Q&A: Runner's knee or TMS

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Question I have been diagnosed with "runner's knee" many times, but I know that it was at least partially TMS. I would like to start running again and recently read a quote by a TMS author who wrote that "probably 50% of all knee pain is TMS." This is a problem because how do I treat the TMS effectively if I can't be SURE that it is TMS? What factors should someone in my position consider? Incidentally, I'm not an athlete, so I don't mind starting very gently, especially if doing so can help me convince myself that any knee pain I get is "only TMS.

Answer by David Schechter, MD

Practitioner David Schechter David Schechter's Profile Page / Survey Response / Psychophysiologic Disorders Association (PPDA) Board Member

Runner's knee, or patello femoral syndrome, is a description of pain that occurs, with running or after running, in the area of the knee cap or patella. While severe cases do show structural, pathological changes of the cartilage behind the knee, milder cases typically do not show anything on MRI (or surgical inspection) and are not advised for surgery. This condition is treated conservatively. Like any TMS diagnosis, a medical doctor should examine you. He/she will want to take a careful history, including assessing personality factors and psychosocial issues. X-rays and more rarely an MRI of the knee may be needed to exclude any mechanical causes of pain. Essentially my point is that while knee pain can be TMS, it can be caused by structural factors such as torn meniscus, etc. and a good medical exam by a tms doctor who is also familiar with the knee is the ideal way to assess this. Barring this, have the appropriate tests by your primary doctor or orthopedist and then look inside yourself for the patterns of response and patterns of onset and relief typical of tms and mind-body disorders. Truly, David Schechter, MD -- It is important to recognize that no information on this wiki can be considered a specific medical diagnosis, medical treatment, or medical advice. Reading information here does not create a doctor/patient or other professional relationship between you and the answering professional. As always, you should consult with your physicians and counselors regarding new symptoms and any changes that you might make in medications or activities.

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