The time has come for me to pull out all the stops to try to get my foot (and peroneal tendon) into race condition. The US Paratriathlon Nationals are in a week’s time, and my run volume has been low as I’ve been struggling to manage through tendon troubles. I have pretty much resigned myself to living through the discomfort, and I know the difference between discomfort and doing too much—right now I just hover in the “not injured but not happy” zone which is so common for those of us with challenges who do sport.
I was reading my friend Kate’s blog on her use of acupuncture to help with her plantar fascitis (tight foot tendons / ligaments / connective tissue) and I suddenly got to thinking – how long has it been since I visited my STICK PIN LADY.
I wrote about Julie Gear in 2009. She was a part of what I considered “My Team”—the people without whom I wouldn’t be doing triathlon. Julie is a trained physiotherapist who practice at Physio in the City in London, and I saw her from 2008 until 2010 when she went to pastures white (also known as Verbier). When she returned to London I think I saw her once. Maybe. But I definitely fell out of the habit – the practice – of building needle treatment into my overall programme for managing my body, its tightness, and the aches and pains I can get from triathlon training..
Maybe it is because what I go to Julie for is not for the faint of heart. She is a trained acupuncturist, having studied in China. My foot was still aching last week, despite numerous visits to my guru sports therapist Michael. So when I read Kate’s post I decided to get in touch and make an appointment to see Julie.
Go Deeper – Why Some Treatments Differ From Others
This is my right leg, with some very large acupuncture needles inserted along the peroneal muscle, to stimulate release.
I think I avoided making the appointment with Julie because my body did not want to experience the pain that can happen in a session a session with her.
“What?” you say? “Acupuncture isn’t painful!” “Why would you see someone if it is painful?”
No, acupuncture doesn’t have to be painful – and for most people it is not. But seeing Julie makes me realise that no two practitioners are ever the same when it comes to physical therapy. I joked around with Julie and said “wow those are some serious needles – this is not some fru-fru treatment”—
She said to me that when she studied with masters in China her teacher constantly encouraged her to “Go Deeper”. There is no need for a practitioner – or a recipient – to fear acupuncture needles or the depth of their insertion (again – as long as you see a qualified practitioner!).
I mentioned to Julie that in February 2011 on the Strong Like Bull training camp that one of the attendees Anna was a physiotherapist who practiced needling in New York – and that she had tried needle based release on my legs.
Anna needled my calves. The needles she used were more delicate, and not as long, and not inserted as deeply.
Julie asked how that treatment felt. “Well, just not the same,” I replied. “The effect was not as profound, it didn’t last.” The treatment helped to relax my legs, but it didn’t go as far as relaxing my feet. And ultimately, I want my feet to feel relaxed and to feel the benefit of these treatments – that is what defines a good treatment for me.
Different practitioners lead to different results. I go to Julie because I get true results – maybe because she goes deeper. She does not fear placing long needles deeply to adequately stimulate release. When I finish a session my palms may be sweating, but my feet feel relaxed, warm and happy. And happy feet are the true test of success for me when it comes to use of needle-based therapy.
One of the other parts of treatment that I receive from Julie is Intramuscular Stimulation – and *this* is the source of the pain I mentioned before. Acupuncture is fairly pain free. But IMS? A whole other ball game.
Intramuscular Stimulation – IMS
I first read about IMS when an abstract of a paper on the use of needle therapy to help muscle elongation was circulated on one of the yahoogroups for my nerve disease.
The paper mostly talks about the occurrence of nerve-related pain – pain that happens in the absense of diagnosable injury (no inflammation, nothing showing on imaging screens). This can be triggered by a shortening of muscles and tendons, which in turn causes stress to joints and bones. Such shortening can lead to degeneration through osteoarthritis, and can lead to chronic pain in sufferers.
I was intrigued. One of the features of CMT is that it causes atrophy and shortening of the distal (leg and arm) muscles. I have always believed that I need to work on both strengthening and lengthening my muscles, to help manage the impacts of CMT on my life. I decided to look into IMS and researched for practitioners of intramuscular stimulation in London – the therapy covered in the paper – and that’s how I found Julie.
The basic tenet of intramuscular stimulation is to force a muscle contraction to enable the relaxation and elongation of the muscle. IMS uses acupuncture needles for this stimulation. The therapist needs good understanding of the location of muscles, trigger points, and nerve channels. Using a needle a therapist can cause a contraction and relaxation in muscles that fingers or massage cannot reach.
Here is what I have done for my legs and other tight muscle areas (like my hip flexors). Do not view this if you have an aversion to needles. It is pretty intense – and this is only one spot of insertion. On Friday I had about 15 points of insertion on each leg where a long acupuncture needle was inserted and contraction forced.
It can be painful. My palms sweat and I feel anxious in the process. I do my best to focus on deep breathing – but sometimes I forget and Julie needs to remind me to breathe. I don’t know if IMS is for everyone – but what I can say is that it completely relaxes my muscles – and feet.
Following a treatment my feet feel unnaturally warm. Wherever I have been needled feels dead – just achy and tired. Julie says that is because a lot of calcium is released in the muscle contraction. In general I find it takes me a day to recover, and two days for the soreness to vanish. As I am managing a chronic condition it is better for me to continue a regular course of treatment, rather than to stop and start treatments. But of course, because I remember the pain of the visits, I sometimes avoid booking. If only I was better at remembering the after effect – which is a feeling of complete relief!
I had this done last week Friday. And I hope I can schedule another appointment before I leave for my race on Friday. My foot and tendonitis feels better, there is less pull and less general tightness. I also had ultrasound on the tendon to help stimulate regeneration and to provide temporary relief. This was my first ultrasound experience and it felt amazing.
A late last minute effort to get things under control before the 28th – but one that helps I hope!