From Sidelined by Injury to Running 200 Miles Per Week: An Ultrarunner and an Acupuncturist Find the Solution—and a New Perspective

By Megan Toth

July 205

“Success is not a random act. It arises out of a predictable and powerful set of circumstances and opportunities .... No one who can rise before dawn three hundred sixty days a year fails to make his family rich.” ― Malcolm Gladwell, Outliers: The Story of Success

On Course to the Spartathlon: Accupuncture, Trust, and Determination

Malcolm Gladwell writes quite a bit about success in his book Outliers, and he emphasizes that success doesn't fall from the sky to visit the exceptionally talented, lucky, or the ready. Instead, it's more often a product of hours of practice, drive, determination, and applied logic. Running coach and attorney Andrei Nana knows a thing or two about success—and failure. South Florida resident - born in Romania, Nana has quickly built a running career in the international ultramarathoning scene, and now acts as a race director for Icarus Florida UltraFest, a premier six-day ultramarathon event in South Florida that draws athletes from around the world. Yet, Nana is no stranger to setbacks.

Training Through Pain

Currently facing a goal of running the 2015 Spartathlon, a 153 mile (246 km) race from Athens to Sparta, in September, he realized that action was necessary to handle a worsening injury. He completed the race for the first time in 2013, but developed an injury to his tibia/calf. “The entire 2014 I trained and raced on that injury. While I was able to accomplish my goals, finish a race in Italy over 175 miles long and finish the Spartathlon for the second time, my performance was weak. My finish time was 3 hours longer than in 2013. I was not able to properly train and in a way it was a “miracle” I finished the race. The body and mind failed early on and the only thing that crossed me over the finish line was this incapacity to accept defeat built over the years of racing through the force of habit.”

This paradox is something athletes know well: While solution to injuries is necessary, time away from training pushes goals further and further into the distance. Nana was not willing to let his goals move out of sight. This incapacity to accept defeat is something ultramarathoners speak of often. The sport calls on the human to draw from whatever reserves available—mental, physical, and spiritual—to defeat obstacles and finish the course.

Nana says that throughout 2014, training was a nightmare, with pain every step of the way. “There were weeks when I could not walk, the running was with a limp and mentally I was down as it becomes extremely difficult to motivate yourself when day after day the results are decreasing, the pain is increasing and there is no hope for the better. Even if I accepted the pain as part of my routine, most days it would be extremely difficult to wake after 3 hours of sleep to go out and run in pain for the next four hours.”

At the end of the 2014 Spartathlon, Nana decided to take a longer break to allow his left leg to heal. But something else had resulted from running thousands of miles on an injured leg: His body had shifted the weight to compensate almost entirely on his right leg. Once his bone had healed and he restarted training, the muscles of his left leg had atrophied. Within a few months, he was able to run an average 80 miles (130 km) per week, but intense pain required days off every four to five days for recovery. That's when Nana's wife, Claire, delivered an ultimatum. According to him, she suggested that he either find therapy to fix the problem, or she would not help him in future races.

Nana reluctantly agreed to visit specialists at the Center for Massage Therapy in Cooper City, and that's where he met Andrew Farretta, a Florida native who specializes in acupuncture and Chinese Medicine.

Open to Solutions

“Acupuncture was never on my list of viable options,” says Nana, “and with such a large influx of charlatans in the 'alternative medicine' I had no hope for better.” Yet, he agreed to at least find out what Drew Farretta had to offer.

Nana went into the first meeting with Farretta a skeptical, and thus wanted to test his reactions. When Farretta asked Nana his issue and his goal, Nana responded bluntly “I run in average 80 miles (130 km) per week and I am in pain. I am willing to give you an honest try, however I do not have much hope. I can tell you that I am a carnivore (my nutrition needs are met with large quantities of red meat and red wine), I do not eat veggies, I do not stretch, I do not do yoga and have no intention of changing my life style. If your treatment works, it should work on its own without me doing anything else. I will allow you to do/try whatever you consider necessary while I am here, but I have to continue to train. I would like to be able to run 200 miles (320 km) per week in about 2 months, if possible with less pain.”

To Nana's surprise, Farretta said, “All right then, let's start and see how you respond to the treatment.” No twitch, no judgment, no frustration or anger. He continued, “You will likely see some improvement in the first 24 to 48 hours. After each treatment, you need to keep notes of exactly how your leg feels and any changes, and report them back to me the next time I see you.”

To Nana's surprise and satisfaction, Farretta was right. Within the first few hours of experiencing acupuncture with Farretta, the pain began shifting around. Nana followed Farretta's instructions, returning each week for treatment with reports. After eight weeks, he was back on track, running 200 miles (320 km) a week with no pain, and only slight discomfort.

