How to tell the difference between actual injury, bad form or TMS?

Hi all

Having recently resolved my main TMS issue, lower leg pain, and returning to swimming, I then decided to up the ante and have another go at weight training.

When I say 'another go' I mean that for most of my life, every time I try and do weights, I wind up with issues that eventually cause me to quit.
Squats or lunges for example. Any leg /glute work I've been doing causes extreme tightness and pain in my quads and the ITB area that lasts longer than the usual 3 days. My quads and hips wind up with lots of lumps and tender trigger points, enough to put me off doing more.

In the past - before I knew about TMS - was Dx with all the usual abnormalities - chondromalacia, pronation, weak gluteus medius, ITB tightness etc etc. Back then, long ago,, since I seemed unable to overcome these issues, even with rehab exercises, orthotics etc, I eventually just gave up doing weights. But now that I know about TMS, I'm trying again.

Yet, the same old leg issues have surfaced. My solution? Look up whatever might be causing the problem (weak glutes and hips, say all the sites!), and I foam roll my quads and thighs, which is excruciating. What I am trying to figure out though is how can I tell whether I have actual microtrauma (injury), whether my pain and tightness is in fact caused by an 'imbalance' like weak gluteus medius that are 'compensating' (the parentheses are to indicate that this is the conventional explanation and that I am alert to the fact that conventional explanations may not really be the cause), or whether this is TMS in another form? The pain and tightness is certainly enough to keep me out of the gym. I feel like something's terribly wrong with me - why can't I do squats or lunges like other people can? Goes my thoughts.

So what I am trying to figure out is, is it possible that I have structural imbalances that are causing muscles to fire incorrectly, and therefore I should set about strengthening them? Or is this just more TMS huff and puff? I get it that my original lower leg pain was TMS, but this pain feels different, and it does not come and go, it only comes when I train with weights and do squats, lunges or leg presses, then goes away 5 days later. Meanwhile the interim 5 days are very unpleasant and then I don't want to do the next session.
In other words, before I go ahead and possibly waste my time by starting a series of glute strengthening exercises and/or 'remedial practice squats', is there any way I can tell whether it's just TMS?

And yes I know foam rolling is probably also TMSing.

thanks for any thoughts,, still making my way around TMS but getting there....
cheers
Metta

 

Dear Miss Metta, .You should get this checked out with your doc or where you do your training if it really worries you but I would suggest that you are actually trying to resolve what is fundamentally an emotional issue through physical intervention, which is why you are having no success. You understandably seem very caught up in all the possible physical explanations for your pain, a typical response that many of us go through with TMS and one that seems totally logical before we gain THE KNOWLEDGE. You can foam roll until the cows come home, but it is unlikely to help you one jot as you will be addressing symptoms and not the cause.
You know you have already been here before and now for some reason the emotional discomfort is back. You're wise to that trick now so don't let it fool you all over again with a different manifestation. Many of us have fallen into that trap over and over again.
You need to do a thorough emotional spring clean and look at what is going on in your life right now, spend some time being kind to yourself and also consider that you probably experience great anxiety and fear when you do these workouts and have conditioned yourself to expect pain during this type of activity. To overcome this think emotional and if it helps, just do a really tiny amount of lifting, squatting or whatever you do that even your fearful mind can accept could not possibly hurt anybody and then keep slowly increasing it over the next few weeks so your confidence in the TMS diagnosis will grow.
Hope you are feeling more confident soon.
Solange

 

I'm dealing with the same sort of issues. On the one hand, TMS is real. On the other, injury from over-training is real also. I was bedridden for several years, and am trying to get my strength back. I've been in quite a bit of pain, and have been inactive and have lost strength over the past several months as a result of an "injury". A physiatrist told me that I'd torn a muscle. The TMS-oriented folks in my life say that it's all psychological.

For many people, a psychologist might be worth consulting for TMS related issues. However, given my circumstances, I've decided that the only way to get to the bottom of this is to visit someone that knows both sides of the issue intimately. I have an appointment booked with a TMS practitioner that happens to be a medical doctor dealing with musculo-skeletal injuries. I'll report back after my visit.

 

I look forward to hearing your report back!!

 

Me too!

I had 2 hip surgeries and it is very hard for me to get over the muscle imbalance idea. I have the "weak glutes tight psoas" idea implanted in my brain because that's what I have read about and heard from so many sources over the past 12 years.

I did actually have structural damage that was corrected in the first surgery. Still muscle pain persisted. I chalked it up to muscle imbalances at first because of how long it took to be diagnosed. Then I freaked and thought I must have damaged it again. 2nd surgery removed scar tissue and lengthened a tendon. Fortunately it did show me there was nothing abnormal structurally. Scar tissue was restricting but the tendon lengthening did nothing. Guess what...same muscular symptoms prior to surgeries gave come and gone!!!! Then all of the docs and PTs said muscular imbalance due to years of compensation.

