From a diagnostic viewpoint, if I have this correct in my head, you had none of this weakness or sensory changes prior to getting the acupuncture performed? None of this was occurring after a period of time on the bike etc??
Some others have mentioned iliac artery fibrosis-yes this can happen, but you do not tend to get symptoms when you are not exercising as such, you should not have weakness sensory changes with this at rest.
Looking at the areas you say you have the sensory changes (I presume this is the picture with the red circles, and the one with the yellow circles is where the acupuncture was being performed?), it almost certainly looks like injury to the sciatic nerve and common fibular nerve in the region of the top of your popliteal fossa (the area behind your knee, at the top end of this). This does correlate to the signs and symptoms you are getting. I will attach two links which run through the areas that both nerves have sensory innervation (ie where you feel them on the skin) and motor innervation (ie what muscles they control and therefore where you have weakness). As an FYI, what is termed plantar flexion is the ability to push your foot down, ie like stepping on the gas in the car. Dorsi-flexion is the reverse, ie pulling your foot up. What we call a foot drop, ie your foot drops down because you cannot control it, is generally an issue with dorsi-flexion, ie you cannot keep your foot pulled up.
The symptoms you have fit with an injury to your sciatic nerve around about the point that it bifurcates into the common fibular and tibial nerves. These two nerves account for all the symptoms you are getting and line up with where you appear to have been getting acupuncture. It would be interesting to know if it was during the needles being put in around this area that your symptoms started.

Here are two links which show those two main nerves:
https://teachmeanatomy.info/...ommon-fibular-nerve/
https://teachmeanatomy.info/...nerves/tibial-nerve/

When you injure a nerve in this way, unless you transect it, you still have function in parts of the nerve.
When we do peripheral nerve blocks etc we do not put our needles into the nerve itself, as this damages the nerve, and then if we inject local anaesthetic etc into the actual nerve itself it can cause serious damage. We aim to deposit the local anaesthetic around the sheath of the nerve, hence why we commonly use ultrasound for these types of nerve blocks.

Have a good read through all of that and let me know if those signs and symptoms match what you are going through.
Also, has there been any recovery whatsoever?
Finally, where in the world are you based? (that can dictate what sort of recourse you may have able to have)
Without wanting to be the bearer of bad news, if this is the case and you have not had any improvement since this happened, the chances of you having any further meaningful recovery are very small (hence my comment in relation to whether you may have any recourse).

Hope this all helps.
Usual disclaimer. Despite being an MD this is the internet and hence any opinions expressed here should be discussed with your own doctors who are able to perform a proper history, examination and order any investigations that may be required. (have to say that to cover myself)

I did not have surgery: the surgeon who made the initial diagnosis discouraged it in my particular case, and after taking that guidance away and evaluating the scenario myself ( mid 40s at the time, probably wasn’t going to win any Olympic medals anytime soon, race long course only), I didn’t pursue it. I don’t regret it.

A major factor in that choice was it presented minimal impairment, in the bigger picture. as I mentioned, it presented only after a set period - about 8 minutes - at LT intensities. So, I needed to adjust sessions (and expectations) to 8-minute (instead of prescribed 20+ minute) intervals, reduce recovery intervals. and accumulate total session time in LT using an aggregate of these shorter intervals. Over the years, I don’t think I sacrificed much adaptation or development as an athlete, although it was frustrating to never be able to come up with a perfect measured or Modelled ftp. ( I worked with a coach who I think I drove mad with my inability to give him power or pace files from ftp tests or a 5k, so there were many years where I based numbers on a whole range of non-customary measures. I think I did 20? 15? IM since the diagnosis and it never occurred in a race.

I rarely experience it these days, which I attribute to having less strength, and simply not forcing the muscular contractions and blood flow that I used to. That’s my working theory, as I can’t imagine the kink in the artery that was revealed in the imaging had straightened itself out!

Thanks for revisiting this discussion: as I mentioned, finding the initial diagnosis was the most challenging part, and I look back and laugh at the number of dead-ends and misdiagnoses I had over a period of years.

Thanks so much for your thorough analysis!!
According to the various medical evals I've had done, the foot per se doesn't show loss of strength. Therefore I'm assuming the weakness must originate further up the chain since the Biodex machine indicates weakness. The sensory changes occurred as I was still on the table getting acupuncture treatment. Since I was rehabbing a hip injury on the opposite side (the reason for getting acupuncture) and not running much, I'm not able to pinpoint the exact timing when the weakness started.

Thanks for the links. I read them both. Regarding the common fibular nerve, I don't have a foot drop as they describe it, as I'm easily able to keep my foot pulled up. But while walking/running I'm not in total control of my gait and where the foot lands on the ground. The numbness is in the big toe (also on top in extension towards the ankle). I have sensation between toes 1 and 2, and also in toe 2.
Concerning the tibial nerve, the numbness isn't across the entire sole, just the forefoot.
The nerve conduction test (NCT) that was performed in 1/22 showed neuropathy of the peroneal nerve (I will go ahead and email you a copy for your review). However, the previous NCT from spring of 2007 (after my navicular surgery) was almost identical. Back then I had a little bit lack of sensation along the peroneal nerve for a few months, which subsided. And for 12 years I had no problem competing at a high level.

Could it be that the lack of sensation impacted my gait and thus changing the hamstrings and causing them to be in a somewhat constant state of contraction? When running it feels like I have to push against brakes - enormous effort with little reward. In spite of all the training over the past 4 months, there has been little or even no improvement in speed or feeling less taxed while putting in the same effort. The hamstrings go into a "crampy" sensation and eventually it makes running unbearable. It feels like running with a wooden leg. No, there hasn't been any recovery.

I live in the U.S., Florida.

Different situation, but when I was in hospital after a serious ski accident, I had numerous cannulas in my arms. A nurse had put one in my hand and a while later I noticed that my hand looked like someone had taken a surgical glove and blown it up.

They removed the cannula and it took days for the saline to leave my hand. Afterwards I was left with a totally numb little finger (don’t know if the needle or fluid damaged the nerve). It stayed numb for months and then one day I realised it was completely back to normal. Nerves are weird.

That's awesome!! I'm so glad you were able to prevent the onset of pain by adjusting your interval training and still continue competing in so many IM races. And, hopefully, there are more to come....
As my symptoms are there even during rest and low-intensity workouts - more during running than cycling - it seems iliac artery fibrosis might not be the cause of my numbness and weakness.
Yes, endless dead-ends and misdiagnoses are extremely frustrating. I couldn't agree more. Especially when they continue over numerous years and no improvements are made.

Glad it all went away. Did you have any treatment on that finger that may have helped for the numbness to subside?

Nope, it was just a case of waiting.

Can’t help, just wishing you well.
Injuries suck.

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maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD

Thank yoh very much!