I'm a TMSer Triathlete

You know how in AA meetings people get up and say something like "Hi, my name is Frank and I'm an alcoholic". Well, I assume that this is how it is real life because I'm basing my assumption on what I see on TV. In any case, I think they do this because they label themselves that way so that they know that they will be living with it all their lives and they need to always be vigilant to avoid "falling off the wagon".

Well, my name is Enrique and I'm a TMSer. I know I have tendencies toward chronic pains caused by emotional repression. I've had it all my life. I can recall having migraines as a young boy and my first bout with back pain was when I was only a sophomore in high school. So yeah... I'm a TMSer.

So now that I've been aware of this for 5 years, you would think that I'd be over the pain generating thought patterns, right? But no. I still get pains. I've just gotten pretty good at thinking psychological rather than thinking physical. I'm not very consistent with my emotional journaling and my "thinking clean" so pains pop up every once in a while reminding me to address some repressed emotion or internal stress that's being generated.

Usually, I start journaling and thinking about what might be bothering me emotionally and the pain resolves soon enough. In early March however, I woke up one Saturday and felt some pain in my achilles tendon. I felt it the moment I got up out of bed. Now the day before, I had just done a very hard bike workout and a very, very tough run later in the day. I'm a part-time triathlete and since January 1, I've been hitting the bike and run workouts 5 days a week, consistently. So that's 9 weeks of very hard training. In fact, week #9 was especially hard because I increased the intensity (called VO2 workouts) to increase my speed on both bike and run. I'd been doing the "advanced" level of the workouts, too. There are 3 levels: beginner, intermediate, and advanced. Of course, being the overachiever that I am, I chose the advanced, even though this was my first time using these specific plans.

Anyway, at first, I got up and thought.... oh this is just another TMS attack. Just treat it like that and it will go away. But day after day, after day after day.... it didn't settle down. An acquaintance of mine who was also doing the same workout plans, reported in with achilles tendinitis and was out for a few weeks already. Hmm... my mind starting thinking.... maybe this isn't TMS. Maybe it's an overuse injury. Maybe.... maybe.... I started thinking of the reasons that it could be an overuse injury. I was doing the Advanced plan. Week 9 jumped in intensity.... much harder than weeks 1 through 8. Yes.... perhaps this is a real injury for once. So I started doing the R.I.C.E technique. You know rest, ice, compression, elevation. And I started taking ibuprofen. I also stopped running for 2 weeks. I kept doing the bike workouts though.

And after after two weeks, what was my situation? The pain was still there. I was starting to really worry about jeopardizing all that training that I'd done since Jan 1. I started worrying about my season plan. I'm training for a Half Ironman in August. My friend, the guy with achilles tendonitis is still out (12 weeks now) and is pretty depressed about his season falling apart. Is that what I'm destined for?

That's where I was a few weeks ago. I'll come back and post what I did to get over that and be able to successfully complete a Half Marathon this past Saturday. I posted a decent time, too. Not my best performance but still finished 19 out of 103 guys in my age group (AG).

 

Hi. I'm Beach Girl and I'm a TMSer. My emotions tend to get buried so that I'm a "nice person" and thus I have pain.

Enrique, your story is so inspiring! I used to love to run, but that hasn't been on my list of things to do in a long time.

Years ago, I too did something to my achilles tendon. I was walking off the beach up a trail when I felt it "snap". I was with a person who makes me very nervous, and I chalk it up to that. She said something that caused the "snap". I DID go to the doctor and she told me I had "pulled a calf muscle". Um....no.

I did the same thing you did to my leg. Only I had lower back pain AND the pain in my leg. If I wasn't riding our scooter through town (thank God we had one), I had my leg up and on ice. And one day, it simply went away - which leads me to believe it was another TMS symptom. But man does it hurt! I am impressed at how well you did.

A half marathon? Outstanding! You are a shining example to those of us still trying to get back on the horse, as they say. I'll be watching this space to see how you do in the half marathon. I'm sure you'll do great.

