Really Struggling with Knee Pain

[Mr Hip Guy]

I continue to be up and down with this. I get periods of pain-free followed by relapses but I continue to do whatever I want with my knee with impunity. I'm trying to lean into it more when it does hurt, pause there and just try to observe it without fear/judgement (somatic technique) and it definitely helps in the moment. But I continue to be frustrated with why it won't pass 'for good.' I'm guessing there is something that I haven't done yet, or uncovered in my subconscious that is causing this "block."

On a side, related, note, I finished Alan Gordan's book "The Way out" yesterday. Definitely a good read, but in my assessment not as good as Sarno's or Steve Ozanich's. Maybe it's just taste on my part but Gordon tended to continue to dive into anecdotes the further I got into the book and I kept expecting a "program" to follow. I was also a little annoyed that there was no mention of Sarno in the book, from what I could tell at least and I also checked the Index at the back. That doesn't seem right to me and I wonder what thinking led to that omission.

 

[Mr Hip Guy]

I know I just posted earlier in the week but I am really dealing with a flare up right now. Trying hard not to blame the fact I stopped doing my PT work on this issue in support of a TMS diagnosis, but it is really really hard for my brain to accept it.

Cons:
Pain is very specific and on specific movements (certain bends of my knee will trigger it, under load)
Really flares up after certain activities that are historically "bad" (leg strength work, cycling)
Has come back as the benefits of the PT work I was previously doing has trailed off

Pros:
Had gone away previously when I accepted the TMS diagnosis
Somatic tracking work can make the pain lessen "on demand"
I'm a TMS-ey person, with previous issues resolved through TMS work

 

[Mr Hip Guy]

After another week, back with an update.

The flare up referenced above subsided last week and I reverted back to baseline which is currently at about 80% "healed." That means I get pain "under load" roughly 20% of the time, but it seems to vary on what the load activity is (going up/down stairs, cycling, act of sitting up/down). I am taking that variation as another symptom of TMS.

I've noticed that Mondays tend to be bad days in general...this makes sense as I have stress at work and Monday is the end of the weekend etc...but this past Monday was not as bad for some reason? I'm dealing with some stress as our home is being renovated so there is massive disruption for about a week total and we're only a couple of days in (not being able to work from home and we'll need to spend the night elsewhere for the last 3 nights).

As if right on cue, I had a particularly bad night of sleep...not knee pain issues...but other stuff crept up on me: some shortness of breath and lung pain upon deep breaths, nasal congestion, overall tension headaches, etc. But the big one hit last night waking me from sleep with a few bouts of proctalgia fugax which is a highly highly painful spasm shock in the lower pelvic area. I have had these for years, hitting me 2 to 3 times a year but the electrifying shock of pain makes them very very memorable. Now, of course, I see them as TMS (and a search on this site indicates others do too). This whole episode can be viewed as symptom imperative as my knee pain has lessened but this other stuff has come on - or it's just a sign of recent stress triggers, either way it's TMS.

 

[fridaynotes]

ugh. isn’t it so ridiculous that TMS is like a game of wack-a-mole? it’s like you hit one down and then another pops up! it’s quite a process. a life’s work!

 

[Mr Hip Guy]

Yep, whack a mole. The difference being I feel equipped to handle the moles now as opposed to before when I thought I had a mole infestation! The difference in mindset is significant.

 

[Mr Hip Guy]

Thankfully hanging in there about where I was last week, about 80% there...maaaaaybe a little higher than that. Last week was a stressful week (work stuff, our house was being renovated, we were displanted as a result, weather issues, etc) so I guess I should be thankful it didn't worsen?

TMS is trying to grab a toehold in another area though...symptom imperative at work...I'm having issues with Plantar Fascitis right now. I'm a runner so I am very familiar with this condition.

Weird, the above was sitting in a draft reply until I just checked in on this thread now - I'm going ahead and posting it but it reflects where I was early last week.

THIS week, I am actually continuing to get much better - I'd estimate I'm at about 90% on the knees (up from 80-85%), with them only tweaking me in certain situations, almost all of which I immediately just discount as "nothing" and/or think "that's interesting."

