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GIANTSteps
USA
6 Posts |
 Posted - 08/21/2013 : 13:28:39
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Hi all, this is my first post here, as I've only known about TMS for a couple weeks. I've read 2/3 of Healing Back Pain (up through the "Classic Diagnoses" chapter) and will probably finish it tonight.
I've been suffering with runner's knee for the past 15 months or so, and am a classic TMS case (though I've not been formally diagnosed with TMS, my pain has been called tendonitis, tendonosis, patellofemoral pain syndrome, anterior knee syndrome, and runner's knee). Xrays are normal except for a bipartate patella (no big deal) and MRIs are negative for any damage whatsoever. I've drastically improved since last winter, when I saw the scan and my doctor wisely told me "there's nothing wrong with your knee" and that there's no reason to avoid physical activity besides the pain (which was then attributed to anterior pelvic tilt and some minor biomechanical issues that I began focusing on). Needless to say, Sarno's book has been nothing short of enlighening - life changing really. I'm now progressing very well, running again without fear, and can't wait to have my 30+ days skiing this winter. This, however is not the purpose of my post.
What I'm having a hard time understanding still is whether there's a distinction between overuse injuries and TMS. Surely there is a limit on what our bodies can handle, and I would have to assume that at some point a pain reaction to excessive physical activity should be a healthy adaptation (to get one to stop pushing beyond their fitness/ability level to prevent real damage). To present an extreme example: Would I be correct to assume that somebody who's never run more than 10 miles is bound to produce a physically induce pain symptom (rather than a psychological/emotionally induced one), if they try to run a marathon without training?
Sarno's book makes it sound like tendonopathy is always attributed to TMS, but I think I may be misinterpreting this message, as the book doesn't spend much time on this topic. If my understanding about TMS is correct, there can be tendonopathy that is not attributed to TMS, in which case a pain response is elicited by simply doing way more than a body is physically prepared to handle. Please correct me if I'm wrong on this, as I really want a full understanding of the diagnosis. My thinking would then be that if the pain is persistent beyond a reasonable healing period, or becomes recurrent, then TMS is the likely cause (as in my case). Am I close to accurate with the above assessment?
I appreciate in advance your patience with this long-winded question, and am grateful to have this board as a resource. Looking forward to another pain-free lunchtime run! |
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eric watson
USA
601 Posts |
Posted - 08/22/2013 : 10:11:00
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Your pretty accurate
now stop thinking physical
and think psychological ok
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Dave
USA
1864 Posts |
Posted - 08/22/2013 : 11:53:48
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Seems to me you are already overthinking and you have not even finished the book.
I suggest you finish the book, then read it again. Focus primarily on the treatment suggestions, and less on trying to prove or disprove the theory to yourself.
I will say one thing: much of the evolution of the human body can be attributed to adaptation for running longer distances. |
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GIANTSteps
USA
6 Posts |
Posted - 08/22/2013 : 15:25:52
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Thanks both for the thoughtful replies, it's greatly appreciated as this is certainly a learning process.
Maybe I am overthinking a little bit, afterall this is a concept that's entirely new to me and one that goes against the grain of what medical professionals have been telling me my whole life. I realize that my initial post may be overly concerned with the physical aspects.
That said, I fully accept the fact that my pain is due to tension and repressed emotions and have no difficulty in acknowledging the psychological basis of my symptoms. Since my realization last winter that there's nothing structurally wrong with me, I've been able to "think" my way out of pain mid-run so effectively that I'd block out pain (that literally would cause me to hobble and limp) within 5 or 6 steps. I started being able to do this long before I ever heard of TMS, so the mind-body connection is loud and clear. The power of the mind was instilled in me at a young age by my grandfather, who should have died due bone marrow cancer (Waldenstrom disease) a decade ago. He is still living today and manages his pain with his outstanding psychological ability. He has never heard of TMS. Needless to say, reading Sarno's book has been revolutionary in reinforcing what I already suspected, but also in putting it all into context and giving it a scientific basis.