BG

 

this is really interesting to see because as monte mentions successfully ridding yourself of TMS symptoms involves shifting your lifestyle and not treating TMS as a condition but a way of life. What I got from the things he said was you have to change you lifestyle, the way you think and the things you do, to prevent TMS from recurring in the future. So as many posts on here say TMS can come back if you fall back into old routines again (I find myself doing this sometimes) but I would be really interested to read how you got over that bout of pain Enrique and were able to run. I think it will be very inspiring to hear that. I've been having some bad pain days over the last 2 or so weeks and I think the second part of your story would be positively uplifting.

 

I was able to carve out a little time today. It’s actually not easy for me to find some time to just sit down without interruptions and write for an hour or two. But the stars aligned today... One detail that I left out of my first post was about the Achilles pain itself. What was it like and what did I think I have? So I will describe that first.

When I woke up that morning (and it was actually a Sunday morning, not Saturday. I noticed my error when re-reading the post) I could feel pain in the back part of my foot where the Achilles tendon attaches (inserts) into the foot bone. Below is an image that I Googled and shows pretty well where I felt the pain. Pain here generally indicates that it's Insertional Achilles Tendinitis. That's what I thought I had.



On a scale of 1 to 10, I would put it at around a 1 or 2. I felt it most when I took my first steps in the morning and seemed to go away after a while. When I squeezed the tendon, I could feel the pain. I described it as “tender” in my training log. It didn’t hurt enough to keep me from going out on a 6 mile recovery run (i.e. slow pace) that day, but I did start applying ice after that run and in the next couple of days I rested a bit by taking two days off of running and doing RICE.

So back to the story...

It was about a month after the initial onset of pain and it was not any better. I had digressed from treating this as PPD/TMS only to treating it as a real achilles injury. I had already made up my mind to skip the half marathon at the end of April, three weeks away.
Now, I hadn’t completely lost sight of the idea that this could be PPD. But what I was doing was sitting on the fence. I was wavering back and forth between PPD and a real physical injury. I decided to read some of the material on runningpain.com. I had purchased the Master Practice from Monte Hueftle before and used his material often. On his site, I read the following words and it was a big “aha” moment:

So with only three weeks away to the race, I got angry and decided that PPD wasn’t going to win. I wasn’t going to let it blow my season. So (1) I decided to resume normal activity. (2) I decided to stop all treatments. So no more RICE. (3) I made a decision to stop Googling about insertional achilles. (4) I stopped listening to what my injured friend had to say about his injury. Lastly, (5) I made a mental scorecard of the reasons why this was PPD and bumped it up against a list of the reasons this could be a real injury.

I want to talk about #5 because it’s really total coincidence that we submitted a Q&A question to Alan Gordon recently about this issue. See the Q&A here. His answer was almost exactly what I did. When I read his answer, I was amazed at the fact that I had done something very similar to what he suggests doing. He calls it an evidence sheet to list out reasons why this is PPD. While mine was more like a scorecard, weighing of evidence, because I also included reasons why it could be physical.

So my mental PPD vs Physical scorecard looked like this:

Reasons this could be a real injury:

1. I’ve been on the advanced plan, working out VERY hard for 9 weeks. This very well could be an overuse injury resulting from doing too much too soon.
2. The same exact week of the injury I started a new phase, VO2 Max workouts, which increase the level of intensity severely.
3. My teammate doing the same workouts came down with the same injury indicating that it really is a very tough workout plan. Related to this one... there were other people dropping out of the program due to other injuries, but not Achilles. Still, this lent credence to the idea that the training was very tough.

Reasons that this could be PPD:

1. The pain did not materialize during any specific workout. It showed up the day after. That is kind of odd. If it was an acute injury I surely should have felt something after the workouts.
2. I’m a TMSer. I’ve had history of several other pains before (plantar faciitis, piriformis syndrome, knee pain) I even had something similar before (see #6 below).
3. Upon examination, there is no visible inflammation, redness, or warmness at the site of the pain which you would expect if there was an acute injury. There is only tenderness upon squeezing of the tendon.
4. Upon reflecting my logs, the pain came and went, especially in that first week. It hurt some days and other days it didn’t. Additionally, the pain was never more than a 1 or 2 on the pain scale even after a very hard workout.
5. There were other people who have had achilles pain and turned out to be PPD. http://www.tmswiki.org/ppd/Achilles_Tendonitis
6. In 2009, I had similar achilles pain in my other foot after the San Francisco marathon. I took 5 months off of running until I had an "aha" moment treated it like PPD and it went away.
7. My teammate doing the same workouts came down with the same injury indicating that this could be the “contagious” aspect of PPD taking its effect upon me.