I have been having a number of other weird symptoms come up though - my (operated) hip has been twinging lately (to which I am responding "c'mon, gimme a break - that tired old attempt?")...and some general anxiety that I haven't been able to get a handle fully on. I can usually tamp this stuff down when it pops up, but it's exhausting playing whack-a-mole still.

The answer to this - of course - is a daily practice of meditation/journaling/introspection, but that is really really hard to get into a habit of for me.

 

[Mr Hip Guy]

Still moving along and progressing with my knee pain, progress is slow and incremental but it's progress...I'm better than I was last week and I occasionally find myself "reminded" of the knee pain as in "oh yeah, I have that."

Consequently, the symptom imperative is trying all sorts of attempts to see if anything else manages to grab my attention.

Woke this morning (Monday - which always seem to cause flare ups - terribly cliche but I'm sure there's some work-stuff I could explore here) - with a serious "crick" in my neck. We all get these, right? I've gotten them before that stayed with me for weeks, causing all sorts of misplaced stress attempted to fix it with stretches and tissue work and heat/cold etc. The last few times I've gotten a crick, I treated it as TMS and it was gone in 24 hours.

Since my last post, TMS has also tried:

- Hip pain (operated hip as described in my post before this one)
- Plantar Fasciitis
- Headaches
- Ear pain (always my right ear for some reason)
- Nausea/stomach-cramps - I hesitate to list these as they don't tend to be chronic, so certainly possible it's just something I ate
- Sleeplessness - a little bit of anxiety that I wasn't able to tamp down and deal with

 

[Mr Hip Guy]

Still plugging along with progress every week. One major revelation that has helped is viewing the pain in a different context - previously it would be 'oh no, I'm going to be stuck with this forever...if it's this bad now, how bad will it be in 10 years?' That kind of thinking causes the brain to learn that particular sensation/pain is a danger-signal. My new mindset/perspective/context when I feel a twinge is "oh, that's no big deal"...or if it persists I make sure I look at it psychologically as in "what is bothering me right now...or right before I felt this twinge."

I know, I know...this is basic TMS therapy...but it's good to verbalize and vocalize these revelations nonetheless.

So happy to be doing regular strength work, cycling, and running 50+ miles per week...I had tamped-down or eliminated most of these activities when I was really worried about my knee.

 

[mtimoney]

Still plugging along with progress every week. One major revelation that has helped is viewing the pain in a different context - previously it would be 'oh no, I'm going to be stuck with this forever...if it's this bad now, how bad will it be in 10 years?' That kind of thinking causes the brain to learn that particular sensation/pain is a danger-signal. My new mindset/perspective/context when I feel a twinge is "oh, that's no big deal"...or if it persists I make sure I look at it psychologically as in "what is bothering me right now...or right before I felt this twinge."

I know, I know...this is basic TMS therapy...but it's good to verbalize and vocalize these revelations nonetheless.

So happy to be doing regular strength work, cycling, and running 50+ miles per week...I had tamped-down or eliminated most of these activities when I was really worried about my knee.

This is so encouraging to me Mr. Hip Guy. I am full of fear about my knees (patella pain) and I like you have had a slew of other symptoms plus an anxiety disorder. Are you feeling like you can totally keep your knee pain under control by journaling, meditation, squelching fear, etc?

 

[Mr Hip Guy]

I'm 100% sure this is a TMS issue, the best evidence was the drastic reduction in symptoms once I recognized it as such.

But as you can see by reading this thread, I haven't fully eradicated it...and I blame that on not quite getting the recipe right with regard to TMS treatment (I am notoriously bad about journaling and doing the "homework" - I do a little and get relief but don't carry it all the way through, I'm sure there is some deep insight I am not quite getting to in this case).

 

[mtimoney]

I'm 100% sure this is a TMS issue, the best evidence was the drastic reduction in symptoms once I recognized it as such.

But as you can see by reading this thread, I haven't fully eradicated it...and I blame that on not quite getting the recipe right with regard to TMS treatment (I am notoriously bad about journaling and doing the "homework" - I do a little and get relief but don't carry it all the way through, I'm sure there is some deep insight I am not quite getting to in this case).