If I come across as trying to prove/disprove the theory, I absolutely am not. To me this is far beyond theory. Sarno himself states that TMS treatment requires a genuine understanding of the condition, the contributing factors to the symptoms, and of the treatment itself (but that the physiology is rather unimportant). As such I think it's only fair that I gain as much understanding as possible, and my question is presented to further my understanding of the condition, not to question the so-called "theory" (again a word that I don't like to use here).
Anyways, I hope I clarified the intent of my original post some, and that's simply to generate some discussion in an area the Healing Back Pain book (understandably) spends little time on. I'm really just wondering what kinds of overuse injuries can be real injuries that need rest.
Maybe a better question would be "When did you know your 'overuse' injury was TMS?" Perhaps it doesn't matter at all, but the book spends a great deal of time on the minute details of TMS back pain issues so I thought equal understanding on other manifestations of TMS may be appropriate. |
Edited by - GIANTSteps on 08/22/2013 16:21:00 |
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Peregrinus
250 Posts |
Posted - 08/22/2013 : 16:15:23
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GIANT:
You must realize that TMS is not an “either-or” proposition. Pain can be caused by injury or as a result of illness and then aggravated by psychological stress. Vigorous exercise can be expected to result in painful muscles and joints and merely tells us that we gave ourselves a “good workout”. I don’t think it is unusual to unconsciously fear exercise and thereby experience pain before and immediately after our workout commences. I also think it is a good idea to affirm your fitness before a workout and then to congratulate yourself afterward and affirm that your workout demonstrates that you are OK. As I recall, it was Sarno who pointed out that seriously wounded soldiers were successfully relieved of pain by reassuring words. |
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GIANTSteps
USA
6 Posts |
Posted - 08/22/2013 : 16:25:43
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Peregrinus - well said! That's what I was thinking, but having a hard time communicating.
"and affirm that your workout demonstrates that you are OK" - I especially like this. Half way through yesterday's run, I said out loud "Hey knees, watch this!" and took off in a flat-out sprint for about 100 yards, jogged another 1/4 mile before breaking into another sprint. How do I feel today? Better than yesterday! |
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Dave
USA
1864 Posts |
Posted - 08/22/2013 : 16:51:43
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quote:
Originally posted by GIANTSteps
Half way through yesterday's run, I said out loud "Hey knees, watch this!" and took off in a flat-out sprint for about 100 yards, jogged another 1/4 mile before breaking into another sprint. How do I feel today? Better than yesterday!
This is perhaps the most important part of it all. Your behavior towards the symptoms is more important than any deep understanding of how TMS works. Recovery is primarily about reconditioning yourself. Don't be surprised if your brain "ups the ante" by making the pain worse or giving you different symptoms altogether. TMS does not go down without a fight.
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GIANTSteps
USA
6 Posts |
Posted - 08/22/2013 : 17:32:06
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quote:
Originally posted by Dave
Your behavior towards the symptoms is more important than any deep understanding of how TMS works. Recovery is primarily about reconditioning yourself. Don't be surprised if your brain "ups the ante" by making the pain worse or giving you different symptoms altogether. TMS does not go down without a fight.
...And it's just incredable what an impact behavior and attitue really make!
What really flipped the switch to believing the diagnosis is the fact that my pain could be severe in either knee, anywhere (above/below, medial/lateral) around the structure, and often unpredictable... What kind of crap is that? It's just not how real injury works. Just to think I missed out on a year of running, cycling, rock climbing, skiing, backpacking, softball, etc, etc. just because I had given in to the physical pain and assumed I was injured. "I just have bad knees" was my answer. It's downright embarrasing to think about, but the pain was so real! |
Edited by - GIANTSteps on 08/22/2013 17:33:13 |
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tennis tom
USA
4749 Posts |
Posted - 08/22/2013 : 23:08:46
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quote:
Originally posted by GIANTSteps
Anyways, I hope I clarified the intent of my original post some, and that's simply to generate some discussion in an area the Healing Back Pain book (understandably) spends little time on. I'm really just wondering what kinds of overuse injuries can be real injuries that need rest.