So when I thought of it in this way, I very clearly saw that there was more evidence leaning toward this being PPD. So that very next day, I went out for a very, very easy 20 minute run. The pain was a 4 or 5 out of 10!! It NEVER hurt this bad before. The next day it was still feeling the pain at around a 3 or 4 even when not workout out. The only rational explanation for this was that this was the "extinction burst" that Alan Gordon wrote about in his recent submission to the wiki Breaking the Pain Cycle. Basically, what he says is that the pain will often get worse before it goes away, but it means you are on the right track.

Frankly, the only word I can use to describe my feelings that evening is anger. I felt ANGRY. Angry that this symptom is making me waver so much. Angry that I have been doubting a PPD cause. Angry that my mind is doing this to me. I was so angry that I went out the next day and did a very, very hard bike workout. It’s an FTP test and if you are a cyclist you know what I mean by this being hard. There are different versions of them, but basically going all out for 40 minutes to see how hard you can go. Losing your lunch at the end of something like that is not uncommon. I did it to settle the matter once and for all. This is either really physical or it's PPD. Going all out and very hard in my workouts is going to prove or disprove that this is PPD.

Then, to further let this anger out and to metaphorically push myself off the fence, the very next day, I went out and ran a half marathon out and back from where I live. My team mates thought I was nuts, frankly. One moment I’m complaining about achilles pain and the next I’m doing an FTP test and running a half marathon.

Frankly, though, the pain in my achilles never really materialized during either of those workouts and in between them, the pain was kept to a barely noticeable level (1 out of 10).
This again further strengthened my resolve that this is not a real injury. So with these two very significant events behind me, I resumed my normal training and participated in the half marathon race which just a few weeks before, I was considering just dropping out from.

I should also mention that I not only re-read Monte's The Master Practice and re-dedicated myself to thinking clean strategies, but I also listened to Georgie Oldfield's Recovery CD which has really great information that helps me personally to solidify my knowledge and belief about PPD.

Now, since that race on April 28, I’ve continued to train hard and I just ran a 5K today which I finished in 3rd place overall. The pain in my heel is really just a minor sensation. I wouldn’t even really call it a pain. I don’t even feel it while running. It’s still there when I’m not training, which indicates that I ought to keep on journaling and treating like PPD, but the level of doubt that this is physical is very low. I wouldn’t say it’s gone 100%, but I keep reviewing that evidence scorecard in my mind, I keep working out, I listen to the CD, and I keep treating like it’s PPD and so far so good. It’s getting better and better week after week.


I’ll report back when it’s gone 100%, but I’m not there yet. I’ve had some other pains like piriformis that were with me for many months before they finally resolved 100%. So I’m not in any hurry. The important thing is that I can still run and bike and this isn’t going to stop my training and racing seasons in any way.

Enrique

 

Way to go, Enrique!!! Thanks for posting this inspiring story.

 

Yes, this was a big "aha" moment. Even though I knew this from a rational perspective, I couldn't apply it to myself after the pain didn't dissolve like others had before (i.e. back pain, RSI, neck pain). When it didn't go away in a few days, weeks, I started to doubt and that rational perspective went out the window and I backslid into thinking it might be a real injury. Once the doubt crept in, I had a hart time getting it out.

Yes, I took a stand. I got off the fence and decided that I was going to believe that this was TMS and not physical.

And so I'm here to tell you that today, for the first time in a long time I'm walking around with no sensation of pain at all. I'm going for a run tomorrow so we'll see how it feels, but it's feeling so much better.

