#307 Surviving Sesamoiditis and getting back to marathon training

Today on the Doc On The Run Podcast we are talking with Isabel about the strategies she used to recover from sesamoiditis and start training for the London marathon.

Before we get started here I just want to take a second, before I forget and let you know we have created a couple of excellent resources for any runner who has a sesamoid injury.

First, our guest today went through a long battle with a sesamoid injury and then got back to marathon training. During her journey she had to look for and find doctors, physical therapists, and others who could actually help her heal the sesamoid injury and keep running. She put together a list of those providers, and understanding who they are, might help you find someone to help you recovery as well.

In addition, I have created a video for you to answer the number one question I get from runners with problems with the sesamoid bones under the big toe joint. The question is “Can I run with sesamoiditis?”

Both of these resources are free and they’ll be available to you at the show notes page for this episode under the podcast have at DocOnTheRun.com check them out when you get done with this episode.

Sesamoiditis is a condition which can affect runners, a problem which is truthfully not all of that common but when it does happen can been misdiagnosed. The problem is that if you don’t catch the diagnosis early, sesmoiditis cannot worse and go from just a little bit of inflammation within the bone to develop into a full on stress fracture of one of the sesamoid bones.

The sesamoids are two tiny little bones that sit underneath the big toe joint. You basically stand on the sesamoid bones when you walk. But what is a sesamoid bone? Your kneecap (or “patella”) is actually one type of sesamoid bone and the patella just happens to be the largest sesamoid bone in your body.

But for whatever reason these two little bones underneath the big toe joint are what we call the sesamoid bones. You have two of them in each foot. The fibular sesamoid is the one closest to your second toe. The tibial sesamoid is the one closest to the inside of your foot.

Sesamoid injuries can be serious. In fact when I lecture at medical conferences about how to keep injured runners running, one question I always get from at least one doctor in the audience is, “which conditions would you NOT let a runner run with as they heal?”

There’re only a few conditions that I think actually warrant an abrupt stop and running to allow things to calm down and reassess what’s going on. Sesamoid injuries are one of those, primarily because they are small fragile bones and if they become inflamed and turn into a stress fracture they can crack, break and become permanently damaged.

If you have surgery to remove a permanently damaged sesamoid bone, your foot will never be the same. So it’s very important to be able to recognize a sesamoid injury to get treatment as soon as as the problem begins.

Isabel has been very open about her journey with sesamoiditis and even posted some details about it on Instagram. Her story is actually very closely aligned with what I see in most of the runners who call me for a consultation or schedule a web cam visit. Most of them have had an aching sesamoid problem for a long time but they really didn’t know what was going on or why they were having all of this pain under the big toe joint. And lucky enough for us all here today she agreed to come on the show and talk about her sesamoid injury, so maybe you can understand the condition, and how to deal with it a little better.

Isabel, welcome to the show!

Dr. Segler: So, before we get into some questions maybe you could just give us a little bit more detail about your running history and why you became so interested in running and marathons.