Nana wasn't the only one shocked by the experience. Farretta admits to being shocked by Nana's drive and endurance of frustration. “When Nana explained that he was a distance runner who required about 200 miles (320 km) per week of training to maintain optimal performance levels I was shocked. I have never worked with an endurance athlete who, when pain free, was most likely performing at a level few humans will ever achieve. At this point he was running only 80 miles (130 km) a week due to pain.” Being very involved in physical training himself, Drew could imagine how frustrating Nana's situation must have been. “A main focus in my training is injury prevention. When one is highly active five or more days a week, having to take a break to recover from a trauma is frightening.”

Successful Treatment

Farretta was determined to stimulate Nana's body to resolve pain and inflammation through the use of acupuncture, electrical stimulation, and infrared heat application. “Andrei had pain along the medial aspect of the lower leg along the tibia and in several locations in the calf muscles. Pain was also present in tight points around the head of the fibula. Sometimes the pain was dull but could become sharp and excruciating during or following a run. He had received massage therapy with other therapists on two occasions. One of the treatments had provided some temporary relief and seemed to relax the muscles while the other deep tissue treatment only seemed to irritate the calf.

In Chinese medical theory, once an injury is no longer in an acute stage, stagnation of qi (energy) and blood are seen as the reason behind pain. When these vital energies in the body are not moving as they should, discomfort is common. This theory is supported by the fact that many therapies which relieve pain result in increased circulation. Acupuncture, stretching, massage, application of heat, etc. all result in blood profusion in the area treated. The blood carries oxygen, nutrients, and messenger molecules of the immune system to tissues so healing can take place.”

Since a previous massage session had aggravated Nana's pain, Farretta decided to avoid further massage therapy as well as stretching exercises—Nana had explicitly said that he does not spend time stretching the calf. Incorporation of brand new practices foreign to Nana's training routine were not the focus of this therapy.

Farretta explains his process of treating the calf with acupuncture: “Acupuncture began with the use of points located on some of the main channels of acupuncture which were close to or ran through areas of pain. Some painful trigger points in the soleus, gastrocnemius & peroneal muscles were treated. Wires were attached to 2 needles in the more painful locations and electrical stimulation was applied at a level that was comfortable to the patient & would often elicit a muscular contraction with each pulse of the machine. An infrared heat lamp was positioned over the calf.” By the third treatment, Nana reported a feeling of 30 percent improvement, with inconsistent pain levels across his workouts. But by the sixth session, he was running 145 miles (230 km) per week with very little pain. By the end of eight full sessions, Nana was running 200 miles (320 km) weekly, experiencing only occasional discomfort.

Changed Perspectives

Both Farretta and Nana experienced surprise in this unlikely encounter between an ultramarathoner and a specialist in Chinese medicine. “In eight weeks,” says Nana, “I moved from being a non-believer to understanding the amazing healing capacity of Drew Farretta. I fully endorse him now.”

Farretta explains that he was drawn to Chinese medicine and accupuncture after being exposed to ancient healing traditions during his studies of injury and disease prevention. After finishing accupuncture school in 2011, he traveled to China with two classmates and observed Chinese doctors in hospitals and clinics. This exposure informed his belief and passion for alternative healing practices.

He admits to becoming frustrated with the stress of practicing a form of medicine that is not yet widely accepted. “The ignorance of the public—often due to the media, the problems with modern medicine and how it's dominated by the pharmaceutical companies, etc. can be stressful. Walking through a groceries store and seeing all the junk that contributes to the most common health issues is frustrating. I often practice spiritual and personally beneficial activities such as my hobbies to prevent letting this get to me.” Farretta could relate easily to an ultrarunner like Nana, because he leads an active lifestyle and places health and fitness at the forefront. “Outside of the practice, my hobbies are yoga, circus arts, gymnastics, CrossFit, family and friends, and spending time in nature. Of the physical activities I participate in, often seven days a week, are constantly varied but usually high-intensity. Exercise provides relief of stress, and achieving new goals and improvements in strength and flexibility supply positive feelings.”

Both Nana and Farretta continue to focus on the light at the end of stress, injury, and setbacks. Nana expresses gratitude for having met Farretta, and appreciation for his wife's push toward therapy: “I feel now like I have crossed the darkness and I am back to solid training, looking forward with optimism to racing the Spartathlon. Once again I will carry the American flag as a part of the U.S. Spartathlon Team, and for one more year I will get to experience the most amazing race in the world.”

Megan Roth

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Megan Roth is an ultrarunner and law student in South Florida. She writes a blog at www.milesovermatter.com