My Experience With Triggerpoint Dry Needling

If you follow me on Facebook, you are aware of my current frustrations in my training for the Cellcom Green Bay Marathon on May 18th. Yes, this May 18th.....as in 7 days away. If you haven't been following or don't follow me, I'll enlighten you with my current situation. On April 26th I ran the Jailbreak 5k and finished feeling just fine. I went to work that night and felt sore, nothing crazy, just your usual post race soreness. I had off from work on Sunday and just came home from work in the morning and rode my bike. Monday morning I was scheduled for a 4 hour block of EVOC (Emergency Vehicle Operation Course) training from 8-12pm, I was also scheduled to run 20 miles. It was going to be my last long run leading up to the Marathon. I got up at 3:30am to get my run in before my training. My calves were still sore from the 5k, but I figured I would be alright and they would just work themselves out. I was planning on running four 5 mile loops. I finished my first loop with light pain and told myself, lets do another loop and we will reassess at that point. I got about half way and I knew I was going to be done running for the day after I got back home. My left calf was way too tight and painful to continue. I had to ask myself, "Ultimately, what is best for my marathon at this point - quitting after 10 miles or forcing another 10? It was an easy decision, I had to quit. I would get nothing but a possible injury that would prevent me from even getting to the start line. I decided to take some time and rest. I did just that. I took a couple days off from running and swam on Tuesday, did an hour on an elliptical on Wednesday and tried getting a run in on a treadmill. I felt fine the first 5-6 miles but then started feeling a pointed tightness/pain in my left calf again. I stopped again after 10 miles. I again took a couple days off from running and again, tried to get another run in on Sunday, May 4th. This time, I got to about mile 5 and it got bad, my calf was very tight and painful. I pulled up after 6 miles and walked the final mile home. It was at that point I knew I had to do something if I was going to not only get to the start line, but finish.

I shared my current situation with my teammates on The Tri Shop's Triathlon Team. Among the suggestions I had, ART was one of them. ART is an acronym for Active Release Techniques. ART is basically a painful massage with the goal of releasing tension in a muscle or group of muscles. I have a friend who I went to high school and college with who has become a rather successful Physical Therapist in Kirkland, Washington. He has partnered with another PT to start their own practice called, Doctors of Physical Therapy - you can check them out here - www.doctorsofpt.com Through my relationship with him I have seen a lot of posts and information regarding a "new" technique called Triggerpoint Dry Needling (TDN). I have seen photos of it, but never thought anything of it....until now. I jumped online and sent him a message asking about TDN and if it would be applicable with my current symptoms. I was encouraged with his response. He told me my issues could potentially see great results from dry needling. Compared to ART, dry needling will elicit a similar healing response, only in less time and less painful. PERFECT! With his help, we found a physical therapist in the Fox Valley who is certified to perform dry needling. Which brings me to Alex, my new PT of Orthopedic and Spine Therapy. But, before I share my experience with dry needling, I should first briefly explain what dry needling is.

What is Triggerpoint Dry Needling

First off, I am in no way associated with any dry needling certification that is out there.  I have never taken an courses or studied dry needling.  Everything I know about TDN is from many websites I have read in researching TDN prior to me proceeding to actually have it done to me.  Most of this section is from my friend's article from his practice's blog, entitled, "What is Triggerpoint Dry Needling?"  TDN all started when doctors would insert needles into muscles for various reasons and they observed that each and every time there would be an involuntary twitch of that muscle.  Not much was thought of it, until that involuntary twitch was researched.  It was learned that this response can in fact help treat muscular ailments.  So in short, the process starts with the clinician palpating the injured/effected area feeling for "triggerpoints."  Once a triggerpoint is felt, a very low gauge needle is inserted into that muscle.  The needle is pulled in and out, but never coming out from under the skin.  Each individual poke on muscle fibers will elicit a twitch response.  this twitch response is what the clinician is seeking.  When this occurs there are several chemical and physiological changes that occur within that individual muscle which help with the healing process.  The insertion of the needle itself is in fact painless, in fact, I would be surprised if anyone could actually feel the needle being inserted.  The sensation of a muscle "twitch" varies from patient to patient and is often described as cramp-like sensation.  After the initial treatment, depending on the duration and the number of triggerpoints that were treated, the patient will generally have some minor residual soreness which typically lasts about 24 hours.  It seems that majority of patients realize the best results after 2-4 treatments and individual treatments can last up to 72 hours with out feeling the original symptoms.  

