Hess, runners, whatcha know about sesamoiditis?

As some of you know I am a big fokker trying to become 2/3 of a big fokker. I was at about 320lbs when I started eating better, excercising (jogging, P90X) and reducing work/stress hours. I have lost a solid 40lbs but something this week has shelved me pretty good.

Sesamoiditis. (for reference see http://orthoinfo.aaos.org/topic.cfm?topic=A00164 )

When I had my ankle rebuilt I was on my feet almost immediately. Carpal tunnel? Two days and I was at work. but this pain IN the ball of my foot is borderline unbearable. I need to stand, walk (sometimes run) and kneel at work and there is not a position that allows me any comfort for 9-10 hours per day. I have been taking Aleve icing at night and have made a "dancers pad" to isolate the sesamoid but HOLY CRAP this is uncomfortable.

Has anyone battled through this? Does anyone know any other tricks, tips, specific shoes for fatties?

Help me!

Sincerely,

Limping in Lansing.

For the record, I am not a doctor, but have you looked into minimalist running footwear? I know it sounds counter-intuitive, but it has been shown that if you allow your body to maintain its natural gait while exercising/walking, that it reduces potential injuries such as shin splints and what not. It is quite possible that it could help this sesamoiditis you speak of as well.

Again, just a thought, I am definitely not qualified in any way to give you medical advice, just speculation.

You have my sympathies. I have this and a waning case of plantar fasciitis.

You are gonna hate my advice. It's not medical, it's just what I do.

Run through it.

I have found that the gel sport insoles in both my work shoes and running shoes helps a lot. I have found that Aleve works better than Advil. I have 2 pairs of running shoes and swap them daily (which you should do anyway, most shoes needs 24 hours for the foam to recover.

I would also reccomend a high end running store that does a video gait analysis. Have an expert reccomend some shoes (them buy them online, at least the 2nd pair, Zappotos is usually cheaper).

I still limp the first 5 steps after sitting for a while, moreso if I put in a big mile day.

The Vibrams (minimalist running shoes) have helped others, but the milage I put in is just too damm much for those. But my buddies that have them swear by them.

But to that end, I am barefoot or in socks as much as I can get away with.

Yes, your foot hurts like hell. But it beats heart disease, knee and joint problems and not watching both your kids walk across the stage. Which I suspect is what motivated you in that direction in the first place.

I would also venture even with the pain, you feel better. Especially after losing 40lbs, thats awesome. I bet you are on a lot fewer meds than you were just a couple of years ago as well. If you focus on that, I bet you can run through the pain a bit.

Good luck to you.

Mental wrote: You have my sympathies. I have this and a waning case of plantar fasciitis.

I had that for the 1st 6mos of running. A neat trick - take a plastic 1 litre bottle (like seltzer comes in) and freeze it. Then, put it under your desk at work and roll your sore arch across it all day.

Watch how much of the NSAIDS you eat. They are awsome at masking pain but they really aren't good for the liver - especially if you sometimes medicate that with booze.

I just bought those merrell trail glove (not the gay five fingers, the gay merrels) and first time out, four miles, pulled a calf muscle like an idiot. This was yesterday. If you do go that route, build up to it. In my mind it makes sense, but now I'm sidelined for a week or so.

They just released the New Balance Minimus, I have a pair of Nike Free Run and I love them. The Minimus looks cooler though. I plan on getting a pair of Vibrams in the next week since I have a Tough Mudder Event coming up in less than 3 weeks, and jumping into water with shoes freaked me out last time, so Five Fingers it is.

What about work shoes? Think of me as a postman, I am always walking and outside of an hour per day I do not get a chance to sit...

One thing that might help is to take a foam cup fill it with water and freeze it. Then rub it into the spot by slowing pealing back the foam.

I won't pretend I'm any sort of sesamoiditis expert. I am an amature runner, was rather heavy, and have had a lot of foot pain over the years.

Be moderate in building up to things. Wish I would really learn this lesson. Just because I ran 1 mile last week doesn't mean I can run 10 miles this week. Oh, I might make it. But I'll be lame for weeks or months. Building up endurance is god awful hard for me. I want it all, right now.

Running shoes that fit. Amazing the difference they make. I was a cheap skate and would run in whatever I found in Walmart for $10. Lots of pain as a result.

Crocs. Really stupid ugly shoes. I look like a clown in them. And, after months of wearing them the planar facia stuff and the bunion pain have all faded to virtually nothing. Let me wear my normal work boots for a few days, and it starts coming back.

Cortizone shots. Only had a few, and getting them hurt like the dickens. But they gave a lot of relief for a number of weeks.

