Sesamoiditis

20 07 2012

At the beginning of May, a few days after my marathon, I noticed a pain in the ball of my right foot when I walked. I stopped nearly all my running, but kept swimming and biking in hopes that eliminating high-impact exercises would fix it. The pain receded, so at the end of May, I did a sprint triathlon. Unfortunately, I wasn’t completely healed, and there was still pain in my foot after racing. So, I headed to a podiatrist.

The doc took an X-Ray of my foot and gave me a little lesson on foot anatomy. He pointed out my sesamoids, explaining to me that they were like the hinge of my foot.

 

(source)

He said that the tendons surrounding my sesamoids were probably inflamed, so I should ice and take ibuprofen. He also suggested custom orthodics and gave me a dancer’s pad to help relieve some of the pressure. The dancer’s pad is just a piece of foam with a piece cut out for the ball of my foot. The cushioning hits the ground first, instead of the ball of my foot.

I wore the pad every day and did minimal running. I iced occasionally before bed, but didn’t think the pain was significant enough to take an ibuprofen. Again, it started to feel a little better, but the pain, though lessened, still persisted.

Maybe my running shoes contributed to the pain? So I bought new running shoes.

Maybe I need more support in the shoes? So I bought a pair of (non-doctor prescribed) orthodics.

Despite making these changes, I could still feel pain. It wasn’t unbearable pain, but it’s the pain that’s there just enough so that you know something is wrong. I scoured the internet for what might be wrong and how to fix it. Everything I read said it was sesamoiditis and the only way to get better was to rest. UGH. I have races I am signed up for! Resting is not an option!

So, I decided to get a second opinion and go to an orthopedic doctor that my friend Jess suggested.

After some he checked out my foot and the X-Rays, he confirmed sesamoiditis.

According to Foot.com, sesamoiditis is a common ailment that affects the forefoot, typically in young people who engage in physical activity like running or dancing. Its most common symptom is pain in the ball-of-the-foot, especially on the medial or inner side. The term is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis – the tendons around the bones become inflamed as well. 

My orthopedist gave me more specific instructions about icing and ibuprofen. He told me 3 ibuprofen, 3 times a day for 10 days. I need to ice at least 3 times a day, for 20 minutes. He gave me I purchased some shoe inserts while there, and made an appointment with the physical therapist. I guess I just needed a more explicit treatment plan than just “ice and take ibuprofen,” because I’ve been following doctor’s orders so far!

On Wednesday, I went to my first PT appointment where I learned some exercises I can do that will help strengthen my foot and ankle.

I also experienced iontophoresis:

According to Wikipedia: Iontophoresis (a.k.a. Electromotive Drug Administration (EMDA)) is a technique using a small electric charge to deliver a medicine or other chemical through the skin. It is basically an injection without the needle. The technical description of this process is a non-invasive method of propelling high concentrations of a charged substance, normally a medication or bioactive agent, transdermally by repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle. One or two chambers are filled with a solution containing an active ingredient and its solvent, also called the vehicle. The positively charged chamber, called the anode, will repel a positively charged chemical, whereas the negatively charged chamber, called the cathode, will repel a negatively charged chemical into the skin.

I didn’t really feel anything during the treatment; I just kind of sat there while it did its thing. I have a few more treatments left, so we’ll see how they go.

I’m glad I have a more specific treatment plan from my orthopedic doctor. I just hope it works! I kinda wish I had gone to him when I first started experiencing pain; but I can’t go back and change things now. I just need to follow his guidance and hope for the best. My fingers and toes are crossed!

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18 responses

20 07 2012
sallaboutme

Yikes! I don’t really understand how the Iontophoresis works, but if it’s pain free, that’s good. Years ago I had a dr tell me I have a problem with my sesamoid bones on my right foot (probably from wearing heels). He basically described it as one of my bones is broken or chipped and it presses on a nerve or something when I’m up in a position like in high heels. I know it hurts like the devil so I feel for you! Hope you get quick relief and recovery!

21 07 2012
Feerlessfood

I went there FL ortho too! Good people. Hope you feel better Steph!

22 07 2012
RunSingTeach

i broke my sesamoid bone last winter and was booted and off running for 12 weeks. Ugh! Stick to that ice regime!

I see you got newtons for your new shoes. I got a pair (switching from asics) and found that the lugs on the forefoot really gave another level of cushion.

Good luck!

22 07 2012
321delish

12 weeks!! If things don’t get better, that’s how I might be spending my winter 😦
Thanks for checking out the blog!

25 07 2012
Allison

Ugh, I hope your foot is feeling better soon!

