Early last August I was cruising down the rocky trail back into the treeline above Loch Long after a nice wee loop taking in The Cobbler, Beinn Ime and Beinn Narnian when, not paying attention, I smacked my foot off a particuarly agressively spiked rock. At the time it reduced me to a hobble, but I didn't think much of it. For the next month it was giving me issues but it wasn't a huge concern given I barely saw tarmac until I returned to Hong Kong in September. I had major issues with it during the CCC but was able to get through it and shortly there after it vanished.
Fast forward to December and 70km into the The North Face 100- Hong Kong, and while in a solid 4th place, out pops the same issue after months of silence. This time I wasn't able to run through it, and while it was far from the only critical issue I had on the day it was a major factor in me withdrawing at 80km. More than a month later and it is still severely limiting my running. Rest, anti- inflamatories, ice and taping were all duly used to try and resolve the issue with no discernible improvement. It was time for affimative action.
Being based in Hong Kong opens up a whole host of alternatives to 'traditional' sports physiotherapy or podiatry. Affirmative action in this case meant my first trip to the infamous Needle Man.
Alain Chu is well known in trail and ultra running circles. His reputation preceeds him, both in terms of his ability to help runners get over long standing injuries but also in terms of the amount of pain he is able to inflict while doing so. With a reputation like this you have to be pretty committed to proceed with is treatment, and it was with not small amount of trepidation that I booked an appointment to see him.
Chu apparently used to be a physiotherapist (as well as an alpinist) and now runs his own clinic specialising in chronic musculoskeletal pain and sports injury treatment. He developed his own techniques out of a frustration with the results he was seeing from traditional treatment approaches. These treatments involve the exclusive use of needles, with the focus being on stimulating myofacial release by making incisions in the muscle and myofacial layer to encourage healing. Or to put it simply, he sticks needles, really big needles, into to you causing internal lacerations to free the fascia and promote healing. Sounds painful? It is.
Upon entering his surgery your are greated with numerous stern warnings posted at the reception warning needle phobics and skeptics that they are in the wrong place. If that was not enough you are then handed the final rules of engagement in the form of a highlighted print out. If you weren't concerned before hand then you would be now. I was called in for my consultation and explained my issue and described the injury in detail, numbness, pins and needles building up to sharp pain after a while. As I had suspected it was quickly diagnosed as a Mortons Neuroma like issue. Flicking though an anatomy book I was given a guided tour of the problem. Basically I had injured the tissue around the nerve between my 3rd and 4th metatarsal. As this tissue becomes inflamed after running on it, it swells and traps the nerve causing the pain. It was apparently treatable with needling with cutting needles but it would be tricky since it would require precise placement so close to the nerve which might require a few visits to get right. Given the location on the bottom of my foot it would also be very painful and I was warned it was 'more like a minor operation than acupuncture'. This understood I was directed to the treatment room for the first attempt, by now sweating.
I was directed to lie face down on the treatment bed, and had my foot cleaned up (since rather embarrassingly I'd apparently I'd neglected to clean the bottom of my foot properly before hand) , disinfected and then prodded and poked to identify areas of relative tenderness and focus of the pain. He then gave me a warning and I felt the first sharp prick of the obviously substantial needle. Initially it wasn't that bad, but then after after a second warning the pressure increased and the pain became briefly excruciating, and was accompanied by what felt like a light crunch as the needle went deeper into in my foot. I was repeatedly asked if the pain was local or if I felt pins and needles in my toes, as he was concerned about hitting the nerve. The sharp pain didn't last long and remained local, though it sure as hell wasn't fun. Mr Chu mentioned at one point during the procedure that I must have a very pain threshold, to which I joked about something running 100ks in the mountains preparing me for it. I suspect it was intended as a comfort than a statement of fact. 5 or 6 of these painful incisions later and I was done. Despite my curiosity I never actually got to see the needles.
Fingers crossed it helps me get back on the horse.
