#471 Rehab after tibial sesamoid non-union removal surgery in both feet - DOC

#471 Rehab after tibial sesamoid non-union removal surgery in both feet

Today on the Doc on the Run Podcast, we’re talking about what to think about when a doctor is trying to rehabilitate a runner after tibial sesamoid non-union removal surgery in both feet.

Today’s episode comes from a question from a doctor at the International Foot & Ankle Foundation medical conference where I was lecturing on “Stress Response, Stress Reaction, and Stress Fractures in Athletes.”

You have two sesamoid bones under the big toe joint in each foot. They are each about the size of kidney beans. When one of them develops a stress fracture, it can break. If it breaks into two pieces, it can be very difficult to get the broken sesamoid to heal completely. If it doesn’t heal, becomes arthritic and turns into what we as doctors call a “sesamoid fracture non-union” your doctor may recommend surgery to take it out.

There are three reasons sesamoid fractures are so hard to heal in runners. 

  1. The sesamoid bones have a relatively poor blood supply and so they just don’t heal quickly.
  2. Every time you walk or stand about 25% of your weight is on a broken kidney bean. 
  3. Every time you wiggle the big toe, it tugs on the sesamoid bone pulling the fracture apart.

For those reasons, I personally think of sesamoid fractures as one of the very worst injuries to afflict any runner.  

We all think off the surgery as the most important indicator of whether or not the runner will do well. We often the type of surgery of type of overtraining injury dictates the timeline for full return to athletic activity. 

Today I was invited to give a lecture at the International Foot & Ankle Foundation medical conference in Hawaii. During the live Q & A a few doctors had specific questions about what I would do to treat certain patients. One great question was from a doctor who wanted to know what I would do to help rehab a runner after bilateral tibial sesamoid non-union surgical removal, meaning the runner had both of the inside/tibial sesamoid bones removed in both of her feet, because they wouldn’t heal.

I have the audio recording form the live Q & A so you can listen in on my answer to that doctor.  

Listen to the podcast player above to hear the answer I gave to the audience.

The point here is that you as the recovering athlete need to take the advice from the doctor, listen to the doctor’s projected timeline based on their experience with average patients, and then ask them this…What would it take for me too recover faster and cost a couple of weeks off of that timeline? What can I do that will help me get back to running sooner?

Don’t ever forget…100% rest = 100% loss of running fitness.

Make sure you ask better question when you go to the doctor with a running injury!

If you are injured and don’t know what to do next, you need to check this out!

100% rest = 100% loss of running fitness.

“You CANNOT just sit and wait for healing to happen if you really want to run again!

1 Mental Trick elite runners use to speed recovery:

ALL elite athletes who get back to running faster use this simple mental shift to re-focus on the goal of running…fast! 

12 Clear Steps to speed up running recovery process:

Many runners and doctors get this wrong. You must follow these steps IN ORDER, if you really want to recover and run sooner.

I will show you the exact process I use with injured elite athletes during consultations…