#354 Why is sesamoiditis so serious in a runner? - DOC

#354 Why is sesamoiditis so serious in a runner?

Today on the Doc On The Run podcast we’re talking about why sesamoiditis is so serious in a runner.

In this episode we’re talking about sesamoiditis and why it is so serious in a runner. The sesamoid bones, these two little bones and they sit under the big toe joint and interestingly when I show X-rays to someone like somebody who has a stress fracture almost always the first thing they say is “what are those two things” and they’re pointing to the sesamoid  bones.

Sesamoid bones are basically like your kneecap. They’re embedded within the tendon under the big toe joint and they help your big toe joint  just work more efficiently. But the problem is that you’re stepping on them and you’re standing on them. And so when they get injured, it’s really hard to calm them down. 

They are also very small and they don’t have a great blood supply. So if you get a problem with the sesamoids and you get sesamoiditis, it gets flared up and gets worse and worse and worse. A lot of times it’ll turn into a sesamoid stress fracture which is very serious because it can actually crack and break. Then you think “what’s a big deal?” Well, one of the worst injuries you can get is a broken kneecap because it’s inside the joint and the cartilage on the inside of your kneecap has to move back and forth for your knee to work correctly. So if you break it is really not good. You do not want to break your kneecap and you really don’t want to break the sesamoids.

Unlike your  kneecap the normal treatment for a sesamoid fracture that gets worse and won’t heal is to remove the sesamoid bone. Now that causes a problem if we remove the tibial sesamoid, the one that’s on the inside of your foot, the arch side of your foot. Well, then you can get a bunion deformity because those two bones are sitting side by side and they actually make the toes stay erect or in the straight position. And when you remove one of those two bones the toe can start to drift in one direction or another. 

So you start to get problems where your foot doesn’t bend in the shoe correctly, your foot’s unstable and of course if you remove one of them you then have twice as much pressure on the other one. It’s a real problem. Sesamoid injuries have to be taken very seriously. If your doctor tells you to stay off of it, you need to stay off of it. 

There’s always stuff you can do to remove the pressure and shift it somewhere else. But you have to be very cautious and you really need to heed the warnings of the severity of the injury because you don’t want to play around with it. And that is really why sesamoiditis is so serious in a runner.

Now listen one of the things you can think about if you have a sesamoid injury is what to do about it. If you go to this episode you click on a link, I’ll take you  through a training series that will help you really understand some of the things you need to think about when you first get injured and you have a sesamoid injury because unlike a kneecap, the sesamoid is something that you’re walking on.

If you have a sesamoid injury you have to make sure that you treat it appropriately. You want to really do

Everything you can to maintain your running fitness during this period that you are healing because otherwise you’re going to get severely deconditioned. So check out the training I made for you in the show notes and you can click on the link below  to get access to it.

It’s a free training. It will help you understand a little bit about what you should do right now if you’re in this phase where you are injured and you need to keep this thing moving, you need to maintain your fitness. This will really make a big difference whenever you have a sesamoid injury. Go check it out!