You're a very good writer BTW. Dr. Sarno has said: "If it's too heavy to lift, you wouldn't be able to lift it." Regarding "over-use" injuries, speaking as an amateur athlete, I would say the muscles would fatigue before you could injure them, baring injuries from trauma. I've done thirteen marathons and never injured anything. I did the 7.6 mile Bay to Breakers Race as a lark for the first time, after an all night party at a friends's house, not being a runner and not having done any training for it. I ran the first 3.5 miles without stopping and then walked and ran the last half of the race. If you could get injured by overuse, that should have done it to me. I was painfully SORE and could barely walk for a week afterwards but did not get injured. Like my yoga teacher says, "The mind gives up before the body".
==================================================
TAKE THE HOLMES-RAHE STRESS TEST
http://en.wikipedia.org/wiki/Holmes_and_Rahe_stress_scale
Some of my favorite excerpts from _THE DIVIDED MIND_ :
http://www.tmshelp.com/forum/topic.asp?TOPIC_ID=2605
==================================================
"It is no measure of health to be well adjusted to a profoundly sick society." Jiddu Krishnamurti
"Pain is inevitable; suffering is optional." Author Unknown
"Happy People Are Happy Putters." Frank Nobilo, Golf Analyst
"Be careful about reading health books. You may die of a misprint." Mark Twain and Balto
"The hot-dog is the noblest of dogs; it feeds the hand that bites it." Dr. Laurence Johnston Peter
"...the human emotional system was not designed to endure the mental rigors of a tennis match." Dr. Allen Fox
======================================================
"If it ends with "itis" or "algia" or "syndrome" and doctors can't figure out what causes it, then it might be TMS." Dave the Mod =================================================
TMS PRACTITIONERS:
John Sarno, MD
400 E 34th St, New York, NY 10016
(212) 263-6035
Dr. Sarno is now retired, if you call this number you will be referred to his associate Dr. Rashbaum.
"...there are so many things little and big that are tms, I wouldn't have time to write about all of them": Told to icelikeaninja by Dr. Sarno
Here's the TMS practitioners list from the TMS Help Forum:
http://www.tmshelp.com/links.htm
Here's a list of TMS practitioners from the TMS Wiki:
http://tmswiki.org/ppd/Find_a_TMS_Doctor_or_Therapist
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PJ77
United Kingdom
44 Posts |
Posted - 08/23/2013 : 05:00:04
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Dave,
I have often read your encouraging posts and you always mention "recondition yourself". What would you say was the most effective method you found for doing this. I have read Ace's Keys and printed them and re read them several times and am using them, but was wanting to know what you do/did to recondition yourself.
Thank you. |
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Dave
USA
1864 Posts |
Posted - 08/23/2013 : 09:10:20
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quote:
Originally posted by PJ77
I have often read your encouraging posts and you always mention "recondition yourself". What would you say was the most effective method you found for doing this...
There is really no magic to it. It is simply repetition and time.
Every time you are aware of the symptoms, accept them as benign. Treat them as a signal that you might be repressing something. Maybe something happened recently in your life that has stirred up some negative feelings that you are not fully in touch with. Try to figure out what it might be.
Instead of focusing on the pain, you are focusing on your emotional state. It is impossible to know exactly what triggered the TMS pain, or even if there is a specific trigger. That does not matter. It is the act of trying to figure it out that is important.
If you do this on a regular basis, it sends a message to your unconscious mind that the symptom is no longer grabbing your attention. Therefore it ceases to serve its purpose. Over time the symptoms fade on their own. You might always get them in some manner, but they are inconsequential to your daily life. They are nothing more than a temporary nuisance. In many cases you might not even notice them.