I should mention that I have not stopped working out since that day I took my stand. I've been hitting the workouts consistently and hard. This weekend, for example, I biked for 75 min on Saturday which consisted of a warmup, 14 x 2 minute hard intervals with 2 minute rest in between, then 25 minutes of steady moderate-hard pace. After which I then ran 25 minutes at a fast 10K pace (this is called "brick" workout when you do a bike session then a run right after). So a total of 1 hr and 40 minutes. Then on Sunday, I got up early to avoid the heat of the day and ran 2 x 1/2 mile intervals at 10K pace and then added 11 miles at easy pace with some friends. During those workouts and in between, I was still feeling the pain from around a 1 to 3 pain level. So it was still lingering. Today is really the first time that I'm walking around with zero pain.

I want to post when I have more time this week what I've been doing since my last post on May 6th, because I believe it's what has taken me from pain at 1 to 3 levels to zero today. I'm hopeful that this trend will continue and by Sunday (my next big race, a 12K) I will have zero pain consistently, day after day.

Thanks yb44! I appreciate your comment.

 

thanks so much for posting this enrique. this shows that im not the only one that has come under the doubt problems of "is this TMS or really physical" before. its especially encouraging to see that you got out of it, pushed through and told yourself it was TMS, and treated it as such and now you're doing a ton better and pretty much at 100%. its pretty amazing actually to read this because i for one have had instances before where I started doubting myself again whether it was TMS or physical pain (this pretty much happens on the bad pain days) and i get pissed off because i feel like it is ruining the work im doing on TMS and trying to take over again. i think its definitely something that is a lifestyle change like monte says and as you're illustrated with your post here.

its interesting how TMS can come back after like 6 months of no pain, it strikes an area of your body you've been training hard, and makes you think you had a real physical injury because it picked the perfect place for it to surface. the really encouraging part is that you did RICE and the physical treatment for it, it didn't help, but when you got angry and moved into treating it as PPD/TMS it started getting better to the point now where you're pretty much 100%. very encouraging read thanks again especially since you and I have had similar pains like PF and some computer related strains and you've overcame them so its definitely helpful to read

 

i forgot to talk about the scorecard you made as well. i've also done this and the only problem is that i feel like it doesn't always sink in for me. ive thought about making a scorecard like that and reading it every day instead of just when i have a bad day. i listed out the possible physical reasons why this couldn't be TMS and then on the other half I listed why it could be TMS and the list for why it could be TMS is much longer... however on the bad days doubt still rears its ugly head and even though i made that list before you still are on the fence. do you have any tips of getting off the fence in a situation like that? do you think reading that list every day would help?

i also bought the master practice and the stuff monte talks about is really encouraging. he definitely says that treating TMS is work and it isn't some magical thing that will go away if you find that one repressed emotion. that is the hard truth about it that i liked because he didn't give you the impression like it was an instance fix like you read in some other places where people read Sarno and instantly get better. i think in the majority of cases it takes hard work and determination to rid yourself of the symptoms.

 

I agree with what Forest says about reading the list daily. I do this. I also read an affirmation/mantra (more on that below) every time I feel pain, think about the pain, or think about my Achilles at all. I consider all of those thoughts as signals to think psychological.

Sorry it took a while to get back to this subject matter, but I'm entering the final training block for my Tri season. There's not only my workouts to actually "do" but there's a lot of thought and preparation that goes into the next 13 weeks. Not only do I have to make sure I have a good plan laid out, have all my equipment and nutrition worked out, but I also need to make sure my schedule is all lined up with my wife, kids, and work commitments.

Anyway, I'm back to report where I am and to also fill in the blanks on what has gotten me to overcome the Achilles pain without any physical treatments whatsoever.

So in my last post on 5/14, I mentioned that I had zero pain. On 5/15 I also had zero pain. Then on 5/16 I felt a pain at a 1 to 2 out of 10 level. Then on 5/18 it was less. It was clear that the pain was on the way out, but for some reason it wasn't going 100%. I didn't really worry about this, I just kept doing what I'd been doing since May 6 which I'll post below. Before I do that, I want to say that on 5/19, I ran my 12K race, the Bay to Breakers. I didn't do as well as I wanted--- I came in 2 minutes slower than the previous year. But, I was still VERY pleased that I was able to run it with no pain and really at a very high level of intensity. The day after the race I had zero pain. The day after that 5/22, I felt a very small sensation. And finally, now on May 25, I am at a pain level of zero again. I'm certain that it's working it's way out completely.

