Newbie seeking advice- Is this TMS?

Hi everyone,

I'm Katie and I'm 25 years old and I've been dealing with horrible ankle/foot pain for the past year and half. About two weeks ago I discovered Sarno's Healing Back Pain while researching cures for chronic pain. A lot of things resonated with me I went out that day to get the book. I read it over the course of two days and immediately thought that it might be the answer. I bought Mindbody Prescription a few days later and read that. Problem is, I'm having trouble getting over a structural abnormality due the findings of an MRI 6 months ago and another MRI last week.

Here's my background story:

In March 2013 I sprained my ankle by stepping off a curb wrong. I got it Xrayed and it turned out to be an avulsion fracture (like a grade three sprain where a piece of bone actually chips off). I did the normal RICE and it seemed to get slightly better, but then stabilized in a constant state of pain. I described the pain as a burning, searing, dull pain around my ankle bone that increased with any activity. Fast forward to about two months ago, the pain in my ankle seemed to transfer to my heel area primarily. It's gotten so bad and painful that I can barely stand at work, and since I'm a personal trainer, it makes work very difficult. The pain now feels like a deep blister, with some dull burning pain. I also seem to have lost some range of motion and strength in the ankle. I had an MRI done 6 months ago, which suggested "abnormal distal tibialis posterior tendon consistent with chronic tendinopathy". Since the pain has worsened and seemed to have changed areas on the foot, I got a second MRI a week ago. It came back with the same findings, with a slight increase in the inflammation of the tendon since the prior study. I've researched distal tibialis posterior tendon dysfunction, and it seems that it's a progressive issue, and if not addressed properly will lead to a collapsed arch and rupturing of the tendon. I have always assumed that this issue was triggered by my ankle sprain in 2013. I've also sprained this same ankle once before, so it's vulnerable. It's been about a year and half since the most recent sprain, and since then I've tried everything to cure it: RICE, physical therapy, chiropractic, muscle stim, rest, change in footwear, diet changes. Nothing has seemed to help, and it seems to be getting worse. However, with the distal tibialis posterior tendon dysfunction, it seems to medically fit the diagnosis (pain is said to switch from the ankle to the heel as the arch starts to collapse, as mine has) and it has me wondering if the new, worsening pain is due to the condition worsening. Prior to this condition, I was extremely active...hiking, backpacking, working out daily very intensely. As mentioned, I'm a personal trainer, and getting through each day right now is unbearable due to the foot/ankle pain.

A lot of stuff resonated from Sarno's books: I've had chronic pain for a year a half. I've become obsessed with the pain and finding a cure, it's the majority of what I think about. I have ALL the TMS personality traits. Since my ankle sprain, my life has consisted of hardship after hardship and big life changes (changing jobs twice, moving twice, car accident, really bad breakup, family problems, personal struggles). Through all of this, I've kept my cool. Everyone thinks I'm calm and collected and gracefully handling all these things, but on the inside I'm upset, sad, and angry. I've always been quiet and keep my emotions bottled up inside, more so than anyone I've ever met. I had some pretty traumatic things happen during my childhood as well. I never really talked to anybody about those issues besides my mom, but I feel that even she doesn't realize the amount of pain I still hold on to. I deal with pretty intense anxiety and panic attacks as well. I've become fearful of every activity, including mundane things like driving or cleaning my house, as any activity seems to induce my pain. I feel like my life has been taken away from me and I'm desparately seeking a cure. I have a past history with IBS, which comes and goes, plus a number of other medical conditions that doctors could never diagnose.

While I seem to fit the TMS diagnosis perfectly, my hesitation comes from the MRI findings. My podiatrist has said that it hasn't gotten better because I haven't been doing the correct physical therapy and suggests starting a PT routine again. I'm worried that if I let go of the medical diagnosis, and try to resume activities, I could risk further injuring my foot, leading to the collapse of the arch, and possible rupture of the tendon. I know I need to commit one way or the other 100% and am stuck on which way to go.

Thank you for reading this lengthy post. Any advice, thoughts, personal stories would be so greatly appreciated!

Best,

Katie

 

Hi, Katie. I'm not a doctor so I can't and won't suggest you stop physical treatments, but it seems to me that spraining your ankle over a year ago it should have healed by now, so the pain you still feel sound more like it's psychological, from TMS. You write that you've had a long list of reasons to be stressed, changing jobs, moving, a car accident, a relationship break-up. Any one of those could cause your unconscious mind to slow the flow of oxygen and blood to parts of your body. It loves to find the weakest place, which is your ankle and foot.

You're right in that you need to commit 100 percent to either the pain being structural or TMS, and I recommend thinking TMS. Many people have found the advice of Steve Ozanich in his book The Great Pain Deception to help them become pain-free.

I lifted something that gave me sharp pain in the back and didn't heal until I began to believe my pain was TMS and not structural, and then by believing that 100 percent. I kept withholding about 10 percent of the pain being structural, but the rest went away when I believed totally in TMS.
Even if Xrays and MRIs show structural problems, the healing may very well come from believing it is psychological from repressed emotions or our perfectionist and "goodist" personality.

