TMS and Future Thoughts

Hello, I've been reading some posts on here about TMS and running/sports injuries. They've been helpful and I'm wondering if anyone has had a similar experience as what I've had the past few years, which is TMS seemingly waiting until you think you're over it--and happy about being over it--to pop back up.

For about five years now I've gone though what I once described to someone else as the entire "encyclopedia of running injuries." All the usual "overuse" suspects: shin splints, plantar fasciitis, IT band syndrome, piriformis syndrome, extensor tendonitis in my foot, labral tear on left hip, SI joint dysfunction in my right hip, calf strains, peroneal tendonitis, etc.

Some of these I overcame, such as an MRI-confirmed labral tear in my left hip, by unknowingly using TMS strategies before I'd even heard of TMS.

To his credit, after my MRI my ortho said he no longer did labral tear repair surgeries and they weren't very effective and that in fact most people had labral tears without knowing it. When I heard that (five months into the pain), I resolved to just start running again no matter if it hurt. The pain went away completely within two months and has never come back.

However, a pattern started to emerge: I would do well with my running routine for about 8-10 weeks, then just as I was gaining fitness, feeling good about my progress, and starting to think positively about future goals and events I wanted to do, a new injury would crop up. Then I'd do the smart conservative thing and take a few weeks off to let it heal and start back up again, only for a new injury to crop up in 8-10 weeks. This has gone on for the last 4-5 years and nothing I do has seemed to make a difference in terms of strength training, slowly increasing mileage, etc., all the things you are supposed to do to stay healthy. There's no reason I should be getting injured this frequently and always in a different spot in the same timeframe.

This past year I learned about TMS after a terrible bout of pelvic pain. It took me about six months to recover after seeing multiple doctors, specialists, and PT, etc. One doctor wanted to do a pretty gruesome sounding surgery. I said no, thankfully. Finally, similar to my labral tear, I got better by applying TMS principles without realizing that's what I was doing. Then I had a relapse last summer, which was frightening but which was also inexplicable from a structural viewpoint, and it was then I discovered Dr. Sarno and started reading about TMS and a lot of what I'd been through started to make a lot of sense.

I've since recovered again from that and gotten back to full activity, but, unfortunately, this cycle of running injuries has resumed. It's the same pattern. I've been able to get in pretty good shape this winter, but now my right hip hurts pretty badly, and it has hit exactly at the time when (1) I started feeling confidence and positivity in my progress and (2) if I take time off to heal I'll miss my goal event this spring. This is the usual pattern.

What I'm struggling with is that for some of these conditions it's fairly easy to rule out structural issues or the fear of the "worst case scenario" isn't all that scary, like if the pain is a tendonitis in my foot. The hip is more enigmatic in that there's a lot going on in and around that joint, it's a "new" pain so it's harder for me to chalk up to TMS, and there's always the "ultimate fear" of a stress fracture that is of course an actual structural problem.

Does TMS just "know" how to strike at the time to inflict maximum psychological damage and induce maximum fear? That's what it seems like to me. It always seems to hit me when I'm at a high point and allowing myself to look forward to a future without being restricted by pain rather than when I'm wallowing in a low point.

 

Do you love running? Is running fun to you or a tool to get fit physically like everybody says to do, another necessary task to be checked off? Have you tried other physical activity and also experience that type of repeated injury? Is it possible that your brain senses that you don't actually like running that well and then running injuries just happen in cycles so you could take a break from running?

 

That is the very definition of TMS. It wants to distract you from your feelings. Whatever scares you the most —or makes you feel the most defeated, like your life is over as you know it—that is what it will do.

Have you read anything by Dr. Sarno? He explains it.

 

I've been there. Look up my threads here by clicking my user name and viewing my threads. You'll find some comfort there.

in my opinion, I'm not so sure that TMS and/or your subconscious and/or your "brain" is quite so devious as to "strike when you aren't looking" - instead, I think what happens is that a) it just strikes, regardless of WHEN and/or b) it strikes something ELSE when it thinks it can fool you with the old location/spot.

But in the end, it's a moot point as to "why" - the fix is the same either way. Good luck!

 

To the earlier commenters point, I don't think the above is coincidence.

