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 Saw knee Dr. - need your opinion/suggestions
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Inferno

15 Posts

Posted - 08/08/2006 :  21:56:28  Show Profile  Reply with Quote
Hi all,

I hoping that several of you might respond with your opinions concerning a knee Dr. that I saw today. As I have mentioned in previous posts, I have had knee trouble, and although I believe in TMS, I wanted to rule out any physical problems by visiting an orthopedic Dr.

In a nutshell, the Dr. took an MRI which basically showed that I had a "small" tear(s) in both my medial and lateral meniscus (cartilage pads) in my right knee. It also showed that my ITB (Ilotibial band) tendon showed tendonitis (for lack of better words). This particular Dr. is very well respected (Dr. Steadman in Vail, CO) and I respect what he has to say. Suprisingly he did not show too much concern about the meniscal tears, even pointing out that in studies that 30% of asymptomatic people have meniscus tears. Infact, most people over 50 tend to have them. This seems consistant with what Sarno says, ie...meniscus tears are a product of aging (like gray hairs).

Sarno claims tendonitis is a TMS equivalent. What I am curious about is this: If tendonitis is TMS, and TMS is harmless, how does Tendonitis show up in an MRI as "abnormal" or enlarged. Almost all Dr.'s would argue that Tendonitis is an Inflamation of the tendon (supposedly documented in studies), yet Dr. Sarno claims there is no inflamation in TMS. By the way, Dr. Steadman prescribed Celebrex for the "inflamation".

I guess I'm wondering how can I get past this Tendonitis and meniscus thing, when in the back of my mind I worry that I might be further "inflaming" the tendon or further "tearing" the meniscus? Ironically, I went to the orthopedic Dr. to rule out a physical problem, but now I've just returned with a physical problem on my mind. I almost wish that I had not gone. Any suggestions?

Thanks in advance

wrldtrv

666 Posts

Posted - 08/08/2006 :  23:38:43  Show Profile  Reply with Quote
Hi Inferno,

Without addressing the TMS possibilities in your question, I can say that IT-Band Syndrome is an EXTREMELY COMMON symptom, espec in runners. Are you a runner? It really is no big deal, nothing to worry much about; more of an annoyance. I had it chronically (a few yrs) many yrs ago and then it disappeared. I don't know why because I didn't do much different. Maybe it was TMS. Or maybe the orthotics helped. Or the strengthening or stretching. Or running smarter.

By the way, I'm surprised your doc prescribed Celebrex. I thought it (and Vioxx) were taken off the mkt last year.
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marytabby

USA
545 Posts

Posted - 08/09/2006 :  04:35:51  Show Profile  Reply with Quote
I have tendonitis in my wrist and thought it was TMS. TMS doc said it was last year, now it's back and he says it's not TMS, and maybe never was. MRI showed evidence of the tendonitis and my symptoms won't go away with all the TMS work this time around. Only option left is surgery. I am torn, because on one hand I want to believe it's TMS but on the other hand it's not going away like it did last year and I'm in so much pain that it's become difficult to use the hand. I am not sure about your situation but since we both have tendonitis I figured I'd reply.
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art

1903 Posts

Posted - 08/09/2006 :  05:16:41  Show Profile  Reply with Quote
quote:
I went to the orthopedic Dr. to rule out a physical problem, but now I've just returned with a physical problem on my mind. I almost wish that I had not gone. Any suggestions?


This is the problem with going to physicians. They find things. It's what they do.

Were it I, I'd forget the meniscus stuff. But the fact that the tendonitis shows up on your mri might bother me some...

I'm personally confused about this whole inflamation issue..I've had swelling that was TMS, but I keep coming back to Sarno and his non-inflamation position...He ought to know, eh?

Maybe Dr Z. would be good enough to chime in, or you could even send him an e-mail.

