#889 What summer sandals can I wear with sesamoiditis? - DOC

#889 What summer sandals can I wear with sesamoiditis?

What summer sandals should I wear if I have sesamoiditis? Well, that is a good question and that is what we’re talking about today on the Doc On The Run Podcast.



If you are out running and you start getting an aching pain under the big toe joint right here, it might be one of these two little bones called the sesamoid bones. The sesamoid bones are one of those things that makes me super nervous if you are a runner and you start getting pain and irritation.

I do think it is one of the things you have to take very seriously, even though they seem insignificant. I mean, they are just two little bones the size of kidney beans, but they basically function in the same way that your kneecap does, except you stand on them. And so, since they are very small, there is a tremendous amount of pressure going through the sesamoid bones and once they get irritated, and you get them moving in the right direction, they start to calm down and they are healing, you do not want to flare them up with something simple like wearing the wrong shoes.

I did a call with a woman who had sesamoiditis. She wanted to make sure that she was moving in the right direction and with summer coming up, she wanted to know what kind of sandals she might be able to wear. She wanted to know if she was doomed to just wearing cushy ugly shoes and the short answer is no. However, you have to think about this, with the sesamoid bones, the short story is that flat and flexible is what you should continue to consider the enemy here.

What I mean by that is the flatter the shoes, the thinner the sole, the more flexible the shoes are going to be and the more you are going to tend to put pressure on the sesamoids. Why? Well couple things, obviously the thinner they are, the less cushioning material can be inside the shoe. Also, the flatter they are, the more the shoes are going to be expected to bend.

I did a call recently with a runner who wants some stylish long dress shoes and unfortunately the really long dress shoes create a lever at the end of your foot, and they are really cranking on the sesamoids with a lot of pressure and that is how he got sesamoiditis. It wasn’t from running at all. It was from some dress shoes that he wore.

By the same token, if you are wearing ballet flats, if you are wearing something that is really flexible, every time your heel comes up off the ground and bends the big toe joint, you are actually putting pressure on the sesamoid so one of the simplest strategies is to wear shoes that are actually not flexible at all that are very stiff. For example, backpacking boots like heavyweight backpacking boots. I know those aren’t cute sandals so that is not exactly what we are after here, but it gives you an idea of what will work.

If you are wearing really thick, really stiff backpacking boots that are designed for you to wear when you are actually hiking with a heavy backpack, they are going to have a lot of rocker curvature under the sole, and they are going to be very stiff. So, if you pick them up and try to bend them, they won’t bend at all. For example, wooden clogs, like if you think about wooden clogs, they do not bend. They are wood but they have a steep curvature right under where the sesamoids are so when you walk, the toe does not bend at all. Your foot rolls with the shoe and that puts less stress and strain on the sesamoids because the sesamoids have been embedded within a tendon.

When your heel comes up off the ground and you bend it at the toes, you are pulling and stretching the sesamoids and that is part of the problem. So, the stiffer the shoes are, the more curvature there is, the better. A good example is wooden wedges. So, in the summertime if you wear wooden wedges that roll underneath you instead of bending, that may be a better choice.

If possible, you would also want to do something to create a little padding or cushioning so that it is not a really hard surface if it is really just a true wooden wedge. So that might help but that might give you some ideas on what might be better if you have sesamoiditis, it is summertime, and you want to wear something other than clunky athletic shoes or hiking boots. Remember,  flat and flexible is the enemy. Find something that has stiffness, that has curvature under the ball of the foot and hopefully it is a bit more padded, and your sesamoiditis will calm down a whole lot faster.

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