While you might enjoy doing race events, there is some part of your subconscious that DREADS these things. All the build up...the training...the worry/angst about fitness, the weather, potential illness, performance, etc ...the physical PAIN of the event itself, and the fear of that pain.....is VERY STRESSFUL and your subconscious could very well be trying to prevent the whole thing from happening by cropping up a TMS symptom every time you think about signing up for a race. I've had this happen to me.

 

When you're inviting yourself back to your regular life, TMS sees it as a terrible danger and spikes the symptoms to throw you back to bed. It might look like a catch-22 situation but it's not. Each time you do that you create new neuropathways. Eventually you'll have created enough for the brain to start choosing this new road, instead of the painfull one.

 

Really great responses in here! One thing you may also want to think about is how much pressure you are putting on yourself. Are you taking some breaks, a day off, or are you pushing yourself and beating yourself up to reach a certain goal or milestone? I love to exercise but when I begin to put too much pressure on myself to do it daily and treat myself unkindly, I get a little twinge here or there. That's when it's time to reflect and think, woah, I'm not being loving and kind to myself, let's dial all this pressure back.

 

That may certainly be part of it. There is pressure and stress associated with the events, for sure, even though I do enjoy doing them. And I also enjoy running and being in shape when it doesn’t hurt!

My suspicion is rather high that this latest hip issue is a structural issue, possibly a stress fracture. But I have been wrong on that before. Hoping I’m wrong again but I’m going to get it checked out to be sure.

I see Mr Hip that you’ve been convinced of a stress fracture before only to be given the all clear. But also that you’ve had a couple stress fractures as well.

Even though I have experienced first hand how well TMS can mimic very painful structural problems, every new manifestation is hard to get a handle on. As I sit here now I would say my current, quite painful hip symptoms are textbook stress fracture. Of course my recent bout with plantar fasciitis was textbook PF as well—until it went away after a few months by me ignoring it!

 

Yep, I also suspected a pelvic stress fracture only to be surprised by an MRI that said torn-labrum - which led me to a surgery - which led me to Sarno/TMS/here.

Sarno always says to get checked out by a Dr first - but depending on their diagnosis, determine then how to proceed. Stress fracture is going to show up really quick and has a clear plan for recovery (cessation of activity for 6 weeks). Soft tissue issues are a different animal altogether and I would urge you put on your TMS hat for those.

 

The common joke is that "I love running - when I am done." - or - "I love HAVING run."

Meaning, if we are truly being honest - none of us enjoys pain/discomfort and there is almost always that when run training. But you enjoy the BENEFITS from a running lifestyle. Our TMS brain doesn't see the long game though, it's only concerned with "oh great, we're going to go do this running thing again - that SUCKS."

 

My husband LOVES running. He runs 5-9 miles per day either on a treadmill or outside. He has no pain, only some discomfort at times. He actually doesn't like the after effect (9 miles, and he tends to feel it), and he is almost 60. He did absolutely notice that when he enrolled in events like 5k's running (which is far less than he normally runs per day) he did feel pain, and would be really hard on himself because he's a push to win or at least push to be best in his age bracket, and always had to better his timing etc. For this reason he runs only for enjoyment. It's meditative for him now. He can empty his mind and just go.

 

UPDATE: I ended up going in to see an orthopedist who recommended an MRI to see about possible stress fracture in the hip. The results are femoroacetabular impingement due to "asphericity" and fraying of the labrum with no tear. No stress fracture, which is great news.

The evidence I'd gathered supporting TMS prior to getting imaging were:
1. Pain came on at a very "coincidental" time that lined up with a pattern of me getting pain related to running.
2. Pain moved locations from groin to hip to back again.
3. Pain worsened with stress at work and home, got better when I wasn't thinking about it (but never went away).
4. When pain started, my foot pain ("plantar fasciitis") that I'd had since September and had been ignoring spontaneously resolved.
5. I had an infected tooth extracted in 2023, and the oral surgeon told me my tooth was one of the top 10 hardest he'd ever worked on in his three decade career (i.e., my bones are probably very strong as well).
6. Pain seemed to get worse when I was putting on my running clothes and shoes .
7. I noticed it didn't hurt to go up stairs, even at a quick pace, but absolutely killed as soon as I started running.