The Structured Education Program could help you a lot:

http://tmswiki.org/forum/forums/structured-educational-program.16/

 

Hi Katie,

I agree with Walt,
The only thing that resonates with my personal experiences is the episode in which both my Achilles tendons started to become unbearably painful from walking more than 15 minutes. The area's were swollen and painful when pressed upon. I started to change foot wear, ice them every time I took a walk and even get correctional inlays; in the end I could only recover by approaching it as plain TMS. Sometimes one of them still is painful, but it quickly disappears when I realize that good, old TMS is rearing its ugly head again. The inlays were all redirected to the bin.

There is a point in TMS healing that you need to make a decision yourself about how to approach your problem. Yes there is a risk that you approach it the wrong way, but doctors and also TMS-doctors are only human, so you need to take responsibility yourself too for that decision. From what you have described I think there is a big TMS factor. I suggest you follow the program Walt mentioned. Maybe this is the time for you to deal with some of the issues that you described in your story....

One major propagator of mindbody symptoms is the fear of those symptoms. It keeps you in a vicious cycle in which you perceive the symptoms as a threat. Once you manage to loose the fear or move the focus away from those symptoms, your mindbody will become more relaxed and therefore allow itself to heal better. This sound easy but usually takes patience and time.

take care,
Giga

 

Thank you both for your replies. You bring up very valid, solid points. I feel that I know in my gut that it's TMS but there is still that 10% that is wondering if it should be treated medically. I've been looking into visiting a TMS doctor to get a definite answer one way or the other. Dr. David Schechter in Los Angeles looks like a good choice as he's a sports injury doctor and specializes in TMS. Additionally, he was the first physician to train under Dr. Sarno, as a medical student. How cool is that?! Since Sarno retired, Schechter now has the most continuous years of experience in the treatment of TMS of any physician. I feel that having a diagnosis from doctor that is so thoroughly trained and experienced in both sports injury and TMS this would finally allow me to get on with treatment, one way or the other.

 

Hi. Katie

I just read your post as I too am new and have what appears to be really the exact same symptoms! Bad sprain last year, two MRIs with findings of tendon issues in same area as you but not where it hurt until now when I was almost completely over obsessing about the original offending area on my foot/ ankle. I'm struggling right now with this symptom imperative but trying to give it no mind-and it's working ( thanks to this forum, Sarno, Steve O and some direct advice I received from some kind members here in connection with my first post where I made the most embarrassing spelling error -which everyone was kind enough not to point out). Throughout my long road to recovery of this particular issue I constantly looked for someone with the same issues- to no avail. Frankly I didn't need that ( as I now know) and probably neither do you so long as you have TMS but I'm Here for you if you need that. Be aware though I'm far from completely cured but I've come so far and back to working out as hard as I did before. Read my original post. Not sure how to link it here.

 

Hi Sissy!

Thanks so much for writing to me. I just read your original post, and you're right, I can relate so well to many of the things you said. There are not many out there that I can find with our symptoms so it's really nice to hear from someone going through similar things.

As mentioned in my previous post, my biggest roadblock was getting over the structural diagnosis of tendonitis in my foot/ankle. I just couldn't shake it, so I decided to see a TMS doctor. I was lucky enough to be able to see Dr. David Schechter in Beverly Hills, CA. I went to him because not only is he one of the most well known TMS doctors, but he also specializes in sports injuries, so I figured I could completely trust his diagnosis. The appointment could not have gone better. He gave me a physical exam, checked my trigger points (I had 3 tender spots upon palpitation), thoroughly went over my past and present life and emotional history, and thoroughly looked at a recent MRI of my right ankle/foot that I brought in. He completely put my mind at ease and diagnosed me with TMS. It was clear that there was no doubt in his mind.

Since the appointment, the pain has improved. Realizing that there was nothing wrong with my foot, I signed up for a gym membership and have been working out for the first time in a year and half. The pain actually goes away during my workouts, which is incredible. There are times during the day when I'm almost pain free, and there are times when the pain seems as bad as ever. I have no doubt intellectually that I have TMS, and now it's up to me to put the tools that that doctors and peers have suggested to use. I'm trying to ignore the pain, not talk about it, carry on with my life and activity as I normally would if I had no pain, and think psychologically rather than physically. I'm already noticing that I'm more relaxed, calm, and happy in my day-to-day life. I'm trying to just be my true self, live in the now, stop caring what other people think of me, and do what I like to do, rather than doing what I think other people want me to do.

From here, I want to look into meditation, visualization, potentially see a TMS or regular therapist, if I can afford it, and continue to exercise the strategies. While I have intellectually accepted the TMS diagnosis, I know I need to fully accept it viscerally, deep down in my gut and heart. I realize it's a process, but I feel that I'm on my way. It's crazy to go from thinking I'm permanently disabled to thinking that nothing is wrong with me and I'm free. I've let TMS keep me down and isolated for so long that it's a bizarre feeling to put myself back out there and start doing the things I love again. I feel like I'm being reborn or something. It's amazing and terrifying at the same time. I'm confident that I will be pain free soon and know that I will come out on the other end of this as a better, more peaceful, happier person.