I've been doing homework - journaling and reading and listening to Sarno's books while driving etc. Much of my leg and shoulder pain is gone. The R knee is what is chronic and the left is beginning to hurt as well. It is a constant source of fear and a big distraction. I am a triathlete and I love to cycle. I absolutely don't want knee surgery. It's already been scoped once and I wish I didn't do that. I love to work out, ride my bike, etc. I have my first appt with a TMS therapist soon and I am looking forward to their insights. Question: just out of curiosity what did your MRI show? Normal wear and tear? Osteoarthritis?

 

[Mr Hip Guy]

Question: just out of curiosity what did your MRI show? Normal wear and tear? Osteoarthritis?

Mine showed some mild arthritis on the back of the patella (knee cap). The ortho attributed this to the rubbing that the misaligned knee cap was doing. This type of imagery is very very hard for me to overcome as I tend to fixate on it to feed my innate need for symptoms to be "structural." So initially the MRI report sent me in a downward spiral, as did the Xrays that showed one kneecap more "misaligned" than the other.

I now strive to view these as what Sarno called "normal abnormalities."

 

[mtimoney]

Mine showed some mild arthritis on the back of the patella (knee cap). The ortho attributed this to the rubbing that the misaligned knee cap was doing. This type of imagery is very very hard for me to overcome as I tend to fixate on it to feed my innate need for symptoms to be "structural." So initially the MRI report sent me in a downward spiral, as did the Xrays that showed one kneecap more "misaligned" than the other.

I now strive to view these as what Sarno called "normal abnormalities."

Yes the body is an incredible machine that heals on it's own. Thank you for your kind words I truly appreciate the help!

 

[Mr Hip Guy]

Today is Tuesday, but since yesterday was a US Holiday it's my first day back at work and therefore it "feels" like a Monday. Yep, like clockwork, my knee pain has ramped up.

My mind keeps trying to come up with "reasons" why it hurts, physical reasons like I overdid it on a home-improvement project I'm currently doing (where I had to climb up/down ladders repeatedly, work while on my knees, etc) or that I overdid it with the running on the weekend etc.

It really is funny how pervasive and downright sinister it is with this kind of thinking. I know eventually I will wrench the wheel to bring this train back onto the track again but wow it can be hard sometimes.

Just writing entries like this often help alot.

 

[Mr Hip Guy]

Another Monday, another uptick in pain & symptoms. Actually there is a lot to unpack here so I'm going to get right to it:

- I ran a marathon last weekend (a week ago), no issues with my knee, just the usual level of pain it has settled into (about a 2 on a 10 scale - occasional twinges but overall pretty good). This is a good reminder that I'm doing pretty well if I can continue to do fairly extreme activities like this. The problem is I tend to focus instead on that 2 and get annoyed it's not a 0.

- Changing focus now to a 100 mile cycle event coming up in a few months, so I'm shifting focus from running to cycling to prep for that. I've not been doing much traditional cycling in a while, honestly my "road" bike has been a trigger for me as it tends to aggravate my knee the most so I have really been avoiding it. I have some stand-up cycles that I've been using instead (ironically one of which was the absolute worst on my knee but is fine now - TMS is really weird). Anyway, the point is I need to get the road bike to that same level.

- Did a somewhat long ride yesterday and the knee was giving me a little trouble especially early on. I tried to apply Somatic Tracking techniques (mostly, just looking at the pain as a curiosity and not a danger) but it was being stubborn this time. It was a little tender the rest of the day and it was hard to tamp-down those feelings that I did damage. I did notice that the tenderness was typical TMS-type feelings, an ache and burn that is very distinctive.

- Some "stuff" is going up on upstairs as I had a lot of trouble getting back to sleep early this morning. Just unnecessary ruminating and worrying over certain things, couldn't seem to shake it. I'm sure being Monday morning had a lot to do with it. My brain has a tendency to latch-onto certain worries and make them seem catastrophic, it really feels like it's my own enemy sometimes. Not sure what the biological/evolutionary purpose of constantly putting me in fear/flight mode is.

