ankle sprain. The pain didn’t really develop until September, when it gradually worsened to the point that I needed a brace and an MRI. Since the MRI didn’t show anything significant, I was able to move around normally again within 5–10 days. However, I also started feeling tightness in my lower back, psoas, and jaw.

In December 2024, on a physiotherapist’s advice, I did 10 wall sit squats. I wasn’t in great shape at the time—up until then, I had only ever done a maximum of two. While I occasionally had knee pain before that, it was nothing serious. Unfortunately, from that day onward, I began to experience pain in both knees. The pain is located on the inner side, around the kneecap. When I’m standing, I feel varying sensations: sharp pain, burning, or mild discomfort. When I sit, the burning becomes more intense. If I lie down, the pain gradually fades from a burning sensation to something more tolerable. The symptoms are identical to those of 2018. The diagnosis too: patellar femoral syndrome. I had an MRI and the results are identical to those of two years ago, when I thought about undergoing stem cell injections (first degree of chondropathy).

I am a perfectionist, a people-pleaser, insecure and anxious. I attended a university program I didn’t really enjoy, but achieved excellent results. My father was strict and anxious. A good person, but too much of a rule-enforcer, as he believed a good father should be. He worked on merchant ships during the first 11 years of my life. I saw him no more than four months a year. He never let me go without anything, but we never developed real dialogue or emotional closeness. We share some hobbies, like football, but we also have different views.
I also suffer from colitis, TMJ disorder, and since my knees hurt, constipation and difficulty sleeping.

I read "The Way Out", "Mindbody Prescription" and "Unlearn your pain". I watch Dan Buglio's videos on Youtube. I have too many tools and I get confused.

I think the fear of suffering is normal, also for tissue damage. But how can I be sure it's TMS if the pain has never completely gone away? Over the past few months, I've only had half a day without pain—and that was after a physiotherapy session.

I'd like to ask those who have dealt with knee problems: is it normal to feel a burning sensation in the same spots, kneecap instability, heat after walking a bit more than usual, crepitus, and a feeling of swelling in the joint?

Doug Kelsey, Paul Ingraham, and Scott Dye are specialists who talk about the 'envelope of function' and the importance of resting the knees until synovial inflammation subsides. They also address the role of mindset and the nervous system, but still recommend approaching physical therapy with caution. When it comes to patellofemoral syndrome, no one has the definitive answer.
Many people have improved by resting and being cautious, gradually increasing the number of exercises and/or steps.

There was a functional overload due to excessive exercises.

So I am a bit confused. I hope you can help me.

 

Hello @Giofe86
"I also suffer from colitis, TMJ disorder, and since my knees hurt, constipation and difficulty sleeping."
This statement sounds a lot like TMS ... however, it is ultimately up to you to decided if you think this is TMS at play. Some level of belief and connection to the idea of TMS is really the thing that will give you impetus to further your belief.
I also think it's great that you've done a lot reading into TMS and found this "confusing" - it is simple and complex at the same time. The methods can be very simple however there is no "set plan" no " follow these 6 steps" and you are guaranteed to be out of pain in a month kind of thing. You need to find the things you feel you can do, at least to start off with. It takes a willingness to experiment and realize that there is simply no plan. Basically, you get to make your own.

You want a practice that helps you explore your emotions and their relation to your past, your present and your personality traits. Lots of people use journaling to do this, some see a mental health professional, some use emotional embodiment techniques. Whatever works for you. Journaling is a very easy and effective tool that is free.

You may need to do some nervous system work: start off with any singular thing : Dan Buglio takes three big breaths, Alan Gordon likes somatic tracking, some folks prefer meditation, others walk in nature - some run. Whatever takes you out of your head for a bit. Just pick one thing. It can change over time, just start with one thing to try.

Mindset: begin thinking about being kind to yourself and dropping beliefs that don't serve you. The idea of overuse doesn't serve you - however the idea of rest and compassion for yourself surely does serve you. Reading, researching and putting your head in the medical model might not serve you right now if you have a lot of fear and obsession. Leave that to doctors if you need to use them, otherwise, it may be more worries that aren't really serving you but feeding into the TMS. The idea of exercise right now might not serve you, but setting your mind to activities and hobbies you love does - surely you have something that you enjoy that incorporates the ideas of some rest but some mental interest. Try to engage in other areas of life as normal: see friends, go to family functions, do chores around the home that you can do this can really help your mood and obsessive thinking patterns about symptoms.