Weird stretches. Certain ones really help things. From knees to butts to ankles, and probably the bottom of feet. Don't know of one for the bottom of feet, but I bet it exists.

Massages. Need more be said?

I suggest a happy ending to the massage, for this and for all malladies.

flountown wrote: They just released the New Balance Minimus, I have a pair of Nike Free Run and I love them. The Minimus looks cooler though. I plan on getting a pair of Vibrams in the next week since I have a Tough Mudder Event coming up in less than 3 weeks, and jumping into water with shoes freaked me out last time, so Five Fingers it is.

I'd be real careful with doing serious activities without a serious breaking in of your legs to the Five Fingers. You don't want to pull a calf muscle. Took me about two weeks to get to a point where I was ok doing 5Ks in them. Blistered a bit more past that, but eventually I was doing blister-free 10Ks in them.

Of course I've been on a 6 month "I hate running" streak right now, so I'll probably have to start the whole process over.

I'm not an orthopod, doode. My ortho experience is pretty much limited to spine. Ortho docs live for bone. (Show an ortho doc some real cool brain images and the first thing they say is "This is not bone.") But, first off, points for picking a real medical web site (AAOS) and not someone's blog. The advice given there seems quite appropriate.

Now, have you been given an actual diagnosis of this? X-rays, etc? Or is this just the result of "my foot hurts and this is what google turned up"? Big difference there, as it could be something else, like a busted foot bone (technical term, like "ankle bone.") Like if one of the metatarsals is cracked like with a stress fracture, that could be treated differently than sesmoiditis, or maybe the same (keep off it, take it easy, etc.)

John Brown wrote: What about work shoes? Think of me as a postman, I am always walking and outside of an hour per day I do not get a chance to sit...

As far as workshoes,I work on a concrete floor and wear Redwing 2231 Steel toed boots. Comfortable as house slippers once broken in and extremely durable. About the exercise thing,maybe a rowing machine would give your feet a break?

Dr. Hess wrote: I'm not an orthopod, doode. My ortho experience is pretty much limited to spine. Ortho docs live for bone. (Show an ortho doc some real cool brain images and the first thing they say is "This is not bone.") But, first off, points for picking a real medical web site (AAOS) and not someone's blog. The advice given there seems quite appropriate. Now, have you been given an actual diagnosis of this? X-rays, etc? Or is this just the result of "my foot hurts and this is what google turned up"? Big difference there, as it could be something else, like a busted foot bone (technical term, like "ankle bone.") Like if one of the metatarsals is cracked like with a stress fracture, that could be treated differently than sesmoiditis, or maybe the same (keep off it, take it easy, etc.)

No confirmed diagnosis. Have an appointment with a podiatrist on thursday. Yes it could be a broken one as well. Today has been horrible with it. Severe swelling and discoloration. I may have to take a trip to the local sports redi-care tonight (the guy is the osteopath that did my ankle) and cancel thursdays appointment if it gets worse.

Busted something. x-a-rays-a-commin'.

Osterkraut wrote:

flountown wrote: They just released the New Balance Minimus, I have a pair of Nike Free Run and I love them. The Minimus looks cooler though. I plan on getting a pair of Vibrams in the next week since I have a Tough Mudder Event coming up in less than 3 weeks, and jumping into water with shoes freaked me out last time, so Five Fingers it is.

I'd be real careful with doing serious activities without a serious breaking in of your legs to the Five Fingers. You don't want to pull a calf muscle. Took me about two weeks to get to a point where I was ok doing 5Ks in them. Blistered a bit more past that, but eventually I was doing blister-free 10Ks in them. Of course I've been on a 6 month "I hate running" streak right now, so I'll probably have to start the whole process over.

Why couldn't I have read this yesterday about 4pm? Pulled the calf muscle trying out the 'barefoot' thing with the Merrells. Are you saying you shouldn't physically run long distances with them? I was an 8 mile daily with the occasional 12-15 with the normal shoes. Is it ok to mix them up with normal shoes?

Dr. Hess wrote: Busted something. x-a-rays-a-commin'.

That is what I am afraid of...

Teh E36 M3 wrote:

Osterkraut wrote:

flountown wrote: They just released the New Balance Minimus, I have a pair of Nike Free Run and I love them. The Minimus looks cooler though. I plan on getting a pair of Vibrams in the next week since I have a Tough Mudder Event coming up in less than 3 weeks, and jumping into water with shoes freaked me out last time, so Five Fingers it is.

I'd be real careful with doing serious activities without a serious breaking in of your legs to the Five Fingers. You don't want to pull a calf muscle. Took me about two weeks to get to a point where I was ok doing 5Ks in them. Blistered a bit more past that, but eventually I was doing blister-free 10Ks in them. Of course I've been on a 6 month "I hate running" streak right now, so I'll probably have to start the whole process over.