- After reading Alan Gordon's book as well as just doing a lot of thinking on TMS theory, I'm starting to think the actual pain-management has a little less to do with fear/trauma/rage/psyche and more to do with specifically seeing the pain as a non-dangerous thing. It is starting to look like, to me, that the entire journaling/meditation/recognizing-pain-as-non-structural is a means to an end - that end being seeing the pain as non-dangerous. I think that is one of the reasons we see Sarno "Book cures" - those lucky individuals skipped the whole process and recognized the pain as harmless and their brain did the rewiring for them. For many though, it's not that easy and they have to "do the work" instead. The idea of neuroplasticity seems to suggest that, for specific pain, we might be able to skip the work. I have gotten annoyed when I see Sarno not getting credit (in Gordon's book for example) or on TV shows about pain management - but really much of Sarno's idea was tied into this inner-voice and our rage - so the reason they're not giving "credit" is because of that aspect being unnecessary.

Sorry some of that is a bit incoherent but it's helpful for me to write this stuff here, it's a bit of a journal process I guess.

 

[Mr Hip Guy]

My knee continues to get better and better, it's at the point where I don't even know if I can quantify a % like I was doing in all the posts above. Less than 5%? and that is despite doing a 3+ hour bike ride this past weekend. This is really working for me.

A couple of observations that I want to record though:

- There was a special on PBS hosted by Deborah Roberts (past ABC news reporter and wife of Al Roker) about Pain and Neuroplasticity of our Brains etc. Very interesting, but it was funny how Sarno or TMS was never brought up

- I noticed on my early morning run this morning, I let my mind wander towards a running race I had coming up soon and there was a particular stretch on the race course that is always very difficult and I call it the "hot box" because that's where the race is made. As I was having this thought I had a massive twitch and shot of pain in my back flare up. I don't usually deal with back pain but I recognized this as TMS "trying something" due to the apprehension and anxiety this thought brought about.

 

[Notters_1983]

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 keep getting paid after about 5km or so of running, to the point that I can run no longer. Does this mean it isn't TMS? I'd pretty much convinced myself that it must be.

 

[Mr Hip Guy]

I think we'll need to hear more details in order to give any kind of answer? Pain/discomfort after a period of running time could just be adaptation to the running stress.

Also, it's possible you've created a conditioned-response where you expect to feel pain after a certain point. This is no different than someone that, for example, might only feel pain a couple of hours after an activity.

 

[Mr Hip Guy]

Aaaaaaaaaaaaaaand, it's time for a relapse.
My TMS heard my bragging in a recent post about being 95%+ cured and decided to give me a good wake up call that it's still here.
So I've had some knee pain in the last 4-5 days. The good news is that it's as illogical as ever and therefore I can easily recognize it as such instead of spiraling down the "it's structural" drain.
One day I will truly have this behind me and I'll be able to say "hey, I haven't felt pain in my knee in weeks" but I'm not quite there yet. But I DO have moments where a certain movement or flexing that used to elicit pain without fail now doesn't have any feeling at all. I call that progress.

 

[Mr Hip Guy]

So it's no surprise that the pattern I follow is to feel better mid to late week and into the weekend, then symptoms ramp up by Monday AM, sometimes even Sunday night. Clearly I have some issues with work, or at least the work week, that I need to figure out.

All that to say that my knee pain settled down ALOT in the past couple of days as I did some TMS "work." What's funny (or not, now that I can recognize this sort of thing) is that couple of other symptoms popped up to try to distract me.

- An awful wrist pain in my right wrist (which I use for my mouse at my home desk). It was really bad midday Wednesday until I focused specifically on it as a TMS symptom and I woke yesterday morning with all the pain gone. It's tried to come back a little though.

- A classic "crick" in my neck that came on Tuesday morning. Now, I've had these happen before where they lasted for over a week. No amount of massage or heat or stretching would fix it but nowadays I recognize these as TMS and they last at most a day or two. It was gone yesterday morning.