Doc On The Run Podcast Dr. Christopher Segler

If you get an aching pain under the big toe joint, it might be an injury to one of the two little bones called the sesamoid bones. 
The sesamoid bone injuries make me super nervous. If you are a runner and you start getting pain and irritation if the sesamoids, you do not want to ignore it. 
I just got off a call with a woman who had sesamoiditis. She wanted to make sure that she was not doing anything to slow the recovery of her sesamoid stress fracture.
With summer coming up, she wanted to know what kind of sandals she might be able to wear.
What summer sandals should I wear if I have sesamoiditis? 
Well, that is a good question and that is what we're talking about today on the Doc On The Run Podcast. 

I was just on a second opinion call with a runner. He is a triathlete, and he has had a long course of foot trouble. He was diagnosed with a plantar plate injury, but was not getting better. 
We figured out some missing pieces of his recovery puzzle and developed a plan of action.
Well, he acted on that game plan and turns out he had been misdiagnosed. What he has is a neuroma (not a plantar plate sprain).
He went back to his doctor and she then wanted to inject his foot with cortisone, but he had a race coming up.
And then he said, “Well, this is the problem. This is why I am calling you again, is that when I saw her, she said you have a neuroma so let's go ahead and inject it with cortisone.”
Can I run a race after a corticosteroid injection for a neuroma? 
Well, that is a great question and that is what we're talking about today on the Doc On The Run Podcast. 

If you get a sesamoid fracture, you are probably worried. This is a scary injury if you are a runner. 
Since stretching is one of the main components of physical therapy after many running injuries, you may think about stretching and why it might help your injury recover faster. 
What is the single most important stretch if you are a runner who has had a sesamoid fracture? 
Well, that is what we are talking about today on the Doc On The Run Podcast. 

One of the most difficult running injuries is a plantar plate injury. 
I know, because I have had a plantar plate sprain myself. 
Plantar plate sprains are really frustrating because the plantar plate is a very small ligament. It takes very little to aggravate or stress the plantar plate, to irritate it, to stretch it, strain it, or injure it further when you are running. 
I had a patient who asked a really interesting question. He said:
“Should I expect to have pain as soon as I start running?”
I basically said, “Well, if you do, you are doing it wrong, because if you are having pain, you are stretching and straining the ligament in the way that is predictably going to re-injure it.”
Should I expect to have some pain when I return to running after healing a plantar plate sprain? 
Great question and that is what we're talking about today on the Doc On The Run Podcast.

If you have a fractured sesamoid bone, the biggest concern is that the sesamoid fracture will turn into a fracture nonunion.
"Non-union" means it did not unite. The two broken pieces did not get back together, and the fractured sesamoid bone did not heal. 
I was talking to a runner who had a sesamoid injury and she wanted to know whether or not surgery was a good option in her case. 
We talked broadly speaking about three different possible kinds of sesamoid surgeries.
Today on the Doc On The Run podcast, we’re talking about surgical options for sesamoid fracture nonunion.

I got an interesting question from a runner who had a plantar plate injury. 
This runner had a long course of sort of misdiagnosis, mistreatment and various plantar plate "misadventures." 
But when we started working together, he started to do some specific things to improve quickly, and he is doing great now. 
He asked:
“Which comes first after my plantar plate sprain heals, will I be running, or will I be wearing dress shoes?”
Well, that is a good question and that is what we're talking about today on the Doc On The Run Podcast.