Broken down into a few steps, it is FAR less daunting. When you are ready, you will naturally begin to incorporate some of the other skills you've learned from books and videos, but to start with, just keep it simple. If you'd prefer a guide, the Structured Education Program on the website at TMSWIKI.ORG (scroll down to find) has a 45 day lesson plan that will teach you some skills to start you off on your journey.

Good Luck!

 

I had TMJ and patellofemoral syndrome (common knee pain). I think everyone has crepitus. Applying the medical terms to these general diagnoses that most people have is a sign of anxiety in my opinion. It plays up the symptoms too much. Patellofemoral syndrome is also called runners knee and a lot of runners talk about it in r/running. Most of them just get better in time. It sounds like you are still on the physical therapy train and you should still do the conventional treatments until enough time has passed until you haven't gotten better and you are officially done with conventional treatments. I didn't give up stretching until the 3rd year into mindbody work and about 16 years into chronic pain. That was when I finally accepted it wasn't doing anything. To me 99.99% of TMJ and knee pain is TMS, especially if you have bilateral knee pain that occurred around the same time.

 

Thank you for your help. Sincerely

Reading that you suffered for 16 years and spent 3 years doing mind-body work doesn't help me—if anything, it increases my anxiety. I also get anxious reading 500 success stories versus 5000 open conversations in the “support” section. That’s only 10%! :O

Do you really think that overloading from 10 wall sit squats couldn't affect both knees? After all, I used both of them!

Until ten days ago, the skin on my knees was sensitive to temperature. Just a drop of water would cause discomfort—a sort of unpleasant sensation. Not anymore, but I still have this annoying burning feeling, especially when I'm standing still or sitting with my knees bent. If I stand for a quite long time, my knees become very stiff.

@Cactusflower @JanAtheCPA, there are things I still don’t understand: why are rest and physiotherapy considered incompatible with TMS? Couldn’t I live a peaceful, normal life by committing to training my whole body, including my knees? Doesn’t rest help reduce inflammation and therefore make me feel better?
What I really don’t get is this: my pain began from overuse, and everyone I know who tries physiotherapy for the same issue seems to get worse. Many people improve simply by walking more each day.

So here’s my question: does doing physiotherapy without awareness, or while feeling anxious and fearful, actually lead to worsening symptoms? Could it be that physiotherapy done with fear makes things worse, while physical activity and walking done calmly and with gradual progress helps re-educate the nervous system in a safer environment?
I have extremely weak and atrophied legs, I haven’t used stairs in 5 months and I use crutches for going down slopes and stairs. I’m also a bit uncoordinated in certain situations. This is why I want to work out and get stronger.

What role does diet play in all of this? Many people also invest in an anti-inflammatory diet.

And what about serotonin-based medications? A doctor friend of mine suggested I might be experiencing postpartum depression, and that a small dose of the “happiness pill” could help.

I’ll tell you even more about what led me to TMS, which I had kept to myself also to avoid being too TMS-oriented.

PERSONALITY: perfectionist; low self-esteem, despite brilliant results; anxious parent and I am anxious too. University against my will. Unnecessary surgical operation. Betrayal by my girlfriend after a 5-year relationship when I was 24. Law-abiding and irritated by those who are uncivil or do not follow rules. Strong sense of duty. 5 unsatisfying years of work. Difficulty expressing real emotions. Critical and pessimistic internal dialogue. Deep sorrow when I receive criticism. Displacement of anger. Jealousy toward friends.

EVENTS: Birth of my child; lots of work and few holidays during the summer (first months of the baby’s life). My parents often at home, repetitive life whereas, previously, I used to travel a lot.

STRANGE ILLNESSES: Twice cystitis during university and 5 months of gastroesophageal reflux treated with proton pump inhibitors; 2 Achilles tendinitis; some periods of constipation (never while traveling); insomnia as a child; foot pain because I was told I had flat feet; nervous colitis; tension in the lower back and iliopsoas; occasional TMJ issues (improved with a bite splint); seborrheic dermatitis; dust allergy (I don’t know if it’s related, but I treated it with immunotherapy).