Though weak glutes may be partially accurate in my case due to surgeries, why then would my body rebel and react to glute strengthening? When I really think, it seems rediculous that None of the PT exercises have ever totally worked or they would work for a while and then stop working to never work again. Same with foam rolling and lots of other self care techniques. This is absolutely ridiculous. I was at PT last week and looking around at older people getting stronger while I am 40 and healthy. Plus, look at all of the athletes who have hip injuries nor severe than mine who get better.
And it may even be because they aren't afraid to or have to exercise!

My PT and I will be stopping appointments at the end of Dec. I basically go for active release every 3 weeks. I stopped tolerating most exercises or stretches she gave me.

Logic tells me I have TMS.
I am interested in really getting a true TMS diagnosis because I do think it could help me move past this crippling fear. There is no doctor near by that I am aware of so I will continue this route and watch for similar stories for now.

 

Hi Shells,

I'm a "hippy" too! Were your surgeries arthroscopies? There are several TMS physicians listed in Virginia and one in North Carolina in the "Practitioners" list here at the TMS Wiki. You may be able to consult with a TMS MD by phone or internet, they may want to see your radiological reports, and not necessarily your images.

G'luck!
tt

 

Hey Tom!
This is great for me to hear! I will have to check more or your posts.
Yes 2 arthroscopic surgeries for FAI and a labral tear. I think FAI might be the new "Fad".

Have you made a lot of progress with the Sarno approach?

I get to about 70-80% then slip back. Picked up Sarno about 1 1/2 years ago and made a little progress. Then setbacks started. I think I need to read another of his books again. I have only read Healing Back Pain.

 

Hi Shells,

Glad to be of help and Happy Thanksgiving! A big thanks to Dr. Sarno for his huge contribution to psychosomatic medicine with his TMS theory, looking forward to seeing the documentary and hope it helps to put him on the medical knowledge map--if it gets just a portion of media play that the movie "Jaws" does he will get the Noble Prize in his lifetime--maybe the committee can give Bob Dylan's to the Good Doctor since Bob seems indisposed--maybe still having problems with rearranging that porta-potty offending his neighbors downwind at Malibu. Bob's award was for literature, and Dr. Sarno has written four books, so it's not that big of a stretch. Sorry for that digression.

I've got to run out to play some tennis now--more like hobble-out actually--I'll try to dredge up my "hippy" tail/tale later. If you're bored between watching parades, you can "search" above for "hip" and member "tennis tom", you should find enough to stuff a farm full of turkeys. I've been exploring arthro, but my surgeon says I'm too far gone for that-- they call it a medical "practice", so I'm waiting 'til they get in some more practice and go pro.

Cheers, talk to you later,

tt/lsmft

 

Happy Thanksgiving!
I will be stalking your posts!!

I can't wait to watch the documentary. I wish I would have seen it when it was on here. Can't wait. Yeah, that was kind of a strange Nobel prize .... no disrespect to Bob.

I hope you are having success with this theory. I think I am worse but am seeing where fear and pressure play such a big role.

 

How did you go?

 

BTW, I've recently started taking the NSAID, diclofenac sodium (generic name), 75 mg 2 times a day , (brand name, Voltaran) for several months now. There was a recent meta-study on NSAIDS in the Lancet, that said this was the best of them. I'm taking the two pills a day and noticed a subjective "30%" improvement. I'm nowhere near running marathons--or running--except in the pool, but my footwork on the courts is better.

 

Glad they are helping you.

 

Sorry for hijacking my own thread back

Update: my issues are form and technique, not TMS. Left to my own devices, my weight training is incorrect technique and causes pain.
when shown bit by bit by a qualified strength and sport trainer how to do a squat correctly, no pain. None. When I follow his technique on my own, no pain. And the adjustment was fairly simple. Now I look like the people in the videos doing squats, not like the people in the videos who are used as examples of what not to do.
The pain has been due to incorrect technique and recruiting the 'wrong' muscles for the job, hence causing injury.
I would say it is not just a case of 'if you can lift it and it still hurts, then its TMS' is not always true.

Squats, I have come to learn, are something that people very often don't get right and you have to learn to move in the correct way. Moving with a heavy weight on your shoulders either too far forward or too far back is going to cause tears in the muscles that are injurious, because you are asking small muscles to carry a load that the bigger muscles are supposed to be doing. When I do it correctly, so long as I keep my body centered and the weight centred, I can do them really well.
Same with lat pull down. Left to myself, I end up with shoulder pain. With a trainer, I am asked to execute the move differently. No pain. I thought I knew how to do these exercises, but I was not executing them properly, no matter how many books, diagrams and videos I'd studied. A strength trainer (a bit different from a personal trainer) who is interested more in functional movement changed that by observing what I was doing, and asking me to make ever so slight adjustments. Pain ended.

So I think you can say this: if you are hurting from weight training, get technique checked out, even if you think you are doing it 'right'.
If after mastering technique and you are hurting beyond 'normal' muscle soreness for 3 or 4 days, then look at TMS as the cause. I think this is important to consider when wondering is it TMS or not.

 

The short answer is, the physiatrist/TMS practitioner wasn't any help. He couldn't comment on any specific issues as being TMS or injuries.