Broken Tibial Sesamoid anyone??
Anybody have experience with this injury? My foot started hurting mid summer and I finally went to the podiatrist about 12 weeks ago.
Long story short, he said I broke it sometime in the past and it never healed. Put me in a boot and said it would take some time to heal, if it healed at all. He said surgery was possible but if it was his foot he wouldn't do it. He said we could do a cortisone shot too but that's more of a bandaid than anything.
So after 10 weeks of zero running and being in a boot, it really feels about the same as it did before I went to the doc. I've ditched the boot as it's basically fallen apart at this point anyway and I'm really back to square one. Funny thing is it doesn't hurt as bad when I run as it does when I'm walking around barefoot or wearing my work shoes.
So for anyone with experience, how long did it take you to fully heal. For the experts, what's the worst case if I just say screw it and start running on it again (since it doesn't hurt bad when I run). Can I really do any damage to these small bones? Or should I just find another podiatrist and get a second opinion and more aggressive treatment maybe?
Long story short, he said I broke it sometime in the past and it never healed. Put me in a boot and said it would take some time to heal, if it healed at all. He said surgery was possible but if it was his foot he wouldn't do it. He said we could do a cortisone shot too but that's more of a bandaid than anything.
So after 10 weeks of zero running and being in a boot, it really feels about the same as it did before I went to the doc. I've ditched the boot as it's basically fallen apart at this point anyway and I'm really back to square one. Funny thing is it doesn't hurt as bad when I run as it does when I'm walking around barefoot or wearing my work shoes.
So for anyone with experience, how long did it take you to fully heal. For the experts, what's the worst case if I just say screw it and start running on it again (since it doesn't hurt bad when I run). Can I really do any damage to these small bones? Or should I just find another podiatrist and get a second opinion and more aggressive treatment maybe?
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I've broken sesamoid bones in BOTH feet - I broke my tibial sesamoid five weeks before IMNYC in 2012. Well... technically, I didn't KNOW it was broken at the time. The podiatrist I went to said it wasn't - it was just "inflamed" - and he gave me a cortisone injection. Two weeks later he gave me a course of oral steroids, and I was able to do IMNYC only having run once in the five weeks prior to the race, and that was just a 30' run/walk test to make sure I'd be able to race at all... I didn't find out that it was actually broken until AFTER the race, and - like yours - it had been broken for some time.
Long story short - I had an MRI that September after IMNYC and found out that it's now necrotic (ie, dead), likely due to the cortisone injection, and if I wasn't able to treat it conservatively, it was going to have to come out. I didn't run from September until January 1st. The boot, the insert (a Dancer's Pad or HapPad) - both made it worse. I had custom orthotics made and that February I switched from Newton Terra Momentus to Hoka One One Bondi B's. I can say with 100% certainty that the Hoka's are the ONLY reason I'm able to run.
Here's what worked for me:
-- Finding a chiropractor who can adjust feet well. If your First Metatarsal is dropping when you run (or walk), you're putting even more pressure on that sesamoid bone. Having my foot adjusted has helped tremendously. I still need to have it adjusted from time to time after a long run.
-- Custom orthotics, although I can get by with arch supports from Dick's or any other running store, as long as they are good arch supports. My arches are high, which is a big contributor to why I've broken both sesamoids in the first place (I broke the first before I was even a runner - so it'd be hard to call that an overuse type injury). Regardless, when you've broken a sesamoid, arch support is paramount.
-- Wearing shoes in the house. I bought a pair of shoes that I only ever wore in the house - like they were my slippers - so I'd have arch support all the time.
-- This little gadget: http://tinyurl.com/m2a9kqr Home Ultrasound machine... I was TOTALLY skeptical but equally desperate. I am/was an Occupational Therapist (I no longer practice) and was the first person to question whether or not this would actually work. Turns out it does, and JW and I have used it for a variety of issues since.
-- The Hokas. I can't tell you enough the difference they made for me. Like I said, I wouldn't be running without them. LOVE them.
I can't really put a number on how long it took me to "totally" heal - by the time I started running again in January 2013 (so... it'd been about four months since I'd run, the last time being a run/walk at IMNYC), I was having little to no pain. I only recall one long run this past season where I was worried it was flaring up again, but luckily I was wrong. What I CAN tell you is that when I started running again, I went out too hard/fast - I did a 5k as my first run back b/c I wanted to test... that was epic stupidity (seriously... who does that???). The next thing I knew, I had a hamstring strain. If you start running again, just remember that you'll be favoring the broken foot and it will alter your gait... increasing potential for injury. Truthfully, you still have TONS of time until IMLP and if I were you, I'd spend a few weeks doing some core stability work and then chat with RnP about a return to running plan (hindsight speaking here!).
GOOD LUCK - and it DOES get better!!!!
Jess
Thanks for all the great info. Like I said, it is truly frustrating as it actually feels better when I run vs when I walk around the house or at work. I may give it a couple of more weeks before ramping back up the runs. I've run three times in the past two weeks, but there's still some tweaking in my foot I feel. All the running has been limited to 20-30 mins max with walking mixed in especially up hill.
Hopefully by January it will be back to 100% although the podiatrist I saw didn't give me very much confidence that it would totally heal at all. I kind of got the feeling that there would always be some mild discomfort there in some way or another.
I am in a similar situation. Broken 3rd metatarsal. No running since September 8th. Broke the bone during IMWI. 1 week air cast non weight bearing, 5 weeks air cast with weight bearing. Follow up x-rays seemed to reveal callus formation but the bone wasnt healing, nor was it lining up properly. Orthopedic Surgeon advised additional rest and another follow up xray, no surgery recommended. He was not concerned with alignment. 13 weeks zero running and 4 x-rays later I just got the green light to start running. I recently went to doctor specializing in sports medicine to get a second opinion. She had same concerns as I did and sent me for a bone and bone density scan as well as a referral to another orthopedic surgeon. A visit to a pedorthist (who also happens to be an elite athlete and Ironman) conducted a run and gait analysis and foot exam determined there doesn't appear to be any lingering favoritism or imbalance while running. He did however put together a plan to get back to running safely. 10min/per day for the first 7 days to stress the body just enough and allow it to recover fully. He then suggested to very slowly increase the time on 3 of the runs by approx 5min each week eventually building to an hour at the end of the a month. Once that has been reached he said I can safely get back to full run training. He also recommended a Met Pad orthodic for cross training, but hesitates to recommend I use them in my Newtons. He also recommended I change shoes for running. He's not a fan of the Newton Lug system especially given my injury.
Like you I don't have any pain when I run, but do experience some discomfort when I walk in bare or sock feet so like Jess, I use "house shoes". I am hesitant to start running as until I have met with the other orthopedic surgeon for the second opinion.
My suggestion is to seek out a second medical opinion. If for no other reason than just to give you peace of mind. That is why I am doing it. Our sport is so mentally driven that you don't need to give "doubt" any opportunity to creep in. Best of luck on your healing and recovery journey.