First, bones and muscles have a lot of blood flow going to them and as you probably know blood carries your body's healing agents. This is why muscle injuries and bones can heal much more quickly than tendons or ligaments which have very little blood flow.
I did several rounds of biopuncture leading up to the September race in an effort to speed along the healing process while stubbornly staying committed to doing the race. Biopuncture is the injection of biologically active substances which are physiologically regulating. The injections generally also include some sort of pain management ingredient. These injections while fairly painful at first leave the area pretty numb after a few minutes, the worst injection was into the second metatarsal joint. I think biopuncture is a useful tool if you start treating an injury pretty soon after it occurs but the level of pain I was in coupled with the fact my tendons where essentially fused together meant that biopuncture was not effective in solving my issue.
After my race failure I threw up my hands and told the doctor I would do whatever he wanted me to so that I could get back to full training by January 1st. He immediately mentioned a boot and PRP. PRP stands for Platelet-Rich Plasma and is a process by which the doctor draws your own blood, spins it for 14 minutes to draw out the platelets and then injections the platelets into the affected areas. This process is the most painful procedure I have ever experienced. Drawing the blood is no problem at all but the needle used to inject them back in is rather large and these injections go much deeper than the Biopuncture.
Dr Scott at performance health suggested that we do three rounds, each spaced a week apart to really get ahead of things and attempt to aggressively get me back to training. The first round as scheduled at 10am and I went to work afterwards and that was a HORRIBLE idea. The pain was intense, white hot pain that made it almost impossible to walk even with the boot. I promptly changed the appointments for the next two rounds to be later in the day. I highly recommend doing the injections late and then going straight home and putting your foot up. You are not supposed to take any sort of anti-inflammatory because your body's natural healing involves swelling and let me tell you my foot looked like a Flintstones foot for the better part of those three weeks. The intense pain that limits walking and movement lasted about 24 hours the first time, however it increased with the second and third rounds. With Biopuncture it is important to get the area moving immediately post injections, however with PRP the goal is actually to keep the area pretty immobilized in order to allow the platelets to do their job and repair the area.
The first round of injections was done on October 13th and Dr Scott said that typically it is 6-8 weeks to notice the gains from the injections, this week is 6 weeks from that first round and I have definitely noticed drastic improvement. I no longer have constant pain in my foot, however I still am not allowed to do much as far as training. We have coupled the injections with pretty intense manual therapy, which is essentially a very focused, very deep massage. For me this has been an extremely painful but cathartic process to break up all the scar tissue and fascia that has formed binding the tendons together and keeping my toes from properly moving.
While this whole process has been extremely painful I am starting to see the light at the end of the tunnel and I even got in the pool on Saturday and swam 1000 meters with the pull buoy, still can't kick but at least I was able to practice!
If you have any other questions that I didn't answer let me know!