#891 Is taping the sesamoids good or bad for swelling? - DOC

#891 Is taping the sesamoids good or bad for swelling?

Is taping the sesamoids good or bad if you have swelling in the foot? Well, that is a great question and that is what we’re talking about today on the Doc On The Run Podcast.



I was recently working with a runner who had really bad sesamoid issues and so in her case, what she was doing was she was taping it, and she was taping it to try to decrease some of the motion around the big toe joint that could have been irritating the sesamoid bones.

Her question was “Should I keep taping the toe?” And so, in short, what she did was she noticed that she was getting some swelling from a different treatment that her physical therapist was doing. But where she had the tape, she did not really have that much swelling. So, she had a bunch of tape around the forefoot holding all that stuff still, and she did not have swelling there. She had swelling elsewhere.

Her question was if I am trying to hold the sesamoid still, and in case you are new to this, the sesamoids are down here, underneath the first metatarsal bone and so, if you got tape all around here, holding everything still then that is going to let them calm down because you are not moving it. You are not moving it, you are not irritating it, it is going to calm down faster.

But anytime you have swelling that would be happening here and you compress it, squeeze it or hold it still, you start getting swelling someplace else. A good analogy to this is that if you have a fracture of your heel bone, you break that, that is a bad injury. It swells a lot. And so, one of the treatments that was done when I was in residency is we would take somebody in the ER if we could not operate on him immediately, we would actually wrap them in a very tight fiberglass cast and put them in the hospital with IV pain medication because it is so painful to squeeze a heel that is trying to swell, but it’s effective.

But when you put a cast on a whole foot, it cannot really swell anywhere. So, it does not swell at all, it just hurts the whole time that is why the IV pain medicine. She was not having that much pain, but the swelling was going everywhere else so she’s getting swelling all over the place where the tape is not on her foot. So, if you have an inflammatory process going on and you are getting swelling and tape is controlling the swelling in one place, it may pooch out somewhere else.

There is a kind of compression sock you can get that leaves the toes exposed and when you do, many times it controls the swelling and the foot of your toes look like Vienna sausages, they swell up a lot because the fluid has to go someplace. So, good and bad. Yes, it can control the swelling right around the sesamoid bones but if you are getting a ton of swelling, you kind of need to figure out why, rather than just keep it taped and hope that the other toes do not get so swollen that it causes another problem.

Yes, it is good for some parts, it is bad for other parts. That is usually the thing with medicine. There is nothing free for some good thing, there is almost always a bad thing. You just have to be aware of those things and then choose what is right for you.

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