I try to stay away from all doctors for just this reason..I juts assume it's all TMS...One of these days i;ll be wrong and they'll have to carry me home on a stretcher, but until that day I'm going to stay the course..
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Nor

152 Posts

Posted - 08/09/2006 :  05:38:19  Show Profile  Reply with Quote
I believe TMS can cause inflammation but that its emotionally driven and not physical. Look at IBS (irritable bowel syndrome) and skin issues. Those are clearly inflammatory processes but Sarno calls them equivalents of TMS. I'd try not to get hung up on the inflammation issue and just call it TMS. I know others may not agree but if it causes pain, why don't you try icing instead of meds and really focus on the emotions simultaneuosly?

Nor
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Inferno

15 Posts

Posted - 08/09/2006 :  06:58:23  Show Profile  Reply with Quote
Thanks for the responses thus far, keep em coming please....


Maryalma8 - Seems to me if the symptoms left for a time, and then came back, that would indicate TMS to me. Sarno seems to indicate that most tendinitis is TMS. I guess we are both in the same boat wondering when something is TMS and when it is not.

Thanks Nor - I suppose that I can't get too caught up in the "inflamation" thing, just work the mind/body angle.

WrldTrlv - I'm not a runner...at least much. Tennis and mostly walking, cycling. Ironically, I have not done too much in the last 6 months because of the pain. You'd think the "tendonitis" would have simmered down by now.

Art - I'd love to make the leap of faith...telling my mind to do it seems to be a different story. I've been telling my knee for several months now that it is TMS, but it is not listening. I agree that docs are looking to "find something", but even Sarno suggests that you "rule out" things. I'm sorry now that I tried to "rule out" anything.
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h2oskier25

USA
395 Posts

Posted - 08/09/2006 :  07:11:40  Show Profile  Reply with Quote
quote:
I juts assume it's all TMS...One of these days i;ll be wrong and they'll have to carry me home on a stretcher


Art, I couldn't have said it better myself. Avoiding Dr's works well for me. There was a time when I had soooooo many . . .

Inferno, you live near Vail, that's so COOL. I'm 5th Generation denverite and I miss Colorado a lot.

Re: inflammation, I don't get worried about it. If the brain can restrict oxygen to a specific part of the body, it can sure cause inflammation.

Beth
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Susie

USA
319 Posts

Posted - 08/09/2006 :  08:01:07  Show Profile  Reply with Quote
Art, I'm with you. I really try to stay away from doctors. My family says when they carry me out with a heart attack,I'll be sure it is tms. Someone said once,maybe Tom, unless there are bones sticking out or blood running out, I'm not going to the doctor.
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Dave

USA
1864 Posts

Posted - 08/09/2006 :  09:26:40  Show Profile  Reply with Quote
My brother has knee pain. He's obese, so it's a combination of too much weight with some TMS siezing the opportunity (he's getting married soon).

My whole family (who do not buy into TMS) lead him down the medical path. He saw one orthopaedist who told him to take Advil. This doctor probably did the right thing. Yet, my family was outraged. No MRI? Advil? Is he kidding?

I joked at the dinner table one night that he should just keep seeing different doctors. At some point one of them will recommend surgery.

Sure enough, doctor #2 ordered an MRI and surprise -- it revealed a torn meniscus. He's going for arthroscopic surgery and my family couldn't be happier.

A tear on an MRI is not necessarily a tear. My brother is not an athelete and he did not have any actue injury. His obesity combined with his job (forcing him to stand all day) puts too much weight on the knee.

Now I just hope he has a nice placebo cure from the surgery. All I can do is laugh to myself and turn the other cheek. My family is hopelessly brainwashed, as are most people in this world, to seek invasive medical treatments.
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tennis tom

USA
4749 Posts

Posted - 08/09/2006 :  10:23:45  Show Profile  Reply with Quote
Great post Dave! That's TMS in a nutshell.

Regards,
tt
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art

1903 Posts

Posted - 08/09/2006 :  12:50:01  Show Profile  Reply with Quote
quote:
My family says when they carry me out with a heart attack,I'll be sure it is tms. Someone said once,maybe Tom, unless there are bones sticking out or blood running out, I'm not going to the doctor
.