The key thing that I started to do consistently on May 6 was follow the protocol that Monte lays out. I posted this elsewhere, but I'm copying it here so that it's all in one place for future reference:

So here's the general protocol that I followed and continue to do so. I posted something similar in another thread but actually added more detail here:

1. I do whatever I could to get myself to believe 100% it is TMS. This is very important. If I am struggling with this, I do the best I can and continue with the rest of the protocol. The more I get rid of fear, uncertainty, and doubt (FUD) the more progress I make and the more I believe. It's a positive upward spiral if I remain consistent. I really struggled with this during the first month that I had Achilles pain. But I remained consistent. I wrote up my TMS scorecard. And the result is that the pain is gone now and really does not impede my training.
2. Consistently on a daily basis I purposefully introduce TMS/PPD knowledge into my conscious mind and therefore, indirectly into my subconscious mind. In my case, I listen to parts of the Master Practice or the SIRPA Recovery CD whenever I can, but minimum 15 minutes daily.
3. I resume normal activity as much as my pain will allow. During this recent episode I kept biking and running.
4. I stop any treatments or searching outside of myself for a cure. If I don't do this I am sending a message to my subconscious that I don't believe this is TMS/PPD. It took some time before I jumped on this wagon due to doubts, but after I did, I began to get better.
5. Lastly, whenever I feel the pain, think about pain, or even just think about my affected area, I force my mind to think clean (as Monte calls it) (i.e. focus on my thoughts, feelings, and TMS personality traits --- not the pain). Pulling out my mantra card was a simple, but effective way for me to habituate the process of thinking psychological.

Well, that about does it. In retrospect, this Achilles tendon pain was another opportunity for me to refocus on my own thinking patterns that generate inner stress and tension. I had become relatively lazy about my thinking and had lost the good habits of "thinking clean". This pain was a wake-up call of sorts for me. Once again, I feel grateful that I have knowledge about TMS/PPD and can come to here to this forum of like-minded individuals and get back on track.
Enrique

 

Fantastic thread will be posting a longer response tomorrow thanks so much for sharing this info

 

sorry took me a while to write this post ive been really busy lately. i think this should be a sticky on this forum because it contains a lot of valuable info about treating TMS especially from people who have overcome it (more than once I might add) because forest i know you had a relapse and enrique you did too with your achilles pain and you were both able to overcome it by using these techniques. im going to be printing this stuff out because its a lot to read on the forum here but is so helpful to hear what you guys have to say.

i bought the master practice too and monte has a lot of good info to listen/read on there. like you said its about treating the pain as a signal to look inside of yourself (not outside for solutions) and see where you are unbalanced. are you being negative too much (me), focusing on the physical, worrying all the time, people pleasing, etc. which all cause inner tension to develop and cause pain. its about changing the way you think that changes your pain which took me a long time to learn because ive been such a negative person for a long time. i think thats probably how this all developed in the first place though. growing up there was a lot of negativity and anger in my house so i dealt with that for years and years. all of that buildup eventually led to this i guess.

one thing i noticed the last couple of weeks is less pain and i think thats because ive been keeping myself really busy and not focusing on it so much. this really helps the distraction away from the pain. its talked about in the book dissolving pain too. the more you focus on the pain the more amplified it becomes so by keeping yourself busy your brain can only focus on so many things at once so you dont feel so much pain. this obviously shows the connection between your thoughts and the pain you feel. you have to get to the root of the problem though which is your attention and your emotions to really cure the issue. distraction does help but ive found you need to adjust your thought patterns, change your negative habits if you have them, and look at your present emotions (more so than the past) to see where you are unbalanced.

 

Wow Enrique:

You are doing so well. I see through your experiences that I'm "sliding" back into the "there's really something wrong with me" place. Although I know I'm NOT. I need a little card like yours. I need to listen to Monte more.

I need to find what is going to work for ME.

Good luck on your training. I love that you are so dedicated to this triathlon. Good for the rest of us to follow and learn.