The evidence making me question a structural issue:
1. It hurts really bad, worse and a different quality than my other running-related TMS issues
2. The pain came on insidiously and seemed to get better with rest and worse with activity
3. I miserably failed the "single leg hop test" that is a hallmark symptom of a stress fracture, and other tests in the doctor's office indicative of a fracture or structural issue.
4. I completed a marathon in December, only took three weeks off, and then ramped up my mileage quite a bit to get ready for a spring marathon, which is typical prior to a stress fracture.
5. Non weight bearing exercise doesn't hurt, but it hurts to load/unload that leg, suggesting a bone rather than soft tissue problem.
6. Pain moving around from hip to groin is also a symptom of a stress fracture in that area, so I couldn't really rely on that evidence as TMS.

I know a lot of people have surgery for FAI. I don't think there's any chance I'll ever be doing that. When I was diagnosed with a labral tear in my other hip in 2021, there was no mention in that report of the "asphericity" of my right hip. It said my right hip was normal. When did it get aspherical? Just three weeks ago?

I'm supposed to do this marathon in April. My TMS brain seems to not want me to do it. Part of me wants to tell TMS brain to go away and leave me alone. Another part says well maybe TMS brain has a point. Maybe you don't really like doing this stuff all that much because of the pressure, stress, angst, etc. associated with the training and build up, even though you really do love the rewards of having done it.

Anyway my hip still hurts but I'm really glad I don't have to be on crutches the next 6-8 weeks. Whether I resume running or not, or, more specifically, hard training, is something I have to think about.

 

It sounds like TMS and the complicated diagnosis would confuse things. Why do you want to do the marathon? Is it something really fun to do? Or is it something to prove yourself, something to achieve so it looks good to others and your self-image? If you don't have to prove to anybody including yourself, would you still do the marathon? Or is it ok to do it without specifica goals, just participation is good enough? Or you just want to run and be physically active and feel good in general? There is a deadline here for the event too, you have the pressure to get better by then.

 

That is literally what FAI is. It means your hip "ball" is not round enough to merge with your hip "socket" and after a lifetime of activity it will tear the labrum (which operates kind of like a gasket) and supposedly cause pain. However, studies have found 80% of cadavers have these tears and never reported any pain (ha ha, of course they didn't they were dead!).

FAI is a common diagnosis and is exactly what my surgery fixed. I had my labral tear repaired (stitched back into place) and my impingement "fixed" (they ground down the bone - I know, gruesome). Feel free to look up my thread on this. It's where my username comes from.

 

Truly easy (i.e. Zone 1) running can be non-painful, which sounds like what your spouse is doing - but even then I would argue it's probably not something a subconscious, inner-child would want to do. And any non-easy running (like for races) is decidedly painful.

 

Evidence lists are one of the most effective means for me to combat TMS. Others I like to recommend:

- Reading success stories here (and the Support forum)
- Listening to Podcasts (I like Eddy Lindenstein's "Mind and Body Fitness")
- Reading and re-reading Sarno's books (or other authors in this area)
- Remembering and reciting Sarno's 12 daily reminders
- Keeping a light heart about all this (this might mean a sense of humor or whatever - but the point is to not worry)

 

He runs at least zone 2 and probably zone 3 much of the time. Again, he feels it uncomfortable at times, but not painful. It's interesting in what we perceive as painful can vary from individual. I mean, he gets a 1 degree temperature and he is beyond uncomfortable and has little tolerance for it. But ask him to run like a maniac and he'll gladly sweat out every inch of liquid in his pores and he is fine. He often says he'd be fine continuing to run much longer distances, but he gets hungry and can't tolerate the hunger!

 

I listen to Eddy frequently. I heard your episode recently Mr Hip!

My orthopedist told me FAI is kind of a trendy diagnosis and he wouldn’t do anything about it because my femur has been this way my whole life and the worst thing that can happen is it hurts. He mentioned the bone shaving surgery, but he doesn’t recommend it at all.

My other hip already has a labral tear in it and has stopped causing me any pain even though I assume it’s only gotten worse!

So now that a stress fracture has been ruled out I’m going to treat it as TMS.

 

You have a pretty good orthopedist!