Where is the real problem? I’ve solved all these issues by managing to overcome fear — fortunately without having to work on the unconscious (I wouldn’t know how to) — but the knee pain is a very significant discomfort. Just think: I can’t walk, stand, or bend my knees while sleeping. Mentally, it’s devastating and depressing.

In 2019 I managed to feel well when I was forced to spend 10 days with old friends because the mother of one of them was dying. We helped the family by getting oxygen tanks and shared painful moments that I had already experienced at 16, when my grandfather passed away.

 

This all reinforces my point that you have anxiety. I could do wall sit squats until muscle failure and feel no pain.

 

I hadn't worked out in a while and didn't have much quad strength. If you ride a bike for 100km, do a lot of squats or do marathons without training, it's dangerous.
I had a delayed pain and it seems that this is common for cartilage problems (which have no nerves). But I have a lot of anxiety, almost desperation and depression. However, I think it is also normal when you walk and sit always in pain!

 

"@Cactusflower @JanAtheCPA, there are things I still don’t understand: why are rest and physiotherapy considered incompatible with TMS? Couldn’t I live a peaceful, normal life by committing to training my whole body, including my knees? Doesn’t rest help reduce inflammation and therefore make me feel better?
What I really don’t get is this: my pain began from overuse, and everyone I know who tries physiotherapy for the same issue seems to get worse. Many people improve simply by walking more each day."

@Giofe86
What do you mean by a peaceful life? Do you mean that you would never feel anything while training, that you would never get injured? That this injury would never make you upset and focus so much attention on the sensations you are having?
My friend, that is not the real world!

Consider: What if your pain did NOT come from overuse? Can you think that maybe you were very tense because you were anxious. Not just anxious that day, but you are often anxious and tense.

With TMS we think way outside this box of injury and overuse and only the things that would be "medical" or "physical". TMS is about our mental and emotional state.
Some people get injured, they heal.
Some people get injured and they don't heal because they begin to obsess, worry, focus, get angry and frustrated and tense about not healing or not healing on their own timeline... there are many factors.

Dr. Sarno teaches us how to heal. If you want to heal, read one of his books.

 

I have read several books, and they all make sense. It's also evident that I’ve experienced many psychosomatic illnesses. I’m sorry that I can’t fully find the courage to believe in this 100%, but I imagine that’s a common struggle.

Still, I don’t fully understand why people don’t resolve it through physical therapy, but instead by gradually increasing physical activity. Does the nervous system adapt to fear through a kind of gradual exposure? Are we too afraid to have traditional physical therapy?

On a physical level, what can I do when I’m in so much pain? Should I stop using crutches when climbing stairs? Can I go to the beach? Or should I simply learn to accept my current condition and slowly add activities over time? It is difficult to be happy with this problem.

In 2019, something very strange happened. As I mentioned, I was helping a dear friend and his mother, who was dying. The pain decreased by about 50%. I noticed it after 2–3 days and interpreted it as a permanent change. I was happy and spending time with friends. I started nostri with

Today, just like in 2018, the pain is very intense and prevents me from doing many beautiful things that could actually help me. I feel deprived—at least temporarily—of the ability to travel, take walks, and experience many other joyful moments. It's also hard to spend time with friends when they want to walk long distances.
But I’m trying to cultivate new hobbies and to meditate, even though I struggle to truly work through my emotions.
To be honest, I don’t even know what the real goal might be—maybe no one really knows. After all, anger is stored in the unconscious, and it’s not necessarily a feeling I hold toward my father, my mother, the mercenary-like surgeon, or my ex-girlfriend who cheated on me (whom I’ve almost forgotten by now).
It could be a more recent feeling, simply linked to the way I’ve become—a perfectionist and a people-pleaser.
In the past, I found a sense of inner peace through cognitive-behavioral therapy, without ever having to express any anger at all.

I'm currently working with a psychologist, but I’m not sure how helpful he is, as he doesn't seem focused on TMS-related issues. I’m also being followed by a physiotherapist who specializes in TMS and studied with Dr. Schubiner.