I believe it is critical to take a long-term view of recovery and not try to monitor your progress. Trust that over time the symptoms will fade on their own. Whether it takes weeks or months or years does not matter, because you have already disarmed them. Long before the symptoms fade, they have lost their power over you. That is the real goal. |
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GIANTSteps
USA
6 Posts |
Posted - 08/23/2013 : 15:58:17
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quote:
Originally posted by tennis tom
You're a very good writer BTW. Dr. Sarno has said: "If it's too heavy to lift, you wouldn't be able to lift it." Regarding "over-use" injuries, speaking as an amateur athlete, I would say the muscles would fatigue before you could injure them, baring injuries from trauma. I've done thirteen marathons and never injured anything. I did the 7.6 mile Bay to Breakers Race as a lark for the first time, after an all night party at a friends's house, not being a runner and not having done any training for it. I ran the first 3.5 miles without stopping and then walked and ran the last half of the race. If you could get injured by overuse, that should have done it to me. I was painfully SORE and could barely walk for a week afterwards but did not get injured. Like my yoga teacher says, "The mind gives up before the body".
Thanks for the compliment :) That's a great account of your experience with this. Always wanted to run B2B, by the way - it's always "next year...".
I swear every single passing day since realizing my real diagnosis has been better than the one before. This is like a new lease on life, to use a dreadfully overused term.
Today when I was running on my lunch break, I felt just a little discomfort in my left knee. "Oh no you don't..." I broke into a 150 yard sprint. Discomfort gone. Whoa. |
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PJ77
United Kingdom
44 Posts |
Posted - 08/26/2013 : 02:57:46
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Dave,
Thanks for your explanation regarding this. However I have been doing this for a good 2 years, but I have found doing this is not enough on its own. I have had a quite a spasm in my lower back 3 weeks ago and I have been doing the TMS recovery for the past 18 months. I cannot seem to ease this off, unfortunately I have tried to figure out what it could be but no luck so far. However my movement is getting less and less with each day, rather frustrating and not sure where to go next. I had been doing quite well the past 5 months but this one does not want to ease off. |
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Dave
USA
1864 Posts |
Posted - 08/26/2013 : 16:00:29
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quote:
Originally posted by PJ77
Thanks for your explanation regarding this. However I have been doing this for a good 2 years, but I have found doing this is not enough on its own ... I had been doing quite well the past 5 months but this one does not want to ease off.
Are you sure that you have examined any potential life changes that might be affecting you on a deeper level than you realize? Sometimes it is not obvious. It may be something that on the surface seems "just fine" but is in conflict with what the "child inside us" wants.
If the pain persists Dr. Sarno would prescribe psychotherapy to help uncover the potential sources of rage. Even if you do not subscribe to the "unconscious rage" metaphor of TMS, it may be helpful to look at things from that perspective.
Also consider that the symptoms that persist are the ones that succeed in grabbing your attention. So as hard as it is, try to find a way to ignore them and resume physical activity even if you have to push through the pain.
Of course, any pain that persists should be checked out by a physician to be certain that there is nothing seriously wrong. |
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PJ77
United Kingdom
44 Posts |
Posted - 08/27/2013 : 03:47:45
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Dave,
I've suffered from TMS symptoms all my adult life (for the past 18 years), whether it is anxiety or severe lower back pain. I have known about TMS for the past 7 years and successfully overcame my back and neck issues then, which then followed by anxiety and acid refulux. As my anxiety levels shot up (I was working 90 hours a week) I have been since crippled by severe lower back pain for the past 30 months.
I have had the usual MRI's showing herniated/worn out discs (scans taken 10 years ago, not had any since), the usual stuff, "if it does not resolve we will operate" but go for physio first. I have been diagnosed by 2 different TMS specialists as having TMS, but with all the journaling this has not helped either.
I have had counselling for 10 months with no improvement, EFT also as well as hypnosis.
All I can say is when I feel good in myself and also when relaxed, the pain is easier. Otherwise when not feeling this way, the pain can be crippling. It certainly does get my attention at the lower back, and I am not sure I have overcome my fear of it. However last week I thought I overcome the fear but then with my constant worrying nature (i am always planning ahead) it went into spasm. |
Edited by - PJ77 on 08/27/2013 03:51:10 |
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Dave
USA
1864 Posts |
Posted - 08/27/2013 : 10:18:44
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The fact that you add EFT and hypnosis to the mix makes be wonder if you have truly committed 100% to the TMS diagnosis, or still searching for a "cure."
