I’ve been chronicling the treatment of my plantar fasciitis— I badly tore it in a freak accident with bees last August. Making the switch back to more minimalist shoes has probably been the single most helpful thing I’ve done so far to functionally get my foot back to normal. However, I’ve also been seeking out medical treatments to alleviate the pain and scar tissue, namely acupuncture and ART (in combination) with my Chiropractor, Kevin Jones at Chiroplus, and then also dry needling with my PT/runner friend in Tulsa, Terri Cassel. I’m thankful to have these two wonderful healthcare professionals in our area, and I highly recommend them to others! I thought it would be helpful to write a blog about my experience with both, as I’m sure there’s others out there considering these treatment methods and wondering how they compare and contrast.
I’ve had great success in the past with acupuncture, as I previously blogged about how it kicked an IT band issue and a 2 year Sciatica/pain-in-the-butt issue. My understanding of how acupuncture “works” is that there’s ‘energy pathways/meridians’ running through the body, and they can become ‘blocked’/irritated. Sticking acupuncture needles in different ~peripheral spots along these pathways helps to clear the pathways so the energy/”Qi” can flow. There’s other theories on how it works, like overstimulating the nerves and getting them to “release”… and causing the release of endorphins for pain relief and muscle relaxation.
My experience is that whether acupuncture works for a problem depends on both the problem/severity and also the skill of the practitioner. I remember when I dealt with my hip and right foot stuff (my other foot, not the left foot that has the PF), I had acupuncture done by two practitioners– a chiropractor in Indiana who was not-so-good and then my “magic man”, Dr. Harold Owens (rest in peace), who was the best acupuncturist I’ve worked with. I got some relief, but I could tell both problems were still there. This indicated to me that I had a serious problem– I ended up getting hernia surgery in 2010, while we were able to kick my labral tear pain with a diagnostic amount of cortisone and rest. These were problems that not even Dr. Owens could kick!
As far as my current plantar fasciitis problem, I’ve been seeing Dr. Kevin Jones in Oklahoma City, who does both acupuncture and ART together. I previously wrote about getting ART treatments with Kevin last spring (my other foot). To describe a typical treatment, Kevin inserts the thin needles peripherally around the painful knot on my heel (feels like a prick, like if you got a shot or blood draw). I lay there quietly/relaxed for ~10 min., he might tap the needles to stimulate them, and as he describes it it causes the area to relax, release endorphins, and increase blood flow and healing of the area. For the most part, it’s a pleasant experience and not very painful/squeamish. Then he removes the needles and performs ART, to hopefully get a myofascial release of the scar tissue.
My experience in the past is that I could be cured with 1-3 acupuncture treatments. I’ve seen Kevin at least 10 times (2x/week for 45 min. per treatment), and while I always feel pain relief, only about 3 out of the 10 times have I felt a significant myofascial release. This indicates to me that either 1) Running is continuing to mechanically irritate the area and prevent it from fully healing, which may mean the need to rest and/or 2) I need more direct, aggressive treatment to stimulate the scar tissue area and get it to heal properly.
Most definitely, my PF is not just a “pain problem” that can be successfully treated with a few acupuncture treatments– there’s significant scar tissue (although it’s shrinking) that needs a direct, aggressive treatment approach. As I’ve mentioned in past posts, each person’s case of PF is different. Each person needs to figure out for themselves, through trial and error, what treatment(s) work the best. For someone who has a less severe case of PF (and not pushing their body like I do!), the combination of acupuncture with ART might be totally effective. However, given the severity of my PF, I decided to give dry needling a try, since it’s more direct and aggressive.
Contrary to the “peripheral” application of acupuncture needles, dry needling works by sticking acupuncture needles (which Terri says are the same gauge/size as acupuncture needles) directly into the sore area and trigger points of the muscles (~nerve bundle), to get the nerve/muscle to release/relax and stimulate blood flow and healing of the area. Most people have likely heard of “trigger point therapy”, whereas a massage therapist applies external, manual pressure or you might do so on yourself at home. Dry needling does the same thing… except sticking needles directly/internally into the trigger points! It’s called “Dry” needling because whereas ~prolotherapy/PRP injects some type of fluid into the area, dry needling doesn’t.
Additionally, whereas acupuncture needles are inserted all over and I lay there quietly/relaxed for 10 min… with the dry needling, Terri inserts the needle into the trigger point and wiggles/pecks/flosses around for ~30 seconds. It’s much more squeamish and feels weird! I might feel the muscle twitch and release or feel a zing. Also, acupuncture needles don’t go very deep– with the dry needling, Terri inserts the needle all the way to the bone, so much deeper and direct!
For my plantar fasciitis, Terri decided to work both my calf (which she says is tight) and also my foot. As she pointed out, working the calf for some reason leaves you feeling VERY SORE/cramped… like there’s no way you could go run after getting dry needling done on your calf, but you’ll be fine the next day. However, working the heel is one of the most painful areas in the body (heels and palms), but after the treatment you’re not as sore (as the calf!) and actually should feel better.
I’ve seen Terri twice so far, once/week (she’s up in Tulsa, 1:50 from us). Dry needling is usually done by a PT and is a fairly new procedure. While searching around the net trying to find a practitioner in our area, I found one local guy who does it… but he’s out-of-network on our insurance! It was by chance that I decided to contact Terri, since I know her, and found out she not only does dry needling but is also covered by our insurance! If you’re looking for someone in your area who does this, ask around to other runner friends and PTs. You might have to drive a distance, since not as many practitioners do it.
As far as the effectiveness of dry needling, I most definitely felt like it helped my foot to “release” and be in less pain. I did a hard workout 2 days after treatment, 16 x 90 seconds, and it was the best my pushoff has been– definitely more power and fluidness in my gait. My foot didn’t poop out and get sore during the workout… but it did get sore during my cooldown (~running more on my heels).
On the second treatment (Terri worked more directly on the spot that bothers me), she mentioned that she feels a “softness” on my heel and thick scar tissue when she inserts the needles. I told her the MRI back in January showed edema outside the bone and within the bone, along with thick scar tissue. My theory is the lingering scar tissue is continuing to “bruise” and irritate the bone/nerves and create edema, which is why I tend to get sore landing moreso on my heels (as I mentioned with all the downhill running at Two Oceans, or getting sore on my cooldown). Terri recommended that I try A-stim or Graston next (Edit: A-STYM), to see if we can get rid of the scar tissue. I’m trying A-stim next week with Terri’s co-worker, so this might be a future post! I’ve also thought about taking a rest at some point soon, to see if we can get the edema to subside and allow the area to fully heal.
In conclusion, you can try for yourself on whether acupuncture, dry needling, or both in combination provide the needed relief for plantar fasciitis or another injury. If anyone has questions or feedback, feel free to comment!