Triggerpoint Dry Needling can be used to help treat the following conditions:

• Muscular Hematomas
• Muscle Tears
• Compartment Syndrome
• Medial Tibial Stress Syndrome (Shin Splints)
• Rotator Cuff Injuries
• Tennis Elbow

My Experience With Dry Needling

After my last attempt at running that Sunday morning, I knew something had to be done, otherwise there was no way I would finish my marathon on the 18th.  I called up Orthopedic and Spine Therapy (OST) to schedule an appointment as soon as possible, specifically for dry needling.  Luckily, with my insurance I was able to schedule an appointment without a doctors referral.  OST was able to get me in on Wednesday morning.  That morning, I went in not really knowing what to expect.  I have no issues or fears with needles, never have.  I was expecting the twitch to feel similar to the use of an e-stim (Electrical Muscle Stimulation) unit, which really has no pain involved at all.  After a brief analysis of my "injury," we jumped right into the Dry Needling.  Just as I had read, the insertion of the needle was pain free, I couldn't even feel the needle going in.  But then he started to poke the muscle belly.  Oh boy, that I could feel.  Theoretically, a patient will feel a more aggressive twitch in the injured muscle tissue compared to a supple, relaxed, uninjured muscle fiber.  The twitch had an electrical pulse feel to it.  I could feel my muscles tightening with each individual poke of the needle.  Now, I will be completely honest, I am a sucker for pain.  I enjoy the way tattoos feel, I enjoy e-stim, and I enjoy suffering - to a point, obviously.  The "pain" associated with TDN is a very gentle pain - if that makes sense.  It doesn't hurt, but there is a level of discomfort associated with TDN.  I have heard that other patients often find themselves holding their breaths or even gasping during some of their twitches.  As for me, I found it to be relaxing....yea, I know...weird.  My first TDN session consisted of 30-40 minutes of straight dry needling.  Some patients can only handle one or two triggerpoints, were I think we did a good dozen individual triggerpoints.

Immediately following my treatment, my calf was tight as hell. We did some light stretching of the gastrocnemius and soleus muscles (the two muscles of the calf) and ended with 5-10 minutes of just relaxing with a heating pad on my calf.  The remainder of the day, my calf was so tight I was forced to walk very gingerly.  I tried to stretch it as much as I could to help alleviate some of the tightness.  The next day I felt better, still a tightness in the calf, but I was walking normal and felt like if I had to, I could have ran.  My plan for prepping for the Cellcom Green Bay Marathon was to swim all week and do no running until the week before.  I had made two scheduled appointments for additional TDN treatments, on Friday and then Monday.

Friday morning was my second appointment.  My calf felt normal going into my appointment, I had little to no residual tightness.  This session consisted of few TDN treatments, probably closer to 20 minutes of needling.  The twitch responses were not as aggressive nor were they as painful as the first time.  I was also walking more easily immediately following the treatments.  The next day, I felt great, still a bit tight, but nothing more then how I feel after a tough running workout.  I utilized my heating pad and foam roller daily to help with the tightness.  I also stretched my calf whenever I had a chance.

The Sunday following my second appoint I finally got out for a run - my first run since being forced to stop in the middle of my run due to the pain in my calf.  I wanted to do an 8 mile run consisting of two sets of 3 mile loops done at my goal marathon pace of 6:50/mile.  I started the workout with a one mile warm up and jumped into my first set of 3 miles.  I felt great, my calf felt like it did earlier in the year.  I did notice a slight tightness in my right calf now, but didn't think anything of it.  As I got into my second set, it continued to get tighter, until with about a half mile to go, it just locked up, like a bad cramp.  I called it a day right there and just walked home.  I had no issues with my left calf for the first time in 3 weeks.  It was now my right calf. My plan of action now, is to go to my next appointment which is conveniently tomorrow morning and get both calves addressed adn hopefully be a green light in a week.  I have never been so unsure about a race.  It could go better then planned and I can beat my goal or I could seize up and not even get through the first 5k.  I do know one thing though, I will be there at the start line with my game face on and the mentality that I will finish.

I am sold on TDN as an effective treatment for muscular issues, no doubt.  The fact that my left calf felt like a new muscle in just a week is remarkable.  Now, just to get both calves figured out and hopefully healed up not only to finish the marathon next week, but to set myself up for a successful triathlon season which begins immediately following the marathon.  I will definitely update this post after the marathon with how the race went and how I feel TDN treatments effected my ability to run the marathon.  But, for right now, I am personally at a loss for proper words to describe how I am feeling about the marathon.  I am both excited, as this is one of my all time favorite races, and also a bit scared.  Scared of the unknown of what the day will bring.  As for TDN, I am believe TDN gets a definite 'YES,' and I would highly recommend it for muscular injuries.  You can find a local TDN therapist at this website HERE.