6 08 2012
Top Gun Triathlon « 321delish

[…] and told me I was looking steady. I kept running, but felt really slow. I was also worried about my foot, not wanting to push it too hard. At the first water stop around mile 1, I grabbed water and threw […]

25 08 2012
Jenny

Dear Injured Athlete,

I was looking for a recipe when my dyslexia kicked in (I put 321delish instead of 123delish). Anyway I stumbled across your post about sesamoiditis, and I felt compelled to respond. I had sesamoiditis in both of my feet, and I suffered through the same miserable pain for 2 years, no exaggeration. I tried everything from seeing a podiatrist, an orthopedist, $600 orthotics, physical therapy, steroid injections, acupuncture, naproxen, stretches, orthopedic shoes & boots. After feeling like there was no end to this madness I went to an orthopedic surgeon & had my sesamoids removed – THE BEST THING I EVER DID!!! After 2 & 1/2 months of healing from the surgery & 1month of retraining myself I ran & finished The Cooper River Bridge Run (an annual 10K road race in Charleston, SC). It has been 3 years since my surgery & I haven’t had any problems what so ever it’s like having a new pair of feet! Generally once a sesamoid becomes injured it becomes a chronic injury simply b/c you have to do normal everyday activities walk, stand, go to work, etc. If you are not completely off your feet for 2 months, or you resume normal activities before you’ve actually healed you will end up in the same boat. Drugs help temporarily mask the pain (Band-Aids) putting you at risk for further injury. Let me put it this way doctors are in the business to make money, if they don’t have patients they don’t make money, the patient needs help which puts you at their mercy. I know this is a giant run on, my apologies. It was strange I saw this & your story got me fired up remembering what I went through. I know all injuries are not the same and not all doctors’ practice for money, but if you are not feeling any better by now & you’re getting frustrated I’d seriously look into surgery. If you have further questions feel free to email me.

Best of luck to you!

25 08 2012
321delish

Thanks for your comment Jenny! Man, you certainly give me something to think about! I’ve seen mixed comments about getting them removed. I don’t know that I want to go that route just yet, but it’s good to hear that it worked for you!

5 03 2015
Natalie

Steph! LOVE your blog. How is the sesamoid bone holding up for you?!?!

5 03 2015
Natalie

Hi Jenny! I thought I would reach out to you, as I was told I would need to have one of the sesamoid bones removed, and have been very apprehensive about it. So good to hear that you had a healthy recovery and experience with surgery!

I am currently seeing a chiropractor to see if that works before surgery, and although the pain has lessened, it is still there. Would love to ask you more questions, if you would have some time! nikersten@gmail.com Thank you!!!

4 09 2012
Deferred « 321delish

[…] I’ve also been struggling to a foot injury, and I haven’t been able to run nearly as much as I have wanted. But I still had it in my […]

8 12 2012
Ebenezer

I developed sesamoiditis and tendonitis of the Flexor Hallicus Longus while training for a 30K in March. I was able to run until June when the pain just got too intense. I did the same as you; backed off the running, took up swimming and biking and did a Sprint Tri. After taking all of October off I finally got back to running. I am using a Sparco Metatarsal pad and have been able to get back to 7 miles with very minimal discomfort. Doctor told me it might be another 6 months yet before I am healed. Was wondering how your sesamoiditis turned out and if the Newtons helped at all.

9 12 2012
321delish

Thanks for the comment! I’m actually doing a “foot update” post soon, thanks for the reminder! I took a good 6 weeks off and it feels a lot better, but it’s not 100%. The pain is still there, minimal but a nuisance. I bought a metatarsal pad (Dr. Scholl) and it seems to be working to relieve some of the pressure, but I don’t wear it to run because it was making the muscles on top of my foot hurt! So I’m sticking with the cushioned orthodic the doc gave me and keeping my mileage down for a little while longer.

23 12 2012
A Foot Update « 321delish

[…] few months ago I told you that I had sesamoiditis, and then I never really mentioned it again. Sorry ’bout that. I figure now is as good of […]

27 12 2012
2012 Highlights « 321delish

[…] My foot was still bothering me, so I went to PT for sesamoiditis. […]

11 01 2013
2013 Goals « 321delish

[…] a half ironman. Injury sidelined me last year, but I’m feeling much better. So, Rev3 Venice Beach, I’m coming […]

3 04 2013
onelittlebecca

did your foot get better?

3 04 2013
321delish

It’s better, but I still have flare ups:( I just try to ice after runs and listen to my body. If it hurts too much, I stop!

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