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Sesamoiditis

Posted Jul 20 2012 8:45am

At the beginning of May, a few days after my marathon , I noticed a pain in the ball of my right foot when I walked. I stopped nearly all my running, but kept swimming and biking in hopes that eliminating high-impact exercises would fix it. The pain receded, so at the end of May, I did a sprint triathlon . Unfortunately, I wasn’t completely healed, and there was still pain in my foot after racing. So, I headed to a podiatrist.

The doc took an X-Ray of my foot and gave me a little lesson on foot anatomy. He pointed out my sesamoids, explaining to me that they were like the hinge of my foot.

 

( source )

He said that the tendons surrounding my sesamoids were probably inflamed, so I should ice and take ibuprofen. He also suggested custom orthodics and gave me a dancer’s pad to help relieve some of the pressure. The dancer’s pad is just a piece of foam with a piece cut out for the ball of my foot. The cushioning hits the ground first, instead of the ball of my foot.

I wore the pad every day and did minimal running. I iced occasionally before bed, but didn’t think the pain was significant enough to take an ibuprofen. Again, it started to feel a little better, but the pain, though lessened, still persisted.

Maybe my running shoes contributed to the pain? So I bought new running shoes.

Maybe I need more support in the shoes? So I bought a pair of (non-doctor prescribed) orthodics.

Despite making these changes, I could still feel pain. It wasn’t unbearable pain, but it’s the pain that’s there just enough so that you know something is wrong. I scoured the internet for what might be wrong and how to fix it. Everything I read said it was sesamoiditis and the only way to get better was to rest. UGH. I have races I am signed up for! Resting is not an option!

So, I decided to get a second opinion and go to an orthopedic doctor that my friend Jess suggested.

After some he checked out my foot and the X-Rays, he confirmed sesamoiditis.

According to Foot.com , sesamoiditis is a common ailment that affects the forefoot, typically in young people who engage in physical activity like running or dancing. Its most common symptom is pain in the ball-of-the-foot, especially on the medial or inner side. The term is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis – the tendons around the bones become inflamed as well. 

My orthopedist gave me more specific instructions about icing and ibuprofen. He told me 3 ibuprofen, 3 times a day for 10 days. I need to ice at least 3 times a day, for 20 minutes. He gave me I purchased some shoe inserts while there, and made an appointment with the physical therapist. I guess I just needed a more explicit treatment plan than just “ice and take ibuprofen,” because I’ve been following doctor’s orders so far!

On Wednesday, I went to my first PT appointment where I learned some exercises I can do that will help strengthen my foot and ankle.

I also experienced iontophoresis:

According to Wikipedia: Iontophoresis (a.k.a. Electromotive Drug Administration (EMDA)) is a technique using a small electric charge to deliver a medicine or other chemical through the skin. It is basically an injection without the needle. The technical description of this process is a non-invasive method of propelling high concentrations of a charged substance, normally a medication or bioactive agent, transdermally by repulsive electromotive force using a small electrical charge applied to an iontophoretic chamber containing a similarly charged active agent and its vehicle. One or two chambers are filled with a solution containing an active ingredient and its solvent, also called the vehicle. The positively charged chamber, called the anode, will repel a positively charged chemical, whereas the negatively charged chamber, called the cathode, will repel a negatively charged chemical into the skin.

I didn’t really feel anything during the treatment; I just kind of sat there while it did its thing. I have a few more treatments left, so we’ll see how they go.

I’m glad I have a more specific treatment plan from my orthopedic doctor. I just hope it works! I kinda wish I had gone to him when I first started experiencing pain; but I can’t go back and change things now. I just need to follow his guidance and hope for the best. My fingers and toes are crossed!


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