Navigating the Challenges of Sesamoiditis: A Runner's Guide to Recovery

Understanding Sesamoiditis:

The sesamoid bones are small, pea-shaped bones embedded in a tendon beneath the big toe joint. These bones act as a fulcrum, providing leverage for the tendons that control the toe. When excessive stress or repetitive impact is placed on these bones, inflammation and irritation can occur, leading to sesamoiditis.

Causes:

1. Overuse and Repetitive Stress: Runners are particularly susceptible to sesamoiditis due to the repetitive stress placed on their feet during running.
2. Improper Footwear: Wearing shoes with inadequate support or those that do not fit properly can contribute to sesamoiditis.
3. Biomechanical Issues: Abnormal foot structure or mechanics, such as a high arch or a prominent bony structure beneath the big toe joint, can increase the risk of sesamoiditis.

Symptoms:

• Pain: Persistent pain beneath the big toe joint, especially during push-off while running or walking.
• Swelling: Inflammation and swelling in the affected area.
• Limited Range of Motion: Difficulty bending or straightening the big toe.

Recovery Strategies for Runners:

1. Rest and Ice: The initial step in recovery is to give your feet a break. Rest from running and apply ice to reduce inflammation.
2. Proper Footwear: Invest in running shoes with proper arch support and cushioning. Consider custom orthotics for added support.
3. Cross-Training: Engage in low-impact activities such as swimming or cycling to maintain fitness without exacerbating the condition.
4. Strengthening Exercises: Incorporate exercises to strengthen the muscles around the foot and toe joints. Toe curls, marble pickups, and towel scrunches can be beneficial.
5. Physical Therapy: Seek guidance from a physical therapist who can provide tailored exercises and techniques to aid recovery.
6. Gradual Return to Running: Once symptoms subside, gradually reintroduce running. Start with shorter distances and lower intensity to avoid overloading the sesamoid bones.

Prevention Tips:

1. Listen to Your Body: Pay attention to any discomfort or pain and address it promptly.
2. Proper Warm-up: Ensure a thorough warm-up before running to prepare your muscles and joints for the activity.
3. Regular Foot Check: Examine your feet regularly for any signs of swelling, redness, or abnormalities.
4. Foot Mechanics Assessment: Consult a podiatrist to assess your foot mechanics and address any underlying issues.

Conclusion:

Sesamoiditis can be a frustrating setback for runners, but with the right approach to recovery and preventive measures, you can overcome this challenge. Remember, patience is key, and listening to your body will help you return to the joy of running with a stronger and healthier foundation. If symptoms persist, consult with a healthcare professional for personalized advice and treatment.

Our Sports Medicine team at Princeton Sports and Family Medicine, P.C. understands the biomechanics of running and the complexity of gait change. We can help with diagnosis and treatment, and we’re also ready to help you optimize your routine to avoid injury in the future!

Author

Peter Wenger, MD Peter C. Wenger, MD, is an orthopedic and non-operative sports injury specialist at Princeton Sports and Family Medicine, P.C., in Lawrenceville, New Jersey. He is board certified in both family medicine and sports medicine. Dr. Wenger brings a unique approach to sports medicine care with his comprehensive understanding of family medicine, sports medicine, and surgery. As a multisport athlete himself, he understands a patient’s desire to safely return to their sport.