Happy Monday, friends! Okay maybe not happy, but...Monday. I wanted to pull this post together in a fairly prompt fashion so that it would be done while the experience was still fresh in my mind and so I could share this experience with anyone who might be considering dry needling as a form of treatment for injury.

Before I tell you what my appointment was like, I thought I'd provide you with a little background on dry needling. Honestly, I had never heard about it until it was suggested that I try it and I saw myself as someone who was fairly up to date on injury interventions and treatments for runners. First of all, do not confuse dry needling with acupuncture, as they are NOT the same. While acupuncture targets meridians in the body, dry needling targets myofascial (muscular) trigger points. The goal (in my case) is to treat spasm and tension related to muscle and ligament strains. This is a great explanation of what dry needling is and how it works.

The short short version is that a small solid filament needle is inserted into a specific area (for me, the insertion was guided by ultrasound) in order to create a twitch reflex. This reflex interrupts the pain cycle. Additionally, the insertion of the needle itself generates an immune system response and asks the body to respond to the increased inflammation. The end game is to increase range of motion, decrease pain, and promote healing. I'm (clearly) not a medical professional so I don't completely understand the science, nor can I articulate it as well as I would like. If I have muddled the explanation at all, forgive me. Onto the appointment itself!

I was treated by Dr. Tobacco, and he was awesome. I'd seen him a few weeks prior for the original ultrasound that identified what was going on. I could have had my first needling session right then and there but I wanted to have a day or two to think about it, do my research, and find out if my health insurance would cover it. Once I decided to move forward and had the thumbs up from the insurance company, I made the appointment. I honestly didn't know what to expect. The whole appointment took 30 minutes but most of that was getting ready beforehand and putting myself back together after.

We went back over what was originally seen on the ultrasound and he explained how things would work. Because of the location of my injury, we had to get pretty comfortable pretty quickly. Runners aren't a modest bunch to begin with, but whatever modesty I had left went out the door at this appointment. As I'd explained previously, the injury is located where the adductor meets sitz bone. Or, as I am calling it, my legbutt. This means 2 things. 1: I'm getting needles stuck into what is already a fairly sensitive area. 2: I'm baring almost all to a person I've met once before for 30 minutes and he'll be paying pretty close attention. Sigh. Remember what I said about modesty?
The face of a very unhappy camper
Because I was prone as shown above, I could not see the needles being put in. Once I was in an optimum spot for prodding, he used the ultrasound (and some hand-poking) to narrow down the spots for insertion (aka find the ouch and then add more ouch). The initial poke of the needle was fine, but location of certain needles and what they connected with shot the pain meter up more than once. I had 5 needles in overall, two or three that stayed in for several minutes as I could tolerate them easier than the others. When Dr. Tobacco and his tech stepped out for a minute, I did my best to snag a selfie of his handiwork. Yes, I got the picture. No, I will not post it here. Ow and ew.
My view while they worked
As I said, I was in and out in 30 minutes. No activity for the next 48 hours, although I could stretch a little later in evening if I felt up to it. On Sunday I could go for a slow 0.5 mile jog (yes, I used the word jog) to see how it felt. Based on the outcome of the jog, we would decide if another session would be helpful. I went back to work for the last couple of hours of the day, but it wasn't ideal. I could not get comfortable at my desk. I wasn't in pain, I was just really uncomfortable. Standing up was the best option but my workspace isn't set up for that (yet). I spent Friday night horizontal and therefore slightly less uncomfortable. All sorts of soul-soothing foods were applied (thanks, MS).  I took a sleep aid after struggling to fall asleep on my own (mental and physical stress, my friends).

Images Dr. T captured to show needle placement
I was achy on Saturday morning but things eased up the more I moved around. Nothing strenuous, just walking around the apartment (and maybe a stop at Trader Joes and Total Wine). Easier time falling asleep, less achy Sunday morning. At this point, I am a little shaky on determining what is actually pain, or whether I am anticipating pain. I felt good enough to try the 0.5 mile jog. I foamrolled first, walked for 5 minutes to make sure I felt warm, and then hit start on the watch. I focused on all the form cues I've been given over the past months, kept things as slow as possible while still making forward progress, and overanalyzed every second. After I hit the mark, I walked another 5 minutes, foamrolled again, and resumed my horizontal position. On a pain scale of 0-10, I'd say that jog was a 1. Progress.
I could waste emotional energy on the time it took to complete that 0.5 mile. But it was my first run in almost 8 weeks. And I was outside in the SUN. It was both a HUGE tease and a HUGE treat. I felt less achy this morning, but after 10+ hours of sitting in a car, at my desk, and in a plastic chair at a study group, I was uncomfortable again. Sitting = stretching the area. Sitting = pressure on an ouchy area. I've got the ball rolling at the office to see if temporary accommodations can be made in my workspace. Fingers crossed there! I am leaning towards a second round of needling, as I feel better after than I did before. I am planning to debrief with Dr. T and my physical therapist tomorrow, let them know how things have been going and see what a return to regular activity should look like.

I have a race this coming Sunday. Ha. You know I'm going to ask if I can go. Stay tuned to see how that shakes out. :) Thanks for hanging in there this long! Have you had dry needling or any other new-fangled treatment before? Would you consider trying it?