From Knee Pain to Running Free: Reflections of an Ultrarunner

From Knee Pain to Running Free: Steven's Insights on Pain and the Subconscious

Sometimes, pain feels inevitable—especially if you're an active athlete who has undergone surgery. But what if your mindset plays a bigger role than you think? Steven, an ultrarunner, shares his experience with knee pain, recovery, and the surprising power of the subconscious.

Steven, a sporty man in his forties, had been a client of mine for several years. One day, he mentioned an ultramarathon he was planning to run that weekend in the Ardennes.  I found that incredible! 157 km through hilly terrain, in the dark, with tree roots and other obstacles along the way… I had so many questions for him. What intrigued me the most was how Steven talks to himself when things get tough?

He already came across as a calm man, and his stories confirmed that impression.  Steven doesn’t panic easily when faced with challenges; instead, he focuses on calming and distracting his mind while running.  He looks forward to the hot dogs or fries offered to ultrarunners.  Yes, they eat hot dogs! I had no idea...

One thought kept crossing my mind: if you're so disciplined in sports, are you truly calm? Is there an underlying stress factor? (‘I haven’t trained enough,’ ‘I hope I’m not getting sore/sick,’ …)

During Steven’s treatments in my pratice, I often had to remind him, “Try to relax.” His body always felt like it was ‘ready-to-go’.  Every muscle was primed for movement.  He spoke about his knee pain and that he had reduced his running, and started cycling more instead.  But after cycling, he still experienced knee pain, which worried him.  I asked if he’d be open to reading Dr. Sarno’s book.  He was immediately interested because psychology and sports is his thing.

A Planned Surgery and the Hope for Recovery

When Steven took home the book on chronic pain, his second meniscus surgery was already scheduled.  In August, he went under the knife.  The surgeon didn't know up front what to expect but did find a small piece of the torn meniscus folded inward, which could have been causing his discomfort.  The rest of his knee—cartilage, ligaments—looked good, especially considering his athletic background.  According to the doctor, meniscus problems at his age are often due to normal wear and tear.

After his recovery period, Steven cautiously started running again, following a gradual build-up similar to a Start-To-Run program.  So far, it was going well, but the lingering question remained: would his knee hold up once he resumed intensive training?

The Nagging Question: ‘Is My Pain Real?’

After reading the book, Steven began looking at his body differently. “At first, I questioned everything I felt—was this even real?” This is a common reaction for people who start realizing that pain isn’t always purely physical. The idea that pain can also be influenced by emotions, stress, and the subconscious can feel unsettling at first.

But what does ‘real’ mean? Pain is always real. What Steven experienced was the realization that pain doesn’t always have a structural cause. Sometimes, fear, focus, and subconscious patterns keep pain alive.

The Power of the Subconscious

Steven describes himself as someone who isn’t particularly sensitive to stress and has a positive outlook on life. That made him doubt: “To what extent am I even susceptible to TMS?” But then, he realized something important—he was focusing on his conscious thoughts, while TMS operates on a subconscious level.

The subconscious can hold onto tension, even if you don’t consciously feel stressed. Think of a muscle that stays tense due to an old habit or an automatic response like teeth grinding. This realization opened up a new perspective for Steven: maybe his subconscious played a bigger role than he initially thought.

What You Focus on, Grows

One of Steven's biggest insights came while running: “I now try not to focus on my knee because I fear that if I do, I will automatically feel something.” This is a powerful mechanism. The more you focus on pain, the stronger the brain picks up the signal. Fear of pain can make you continue feeling it.

Many people with chronic pain have the tendency to constantly scan their bodies: ‘Is it still there? Do I feel it again?’ This unconsciously reinforces the threat and keeps the symptoms alive. By shifting his focus, Steven notices that he runs pain-free. Maybe he was already applying TMS principles unconsciously.

If You’re Not Open to It…

Not everyone is open to the idea that pain might be linked to emotions and stress. Steven saw this in a family member, who was struggling with back pain at the time. The diagnosis: lumbago. At the same time, she was going through a stressful period. “I definitely see a possible connection, but if you’re not open to it, it’s hard to talk about.”

This is a common challenge. The idea that emotions and stress can cause physical symptoms isn’t always easy to accept. But as Steven notes, simply thinking about it and exploring the connection is already a step forward.

What Can We Learn from Steven?

• Pain is real, but not always structural. Fear, focus, and subconscious patterns can keep it going.
• What you give attention to, grows. Focusing less on pain can help you let go of it.
• You don’t have to feel stressed to hold onto tension. The subconscious can create pain, even when you consciously feel relaxed.
• Not everyone is open to the link between emotions and pain. But staying curious can open doors.

Steven's story shows that it is possible to move pain-free, even after surgery. It starts with awareness and how you view pain.

Do you recognize yourself in this? Maybe it’s time to look at your symptoms differently.