 

A small note, but I was struck by this: 'Law-abiding and irritated by those who are uncivil or do not follow rules.' My husband is like this, and I have long suspected he is on the Asperger's spectrum - it causes him really psychic pain to see rules being broken, and he strives to control everything and make it 'correct'.

I think he, and you, (and I!), would benefit from letting go and letting things and people be more. I think it's common for us TMSers to try so hard to 'fix' everything and do it properly and thoroughly that we create more tension for ourselves.

 

@Cariad Thanks for your reply. I agree with you, but it is an unconscious process and I need to understand how to make it conscious.

I take this opportunity to clarify: I wrote "inspiring story" because, in reality, I realized that I had overcome this problem several times, but without thinking about TMS.

In 2019 I was feeling terrible like now (I couldn't walk more than 500 steps, sit with my knees bent, stand in one place for 2 consecutive minutes, climb stairs). I solved it when I helped a friend for his dying mother.

In the years that followed I had milder episodes, but always and only in the winter. I was convinced that it was the humidity and there were two fundamental things: 1 I didn't suffer to this level, so I tried to continue my activities 2 I thought that in the summer I would be better. So, suddenly, while I was walking, in the months of May-June, I noticed that the pain disappeared almost miraculously.

 

It sounds like you have had some moments where the pain went away, or at least lessened. Think about it, why would that happen with a structural disease/injury? Add that to your evidence sheet and reference it often.

Start seeing if you can notice other similar changes - i.e. do some TMS work (like journaling, or listening to podcasts, or somatic tracking) and see if you see any difference in the pain, or if it moves around. If so, you have more items for your evidence sheet.

I know how hard it is, but if you can find any kind of signs of hope - no matter how small - it helps to have that to latch onto.

 

Thank you for your support!

I haven't done any sports for years for fear of getting worse. However, I used to walk 10-20km, I do stairs, descents etc... I had a serious worsening in 2024 after squat workouts for which I wasn't ready. So I have that type of anxiety.

However, I have all the traits of TMS. Today I don't have many exceptions anymore, but in the past months I had them, maybe because I was able to distract myself more easily.

It's easy to keep going when only one knee hurts or you can at least walk for a while or sit. I struggle a lot both when I put weight on my body and when I bend my knees. I can't even cook or shave.

 

This is easier for someone else to say, I know - but believe me when I say that this is your TMS brain talking. It is setting up obstacles for you for why you can't do things, it's even helpfully adding "well if it was only ONE knee then that would be different."

When I was in the bottom-most depths of my TMS crisis and dealing with my hip situation (and waiting for surgery), I had convinced myself that "rest" is what I needed and I used crutches around my house. I refused to attend family gatherings during this time because "I wasn't able." I had issues taking a shower because the standing in the shower felt like it was going to pop my hip out of its joint and dislocate it. I answered the door for visitors and deliveries using crutches. While I was scheduled for surgery on only one hip, both hips had the same pain and condition, thus the "precautions" was taking.

It was all TMS.

At some point, hopefully soon, you'll get to the same realization and you'll look back at this time with amazement that something like TMS could be so powerful as to cause all of the above.

 

Thanks for your message.

I guess, however, that it is still advisable to resume activities gradually so as not to worsen the situation (not the physical one, but the nervous system).

I am walking around the house trying to increase the number of steps. I write a gratitude journal. I meditate. My knees are no longer red and sensitive as before, but the burning is still strong.

I think I still need to strengthen my legs and core because I am weak and it makes sense to do it regardless of TMS.

 

Sarno says to "resume all activities" - he doesn't say to do so gradually he says resume. It's one of his 12 daily reminders. When in doubt I always go back to Sarno.

He also says to drop all PT activities that have the goal of alleviating symptoms - that means strengthening, stretching, foam rolling, massage, etc. You can always do those activities but the key word is your intent - the intent should not be "I need to strengthen my quads so my knees won't hurt."

 

I think that intent and confidence are a gradual process. Did you start with a lot of pain and fear the first time with your hip?

 

Of course, but the longer you delay, the longer your recovery.