BG

 

Hi Everyone! I'm just checking in. 8 weeks remaining until my race. In addition to training there are so many little things that need to be planned for, such as nutrition and bike setup which both have dozens of adjustments and trial and error experiments to go through. When you're going to be racing for 6 hours even the slightest thing can ruin the day. Things like too many calories, not enough calories, too much salt, not enough salt, too much water or not enough water, what to eat right before the race, the day before, two days before?? How to handle the heat if temps get to 90+ degrees? These things are consuming my mind at the moment, but I think that this is actually helping me because this extreme focus on the details is keeping my mind from thinking about PAIN at the moment.

As far as pain goes, the achilles pain is almost all gone. However, there have been instances of the symptom imperative in the form of neck and back pain that have surfaced and then gone away. At the moment, all I have is a little lower back pain (about a 1 of 10 on scale) so it's not a show-stopper.

I hope everyone's doing well. I'll report back again soon!

 

Good luck, Enrique!

 

Enrique, THANK YOU FOR THIS: "I think it's important to make a distinction because it's the difference between being stuck in pain and getting un-stuck. Ignoring the pain doesn't help. (Disclaimer: What follows is pretty much what I have learned from Monte Hueftle's "Master Practice") Pain ought to be viewed as a SIGNAL. A signal to think psychological. What does this mean? It means to accept the pain as a signal to become aware of thoughts, feelings, or typical TMS personality traits that are being exhibited in the present moment. For me personally I have found that I am able to overcome pain when I am able to become aware of my thinking patterns that are generating the inner tension and repressing emotional energy. When I get the signal, I stop thinking of the pain, distract myself from it, and I redirect my mind to start probing my thoughts looking for a thought that is negative (worry, fear, striving, controlling, etc) and then I redirect my mind to a more positive thought or series of thoughts. I carry a written mantra that I read sometimes If I can't think of something. Or I might recognize that I'm exhibiting a certain personality trait such as people-pleasing or being overly self-conscious. I become aware of it and I redirect my thinking to something more open. For example, if I notice that I'm worried about what other people will think of me, I change my thoughts and say "I don't care what others think of me. I'm just going to be the very best person that I can be and do the very best job that I can do. That's within my control. I can't control what other people think. Let them think what they want to think." This is "active" whereas ignoring the pain is passive and keeps you stuck in that inner-tension generating mode which created the pain in the first place and keeps it around.

If I have pain all the time, the I'm pulling out that "mantra" card all the time. If' I'm walking the the street pain free and suddenly I feel some pain in my Achilles tendon (like happened today) I pull out my card and read it and then move on. My card says something very simple on it: "Thank you for signaling me and making me aware of my thoughts and feelings. I know what you're trying to do. I don't think that way any more. I don't need you any more." This might sound incredible simplistic, but it's sending a very powerful message to your subconscious."​

MY NAME IS LARA (AKA LALA) AND I'M A TMSer. I finally just got caught up on this amazing set of posts and so many things you have said have really struck me. First of all...who is this Monte and where do I get a copy of of the CD (or audiobook?) of THE MASTER PRACTICE? What you said above....this was HUGE FOR ME...HUGE. Everyone has been telling me to "ignore" the pain...I understand why, but it never felt right to me...just ignore it? How can I ignore, when it hurts so damn much...your suggestions above really helped me to understand how to deal with my pain in an active way....don't "ignore it," but rather use it as a signal to redirect my thought patterns from signal to probing to understanding to shifting from negative to positive. It's the answer I've been searching for, but didn't realize I was looking for. I am reading Steven Ozanich's THE GREAT PAIN DECEPTION, which has really opened my eyes..and now it seems I need to read/listen to THE MASTER PRACTICE as well (I also have UNLEARN YOUR PAIN on my shelf). So many great resources out there. For so long I thought I only had Sarno to read (and of course I do and always will)...but its so wonderful that the bounty of knowledge and insight keeps growing and growing. Thanks for your inspirational story and amazing suggestions!​

 

Everyone who contributed to this post, thank you! I love the little card mantra idea. I'll try that!