How does taping a tibial sesamoid stress fracture actually help you heal when you are an injured runner? Well, that is what we’re talking about today on the Doc On The Run Podcast.
I was on a call with a patient who is an Ironman triathlete. He had a sesamoid stress fracture, particularly in his case it was specifically it was the tibial sesamoid, and the sesamoid bones are little bones underneath your big toe joint. They are kind of like tiny little kneecaps that you stand on.
To show you when we look at your foot, this is what your foot looks like. These are the metatarsal bones. They are more or less like that. Then you have the cuneiform bones and the cuboid bone and the navicular bone and the talus bone and the heel bone. A whole bunch of other bones you don’t care about and in the big toe you’ve got two bones like that.
The sesamoid bones are sitting right under the big toe joint. You have the fibular sesamoid and then you have the tibial sesamoid and for illustrative purposes I’m going draw this one like it’s broken in half as if you had a tibial sesamoid stress fracture. So, again this one over here that is called the fibular because your fibula is on the outside of your leg. Your tibia is on the inside of your ankle. Fibula is the bone on the outside of your ankle. That is why we call them that tibial and fibular. So, your tibial sesamoid is that one.
How do we tape the toe and help this? Well, what you’re trying to do obviously is if you have two pieces of bone like this and you want them to heal back together, what do you do? You compress them. You want to push them together. You want to make them fit together. So, if they’re broken you want to get the pieces back together and compress them like that. You do not want them pulling apart. That would make the fracture worse, right? You want to decrease that gap in there.
The way you tape the toe is really simple. What you’re trying to do is hold it still. Let’s say this is your big toe. This is sesamoid down here and if you look at it from the bottom it’s broken into two pieces like this. Well, if you tape the toe and you pull it down a little bit that will actually compress those two pieces together. So, if you tape the toe in this direction and you hold it still that number one just holding it still helps it heal.
If you have tape around the toe to hold it still it will compress the fracture. But also, since these two are embedded within a flexor tendon if you get a tear or a break in the sesamoid and then it’s effectively tilted that creates more of a gap on the outside. So, when we tape this toe we’ll often put j-taping around the side of the foot and if you tilt the toe this way a little bit with that tape it actually moves those two pieces together and compresses them together so that there is less stress and strain on the tibial sesamoid fragment.
When you pull the toe in that direction it opens up the gap between the two pieces and when you pull it the big toe toward the tibial sesamoid it actually pushes them together. And then the more tape you have holding it still the more it’s going to mobilize it and theoretically the faster it’s going to heal.
If you haven’t discussed it with your doctor this might be something you want to bring up with them or at least this will maybe help you understand why we would tape the tibial sesamoid when you have a stress fracture and you’re a runner.
If you want to learn more about the principles I use with runners who have stress fractures who want to stay fit want to keep running and want to get back to training as quickly as possible those exact strategies I teach to physicians like I just taught last week at the International Foot and Ankle Foundation meeting in Hawaii. I taught a couple hundred doctors I think, about stress fractures and you can get those strategies for free in the www.docontherun.com/stressfracturemasterclass and I’ll see you in the training.
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