Don't get me wrong, I am certain that you fully understand the TMS concepts and agree that they apply to you, and have even accepted the benign nature of the symptoms. However, in my opinion when you reach a point where you truly accept TMS symptoms as part of your life, and stop searching for new and better techniques to rid them, it gets easier.
I realize that it is easier said than done. The path to recovery unfortunately includes a lot of grin and bear it. The fear and frustration serve to place our focus on the symptoms which perpetuates them. It is a vicious cycle, and there is no magic way out of it. Just try to keep reassuring yourself that in the long run, they will fade. Short-circuit the fear as best as you can. Whenever you find yourself focused on the pain immediately shift your thoughts to the emotional realm. I realize you have been at this a long time, and can understand the frustration, but try to keep the faith in the diagnosis and trust that in the long-term the relief will come, even if it is a lot more slowly than you would like. |
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PJ77
United Kingdom
44 Posts |
Posted - 08/28/2013 : 07:47:02
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Hi Dave,
It is a vicious circle, and I agree with pretty much all you said. However after months and months of reading and emotional work, one does get in a daze when the symptoms are ruling your life 24 7.
When you say emotional work, what do you actually do please? Imagine one has pain/tightness/tension/spasm in the lower back. What do you do? Do you say "how do I feel" or "what is bothering me", and then what? If one does not know how they feel, its blank then what does he do? The pain and all the work has put me so confused that I don't know anything any more. |
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Dave
USA
1864 Posts |
Posted - 08/28/2013 : 10:03:00
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quote:
Originally posted by PJ77
When you say emotional work, what do you actually do please? Imagine one has pain/tightness/tension/spasm in the lower back. What do you do?
I notice it, accept it as a benign signal that something is troubling me that I don't fully realize. Sometimes it is obvious -- for example, I had an argument with my wife the night before, so I think about how it made me feel, whether or not I appreciate how truly angry it made me, and why it made me so angry. This might lead to me having some pretty awful feelings about my wife, which I try to explore, even if they are ugly and I don't want to admit to feeling them. If I am alone and in a safe place I might start screaming "at her." I pay no mind to the fact that the feelings may be irrational or over-the-top. I accept that the "child inside me" might feel a certain way and I try to get in touch with that, and express it if possible. I think about what insecurities I may have that made me so sensitive in the first place.
This might take a few minutes, and by the time I get engrossed in thinking about what negative feelings I might be repressing, I am no longer paying attention to the pain. It is those moments that are so important to the long-term reconditioning process. Effectively I have defused the purpose of the pain. It failed to serve as a distraction, and instead served to remind me to try to experience the very feelings I might be repressing. This is the opposite of what my unconscious mind wanted.
It might not be easy to figure out a recent trigger in your life that may have led to you not fully experiencing some negative feelings. There might not be any single trigger, it could simply be due to a variety of stressful conditions that led to an "overflow" of the "unconscious pool of rage" that led to the symptoms appearing or getting worse. Or, it could be completely random. It really does not matter. The key is to immediately shift your thoughts towards potential negative emotions and try to get in touch with them.
If the symptoms are in fact "ruling your life" then I'm afraid they are serving their purpose and likely to continue. Painkillers or NSAIDs may be helpful to alleviate the pain, at least to a point where you can more easily ignore them. However, if the symptoms persist for a long time despite your doing the emotional work, there may be a cause that you are totally unaware of and can only be explored with the help of a psychotherapist, ideally one who is familiar with TMS. |
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PJ77
United Kingdom
44 Posts |
Posted - 08/29/2013 : 08:03:52
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Dave,
Many thanks for your reply.
Is it possible I can email you and if so do I do it through this website please?
Regarding TMS psychotherapist, there is no one local to me in UK. It would seem if I wish to take up this option I would have to do so over skype. Would you say if I am doing over skype I should get in touch with someone in USA and if so can you recommend anyone please. |
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"Overuse" Injuries
