#307 Surviving Sesamoiditis and getting back to marathon training - DOC

#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.

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: As I understand it all of your trouble began after the Paris marathon. Did you actually notice any of the pain under the big toe joint when you were training for the marathon or did all start after Paris?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: So tell us about your sesamoiditis story.  What do you think caused initial injury to the sesamoid bones? 

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: When the pain under the big toe joint started, did you really understand what was going on, or what did you think was injured in your foot or big toe joint?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: How long did it take before you realized how serious the injury was? 

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: I understand that one of your defining moments in your journey was when a doctor told you that it would probably get worse and he might have to have surgery? Once you saw the doctor and figured out what was going on did you get worried? How did you deal with the anxiety of having sesamoiditis?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: People think of pain when they think of an injury. But for an injured runner, the pain is the least of the problems. You start worrying about having to cancel a race. You start worrying about losing your fitness. You might even start worrying about not being able to run with your friends anymore. What was the worst part about having a sesamoid bone injury?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: Is a huge range of treatments for sesamoiditis, everything from decreasing activity, pads, taping, exercises and even surgery. 

I know the first doctor told you to stop running, but you had already done that, and it wasn’t helping. What kind of treatments did you try that really didn’t seem to help?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: I think one of the most important points that we can take away from your journey is that you should not let a doctor convince you to have surgery when there are so many other options. But maybe even more importantly, every runner who gets a running injury has to understand that there is a solution. There is a treatment that will work in your case. And if you tried some things and you’re not getting better, and you just haven’t found the solution for you, yet. What did you finally start doing that seemed to help you turn the corner and get back on the path to recovery with your sesamoid injury?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: Treating running injuries is not that difficult. Any doctor can help. But keeping runners running while they are injured can be very difficult. But it is most often possible.  I have found that when someone gets an injury like sesamoiditis and then starts to return to running, the recovering runner often develops lots of anxiety, fears and they hold back (sometimes a little bit too much) because they don’t want the injury to flare up again. Once you felt like you’re getting better and started to run again, what was your biggest worry?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: One thing to get advice from a doctor, but I think it’s often far more helpful to hear the story, the feelings and all the emotions that go along with that injury from someone like you, who just happens to be open enough to willingly share it like you have here. So I’m really grateful for you and your willingness to share your story with all of our listeners. For all the people listening right now I might have a sesamoid bone injury, but aren’t sure, what advice would you give them?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: If your best friend got a sesamoid injury tomorrow, where would you tell her to go for help?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: Okay I’m at a go go ahead and say that I think everybody should check out your Instagram, and all of you listening right now should go follow Isabel on Instagram @bel_bites.  We’ll have all the link in the show notes episode under the podcast section at DocOnTheRun.com. And if anybody is trying to figure out how they can, follow you, connect with you, or reach out to you directly, how can they best connect with you?

Isabel: Check out the podcast audio to hear what she said!

Dr. Segler: Isabel, thanks so much for taking time out of your schedule to share your story and inspiration with our listeners today. I’ve certainly learned a lot today and it’s really been great having you on the show! And if anybody is trying to figure out how they can get some Team Lucy gear, follow you, connect with you, or reach out to you directly, how can they best connect with you?

Links mentioned in the Podcast Episode:

Follow Isabel on Instagram: https://www.instagram.com/bel_bites/

Email Isabel: info@belbites.com

 

Get Isabel’s London resources for sesaIsabels London resources for sesamoiditismoiditis here.