Why couldn't I have read this yesterday about 4pm? Pulled the calf muscle trying out the 'barefoot' thing with the Merrells. Are you saying you shouldn't physically run long distances with them? I was an 8 mile daily with the occasional 12-15 with the normal shoes. Is it ok to mix them up with normal shoes?

I have a pair of the Vibrams (yes, the gay Vibrams) and from what i've been told and researched, etc- it seems that most of our feet are not accustomed to natural motion the way the vibrams make you run, and it stresses parts of the body that have not been physically trained to be stressed. They're attached to things that have been strengthened, but are not themselves. I had to work my way up in my vibrams, and I actually did it at work. I have a desk job, but I still probably walk a mile or so a day... with sitting in between. It gave my feet a chance to get accustomed to them, and me accustomed to the difference in gait w/o blowing myself apart.

That being said, I am by no means an expert, just a fat guy that likes comfy shoes.

John Brown wrote: What about work shoes? Think of me as a postman, I am always walking and outside of an hour per day I do not get a chance to sit...

How do fat guys all get into these jobs. My feet have been happiest in Sketchers, either shoes with the boot soles or high top work boots depending on how much slush I'll be standing in. They are light and comfortable, but because the soles are light I wear them out in about 5-6 months tops. How has the p90x been working? I think that is going to be my last resort before getting my mouth sewn shut.

Wally wrote:

John Brown wrote: What about work shoes? Think of me as a postman, I am always walking and outside of an hour per day I do not get a chance to sit...

How do fat guys all get into these jobs. My feet have been happiest in Sketchers, either shoes with the boot soles or high top work boots depending on how much slush I'll be standing in. They are light and comfortable, but because the soles are light I wear them out in about 5-6 months tops. How has the p90x been working? I think that is going to be my last resort before getting my mouth sewn shut.

I have no problem replacing them frequently. I hate wasting money on shoes that don't work.

The P90X... well it is elevating my heart rate for sure! It is hard to move when you have been sedentary, I suggest for tubbies like me to be realistic and use the granny weights and light tensions for the first "round" of 90 days then go to a normal P90X full strength workout after that. It IS worth the money, I am not an advertisement for the brand but I am happy telling people they could use it.

Osterkraut wrote: Of course I've been on a 6 month "I hate running" streak right now, so I'll probably have to start the whole process over.

Join the club, damn I hope it goes away soon. The winter was not good to me weight wise :-(

I can't offer much advice to the OP other than a good running store if you haven't already. I too made the mistake of running in cheap department store "running shoes" and paid the price dearly with a bad case of ITB syndrome. To the point I was nearly in tears just walking, an improved stretching routine and the right shoes fixed me right up and the pain has not come back.

As far as shoes go- I haven't found anything better than Birkenstocks for walking/standing. I can stand about 45 minutes with any other pair of shoes before my back starts hurting. Birks I can stand all day. If you don't want to look like Jesus, they have actual closed shoes. They feel like a berkeleying foot massage after standing in anything else.

foxtrapper wrote: I won't pretend I'm any sort of sesamoiditis expert. I am an amature runner, was rather heavy, and have had a lot of foot pain over the years. Be moderate in building up to things. Wish I would really learn this lesson. Just because I ran 1 mile last week doesn't mean I can run 10 miles this week. Oh, I might make it. But I'll be lame for weeks or months. Building up endurance is god awful hard for me. I want it all, right now.

When I fractured a bone in my foot a few years back, the doc told me not to increase my weekly mileage by more than 10%. This may sound small, but starting at eight miles, the following weeks will look like this:

8 8.8 9.68 10.6 11.7 12.9 14.2 15.6 17.1 18.8 20.7 22.3 25.1 27.6 30.3 33.3

If you really keep up with running, you can make huge gains in your endurance as long as you keep the long term in mind. Last time I reached the high 20's/low 30's in mileage, running started to get really time consuming.

As far as these "running shoes" go, I don't get it. I used to run 4.x miles in the Texas heat with Bruzer (~3/4 Rhodesian Ridgeback) in combat boots. Use 2 pairs of socks. After all, the goal was exercise, not getting somewhere or beating someone.

Bruzer used to love running. He'd let little dogs nip at his heals, but Chows, man, he'd go out of his way to bowl one over in a big fluffy ball. He was attacked one day by a German Sheppard and a Chow while we were out running. He was on a leash, of course. I dropped the leash when they attacked. He just put the Sheppard down and the Chow didn't quite know what to think, but decided it didn't want to mess with Bruzer and stayed out of the way. After that, I would always pause at their fence so Bruzer could pee on it.