So good to hear you're back to working out as hard as you did before! Are you pretty much just ignoring the pain and powering through the workouts? Have you trained your brain to not fear the pain? I'm working my way back up to the intense workouts that I used to do, but I'm on my way.

The biggest obstacle I'm encountering is that I continue to monitor the pain and rate it. I'll stand up and walk to the kitchen and think, "Wow, my foot feels pretty good right now" or "Eek, it feels pretty bad right now." I'll wake up and wonder how the pain will be that day. I can't help but compare the pain from day to day (yesterday was about a 5, whereas today was a 4, etc.) I think part of the problem is that I'm making pain elimination my main goal, whereas working on becoming my true self should be the ultimate goal. Do you have any suggestions for eliminating this thought process?

Thanks again for reaching out. We should definitely keep each other posted on our recoveries!

All the best,

Katie

 

Even just believing 10 percent that the pain is structural will keep the subconscious from stopping it.
I withheld that 10 percent with my back pain and learned that it takes believing 100 percent it is from TMS before the pain goes away.

And Katie, I think you need to give up pain elimination as your main goal and focus instead on all the benefits that come from
TMS thinking, and journaling. If you gauge the pain from day to day, it keeps pain foremost in your mind. Try not to think about
the pain or how it feels today as compared to yesterday.

 

Katie

Although I don't rate my pain I definitely still monitor it which is its purpose, right?. I wish I could give you a simple fix but since I'm still struggling with this, I'm pretty sure there isn't one other than the 100% belief that it has no structural origin. Like you, I always have that 10% that creeps in despite reassurances from both top sports medicine docs and a TMS doc. Love that you were able to see an all in one doc!!! What I can tell you is until we are 100% there we can't get complacent. When I have great workouts, spend hours in heels and basically just have a good day I forget to do my reading and the like and then invariably I have bad symptoms the next day or that night.

I love so much that you are planning to delve deep with meditation etc. and I implore you to follow through. I wish I would have when I was your age and first realized I had TMS. Instead, once my back pain was gone I didn't delve any further- being so busy with my social life and career. I know now that I never cured myself of TMS just the back pain symptom- since I later was diagnosed with " fibromyalgia" and have had a whole host of symptoms through the years. I wish for you that you don't make that mistake and deal with it thoroughly now. That's my best advice to you-oh and wear sunscreen on your face and décolletage all the time!!. (That's not TMS advice but heed it anyway because cosmetic procedures to reverse the sun damage are far from great and are painful- ha)! Do the work Katie to get this under your control now. I'm not complaining about the last couple of decades because I know I have been blessed with a very
charmed life but I can only imagine how it would have been symptom free. I plan to do the work now however and hope you will too.

Sissy

 

I know what you mean, Sissy. I wish I had known about TMS fifty years ago. I could have led a
different life. But like you I'm grateful for learning about it now because it is changing my life
in a wiser direction. I've learned so much about TMS in the past two years since reading Dr. Sarno
and then Steve Ozanich and Claire Weekes and other books. If we hadn't had pain we wouldn't
have learned about TMS and our repressed emotions. That led to me forgiving my parents and others
and makes me feel a lot better about myself. God bless Dr. Sarno !

Sherlock Holmes had a "10 percent solution" but it was opium. I prefer TMS.

 

Have become a big fan of Dr Schechter since listening to his podcast with Peter Zafirides. Another big plus is he is an alumni of Princeton and NYU so is not a kook. This is what makes TMS difficult to accept. As many of us have went from pillar to post looking for the solution we can get our hope ps dashed over and over. When I first read Healing back pain, I rubbished it thinking "it's too good to be true"!
But it's real. This makes it hard for me as I have several Drs in my family circle and when I try to explain the concept their eyes glaze over and it impacts my own conviction.
Hopefully Drs Schechter and Schubiner can help smash the old framework of pain treatment.

 

Hey Irish, you might have to travel this journey without your medical family members' involvement and support. Once you come through the other side then they will see the evidence that TMS healing is real - but then again, perhaps they will never accept TMS healing... To accept TMS healing as a medical professional is to accept that their medical education is flawed - a tough pill to swallow. Don't seek out their opinions on your approach to healing, especially if it then affects your own conviction in TMS.

YOU know it's real and that's all that matters...

BTW Katie - very inspiring, and well done!

 

Hey @katie

I was wondering if you have any updates with the ankle pain and posterior tibilialis (presumable) tendiopathy. I'm in a similar boat as yours. I used Sarno's book to get over dibilitating back pain and got my digestive problems much better. I am having TB ankle pain but it is also associated with weakness. Would love and very much appreciate to hear how are you doing now.