I love this attitude. It just makes things so much simpler. For the first time in years I feel free.

Plus, I truly despise the whole doctor experience..The waiting, the insurance crappola, the usual arrogance both from doctor and staff...
HOnest to God, it's enough to bring on an attack of TMS..
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marytabby

USA
545 Posts

Posted - 08/09/2006 :  15:04:31  Show Profile  Reply with Quote
What is one to think when even the tms doc says it is structural?
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drziggles

USA
292 Posts

Posted - 08/09/2006 :  16:14:18  Show Profile  Reply with Quote
Regarding the earlier inflammation issue, I would say that the mechanism of TMS is still not well understood, despite the good Dr. Sarno's explanation; it is the flimsiest part of the TMS concept. Even Sarno would admit there is not much evidence backing up his proposal, and it is but a speculation. "Altered blood flow" does little to explain migraines, joint pains, fatigue, and many other symptoms of TMS. Research is needed, though I am not holding my breath for it to happen, since no one stands to make any money from it!

Inflammation may play a role in some aspects of TMS, such as tendinitis, so finding abnormalities on an MRI does not surprise me. There is not enough good evidence, in my mind, to know for sure.

And, btw, iliotibial band syndrome hurts like hell! TMS techniques can prevent it from happening; once it's flared up, however, nothing would make it go away until it ran it's course over a day or two...
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art

1903 Posts

Posted - 08/09/2006 :  16:22:33  Show Profile  Reply with Quote
quote:
Originally posted by Maryalma8

What is one to think when even the tms doc says it is structural?



If I'd worked as hard as you Mary, all to no avail, and was being told by my TMS doc that it was probably structural, I'd be ready to believe him...

I think it's important not to feel in any way defeated..If something's structural its structural, and all the mind/body work in the world won't alter that.

quote:
Regarding the earlier inflammation issue, I would say that the mechanism of TMS is still not well understood, despite the good Dr. Sarno's explanation; it is the flimsiest part of the TMS concept. Even Sarno would admit there is not much evidence backing up his proposal, and it is but a speculation. "Altered blood flow" does little to explain migraines, joint pains, fatigue, and many other symptoms of TMS. Research is needed, though I am not holding my breath for it to happen, since no one stands to make any money from it!

Inflammation may play a role in some aspects of TMS, such as tendinitis, so finding abnormalities on an MRI does not surprise me. There is not enough good evidence, in my mind, to know for sure.

And, btw, iliotibial band syndrome hurts like hell! TMS techniques can prevent it from happening; once it's flared up, however, nothing would make it go away until it ran it's course over a day or two...


THis is very helpful to me, and though I'm a total layman, I've always thougt the whole blood flow thing was pretty speculative...
It seems to me that while it sounds good to have such a simple explanation, it's probably not even necessary...Isn't it quite possible that the mind simply perceives pain in a given area? To me that's an even easier explanation with wider application..

YOu were very helpful to me doc with the whole illiotibial thing...just as you say, no way you can stop that pain process once it starts...in fact for me it just continues to get worse until I have to stop running for that day and usually walk home...But I kept running my 3 or 4 times a week, and finally I started to have runs with no knee pain...since that time,I've had no problems at all with it/


Edited by - art on 08/09/2006 16:45:40
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Tunza

New Zealand
198 Posts

Posted - 08/10/2006 :  01:00:47  Show Profile  Reply with Quote
Page 99 of Sarno's "The Mindbody Prescription":

"Although it is less common, swelling of the knee may accompany tendonitis. When I first became aware of this I felt a little insecure about advising the patient that it was part of TMS. In the light of consistent success in treatment, I am now quite comfortable with the diagnosis"

He also refers to Meniscus tears on this page and the page before but it is too much for me to type out as I am meant to be doing some work, not reading the TMS forum. Couldn't resist chiming in though.

Hope this helps.
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