Updated on February 7, 2017
****Edited to add another tip as of 1/27/17****
****Edited again to add video link as of 2/7/17****
Sesamoiditis…ahhhhhhh it’s like a nagging wife that won’t just go away.
Todays post is a follow up to the most popular post on SCB right now, Treating and Curing Sesamoiditis. I get a lot of questions, comments and update requests about it, so this post is long overdue.
***Just to be clear, I am not a doctor. As with all of my posts, this is 100% my opinion and experiences.***
Update on my feet today (January 2017):
My feet are doing a lot better. I’m able to walk/hike 4-5 miles completely pain free. Well, that I know of…..I’m too nervous to push my luck. Though I don’t have any pain after, if I press on the sesamoid to see if it’s really healed, it’s still a little sore. But I’ll take it!
One of the biggest obstacles I had with healing, is overdoing it. Sesamoiditis is tricky in that I would walk more than usual (last October I walked over 9 miles in a day, yikes!) and felt no pain while walking. But after I sat down that night, the pain & inflammation came right back. I was so nervous and upset thinking all of my progress was lost, but thankfully they bounced back within a couple weeks. I know scaling my walking back & resting more were key in helping them recover again.
As far as normal daily life, I feel great! The fact that I have been sick for months has probably helped since I wasn’t able to hike like before and push my luck. Ha!
Over the weekend I walked over 4 miles completely pain free, which a year ago, I only dreamed of doing.
Things that helped me heal:
- EPAT Therapy was hands down the key for me. I think it was so helpful, it probably deserves a whole post dedicated to it. Let me know if that’s something you’re interested in.
Healing progress started to slow down in January of 2016, so I decided to find the best podiatrist out there, and started working with Dr. Saxena in Stanford. He works with professional & Olympic athletes, speaks at medical seminars and such, so I knew he was interested healing & using state of the art technology. He did 4 rounds of EPAT therapy on my right foot (the most painful one) and 3 on my left. Dr. Saxena was the only specialist who offered more than just “ice, rest, crazy expensive orthotics (that didn’t work) & take an Advil” every other podiatrist advised.
It took every bit of 90 days after my last treatment for me to notice a difference, but it did!
- Altra Running shoes are the only shoes my feet like. They have a lot of cushion, a wide toe box and are zero drop, which I believe all three things were pivotal to help healing. I would highly recommend this brand to anyone. They are like pillows of cushion with support for my traitor feet.
I love the Torins so much, I buy several pairs (previous years model) at a time when they go on sale. I currently have 3 pair of these in the same color. I also have a pair of their Lone Peak trail shoe which I like, but don’t wear as often since the cushion isn’t as plush as my beloved Torin.
- Stay below your pain threshold. This is a tricky one because the only way to find your threshold is to push it, which I do not recommend doing. Just be aware of how much you are walking/on your feet. One thing I still struggle with is feeling no pain walking more than usual, thinking my feet have healed, only to be in pain after sitting down. That happened to me in Vegas last October when I walked over 9 miles. Yikes! Thankfully I bounced back within a couple weeks of taking it easy.
- Leg drains. I just elevate my feet using a wall for 10 minutes after a long walk or being on them a lot. I like to think this helps circulate blood to the tiny bones and flush out that area.
- Garmin/step tracker has definitely been very helpful. I don’t think it’s absolutely necessary, but it’s very helpful. I wear the Garmin Vivoactive and LOVE the dang thing.
****Additional tip as of 1/27/17*****
- I want to reiterate physical therapy for sesamoiditis. Last weekend both of my feet started to ache a little bit more than usual. I didn’t increase my walking or do anything different. Then joints in both feet started to get stiff. Nothing like I couldn’t walk, just achy and a little painful. I thought about this post and wondered if I had false hope my feet were on the mend. I went to physical therapy, told him about it and he worked primarily on my hips. Then knees, then ankles & feet to get them to work together again.
Immediately my right foot felt so much better…like everything flowed the way they should. Not so rigid if that makes sense. So I went the following day to have my left (surgery side) worked on. I walked out feeling tons better. Sesamoids are still a tiny bit sore, but overall I’m back to walking up to 5 miles a day without much pain.
Now back to how I got sesamoiditis in the first place: I had genetic hip impingement. In December of 2014 I had arthroscopic hip surgery, which was a success. I never used crutches post op because the swinging motion was too painful. So I just walked a little funky. Like a gangsta grandma limp ha! Well 2 months of walking like that and increasing the distance, made the sesamoid in my right foot an angry elf. A few months later after babying it, my left foot decided to join the party. Sesamoid protest, party of two.
So the sesamoiditis/stiff joints in my feet, all circled back to the hip issue. Again. I’m still struggling to find balance in rebuilding strength in the hip, legs & feet because ironically they all require each other to function properly and not hurt to do the exercises.
So if you are dealing with sesamoiditis, I would highly recommend physical therapy. In my experience, it is highly likely your sesamoid issues are actually caused by an imbalance somewhere along the chain. All it takes is an imbalance to cause your foot to overcompensate for it.
Just my 2 cents fo free.
****Edited again to add video link as of 2/7/17*****
- Due to popular request, this is the video my husband used to make inserts to sort of float, the sesamoid area. It offsets pressure to other parts of the foot.
Things that did not work or help me:
- The boot. In 2014, a podiatrist (who misdiagnosed me with a stress fractured sesamoid) put me in a boot for 9 weeks. It caused more damage than anything else. Thankfully I got a second opinion and was told to immediately stop wearing the boot because I had such low circulation in my foot, it was shutting down. I literally walked out of his office bootless and went straight to physical therapy. I spent over 2 hours in PT that day and my foot felt so much better because of it.
This is what my foot looked like for several weeks being in the boot, before PT:
I ran the boot idea by Dr.Saxena when I first met with him in 2016, and his opinion was to not put me in a boot, because as soon as I got out of it, the sesamoids would likely flare up again. He recommended proper shoes and staying below my pain threshold. So along with EPAT Therapy, that’s what I did. Well for the most part…I just love to walk. Ha!
I realize the boot thing is highly controversial, so by all means, please take my experience with a grain of sea salt and do what’s right for you.
- Orthotics, both custom and OTC. I still have a pile of orthotics I tried and they either made no difference or made things worse. I finally ripped them out and started wearing Altra shoes full time and that is what I’ve done for the last year or so.
- Cortisone injections did not work and I do not recommend them. In fact I now have atrophy where I was given injections on my Mortons Neuroma.
To summarize my thoughts on treatment for sesamoiditis, I highly recommend resting, taking an anti-inflammatory in the beginning, EPAT therapy and Altra Running shoes. I would also try acupuncture since it has been wonderful for my GI issues. That’s what I would do if my sesamoids decide to become traitors again.
Thoughts? Questions? Recommendations?