UKC

I was diagnosed with sesamoiditis (podiatrist also suspected a bit of bursitis) in my right foot back in June, which led to a lengthy absence of climbing as I couldn't wear a rock shoe without causing severe pain. Thankfully, it seems to have gotten almost back to normal but now the left foot has done the same thing. Albeit it feels less severe it's still quite disheartening to feel like I'm about to go through the same healing process over another number of months before it gets better, and worry that climbing footwear is going to cause me further issues down the line. I can still just about spend time in the hills with a decent insole that allows the ball of my foot to sit free without pressure, which is handy as my work has me walking and on my feet over rough ground regularly.

I've tried looking for climbing related articles to the condition and it doesn't seem to pop up often, if at all, which I find surprising as it seems the mechanism for injury would be very common for rock climbers. 

Has anyone else dealt with it? Anything that helped you move on a bit quicker? I've been spending my days icings, stretching, doing toe curl exercises and strengthening my calves as well as regular contrast bathing of the afflicted area. All the literature I've read suggests that by keeping the pain level below a 2 will allow for healing so I've been working off of that basis rather than complete rest which I tried initially and I think it set me back. 

It would be good to hear from anyone else who's had issues over the years. 

In reply to Nathan Adam:

Yea, had that. And yea, it's a total pain, as in proper pain.

Mine went back to normal with a bit of shock treatment. Podiatrist done it in one session. Perhaps I was lucky, I was expecting a few sessions at least. 

That and stretching and mobilisation. 

Did you get advice from a podiatrist on  what stretches and etc to do?

In reply to Nathan Adam:

Speak to DaveMac, he may well have some useful tips for modifying your rockshoes to mitigate the problem.

In reply to daWalt:

Hadn't heard of shock treatment so will look into it. I had a few sessions of cold laser therapy that helped but the local podiatrist (NHS and private) to me is fully booked all the time so I've had to travel to Glasgow for it which was starting to be a financial burden. They seemed keen to give me a steroid injection but without an x-ray or MRI to see if it was a sesamoid fracture or just sesamoiditis, the literature and personal accounts I'd read seemed to think it wouldn't help for a fracture and was hit or miss in terms of actual healing.

No advice for stretches from the podiatrist, just custom insole for my right foot which I've replicated with an old insole for my left shoe. I've found lots of resources online for stretching but always welcome any extra info.

In reply to smally:

Thanks, I'll send him a message. I had a bit of success with using some pads with a cut out around the ball of my foot that took the pressure off when flexing at the toes, he may have some other ideas to add.

In reply to Nathan Adam:

I did and was told I should have it removed as it was necrotic. In the run up spent probably £1000 on custom orthotics with cut out pads, physio and endless new footwear over a period of 12 months including podiatrists who kept trying to put me in posted footwear (with a high heel to toe drop) which seemed to make no sense to me...

...I then started wearing altra shoes with sufficient toe space, and doing intrinsic foot exercises...and then started bare foot running via a running coach recommended to me via vivo barefoot (my NHS consultant surgeon had suggested this root as a final punt after he had become interested in this line of thinking)... anyway hey presto the whole bloody thing went away and I've never had a problem with it since. 

Occasionally a sharp rock under the right point can really hurt me, but it's just an owww and then doesn't bother me.

24-months later I decided to pilon fracture my ankle...and oh wow...that has changed my life and it made me realise how insignificant this sesamoid had been. Don't sweat this injury...it will go away. 

In reply to Nathan Adam:

I think it's shockwave therapy, but you shoudl be able to find it.

I'm not sure if this was the thing that did it, or it could just as easily have been that the podiatrist manipulted the bones back into their proper position and the inflamation went away by itself. there was a lot of pushing, pulling and yanking about going on. 

I guess it depends on what's causing the inflamation, it sounds like your case is quite serious, sure it's not gout? persoanlly, i'd go see the best podiatrist that money can buy (I exaggerate but only slightly) and see what they say. 

In reply to Nathan Adam:

this is just by the way, no advice intended.

it was the 2nd time i'd had this thing with my foot when i'd got to see someone. the first time I just thought I'd wacked it or strained something. 

guy was really good, asked a lot of questions to make sure it wasn't gout (phew!). and spent a lot of time essentially manipulating my big toe. that and a session of shock treatment (weird sensation but not unplesent). apparently it helps break down subsurface scar tissue.

I got the impression, unles I misunderstood, that my sesamoids had effectively dislocated and needed to be put back in their place. I was reccomended to do some pysical manipulation and stretching (pulling more like) of my toe. moving all the toe joints by hand would get a good knuckle-crack and the thing would feel a lot looser, that and pulling on the end of the toe to releave the compression within the joints.

seemed to work, at least it did for me.

ymmv. I'd still recomend you see another podiatrist, as a totally new no history consultation, and see what they say.

In reply to FreeloaderJoe:

Joe, thanks for that. Good to hear you eventually got relief from it, but sorry you're dealing with something else now.

Have heard lots about Altra's and their healing power, have been putting it off but I think I need to bite the bullet and just get some. 

In reply to daWalt:

My first podiatrist seemed to think it wasn't gout, as the pain is coming from the underside of my foot and is sore when the sesamoids are pressed. 

I have made an inquiry with another podiatrist a bit closer to home that offers shockwave therapy so will follow up on that and see what they suggest. 

Thanks again for sharing, it's good to know I'm not on my own with it in the climbing community.

In reply to Nathan Adam:

Interesting. I hadn't heard of Sesamoiditis, but a quick Google has shown it's pretty much exactly what I have and not I'm mega pissed off that the podiatrist I went to see to miss it completely! 

They just wanted to sell me a £395 orthotic. Might actually complain. 

I was getting quite worried it was the onset of arthritis. Hopefully I can start treating it properly. 

In reply to Nathan Adam:

A good physio should be able to help with this.

https://isibookerphysio.com/ should be able to help, given that they've personally suffered with it

In reply to Wide_Mouth_Frog:feel free to drop me a message Nathan. Happy to have a chat - I know it’s super hard to find good information as there isn’t a lot out there online.  

In reply to Alasdair Fulton:

Are you based in Glasgow Alasdair? 

I went to Rebecca Allan in the city center and got sorted with a quick fix insole to take the pressure off the sesamoid bones in my day to day shoes. It'd be quite easy to replicate something similar at home with some old insoles. A few sessions of cold laser therapy also seemed to help me but I couldn't commit to going over and over again given the cost and travel expense, but generally was happy with the treatment I received from them.

The issues I had in my right foot have almost completely resolved with the right rehab and actually putting it through the "right" amount of pain and stress but it felt a bit of a long road. Although I've got hope the left foot will heal quicker.

In reply to Isabelle Booker:

Thanks Isabelle, I'll drop you a message now. Any info or help would be greatly appreciated.

In reply to Nathan Adam:

It was Glasgow, but not that clinic. 

I've got a follow up Zoom call and session when I get back (made a bit of a grumble about the advice not being that great, and feeling like the assessment was just a tee-up for expensive insoles...). 

I had the same a few years back with elbow tendinosis (one one arm) followed by tendinitis a year later on the other. Slightly different rehab, but definitely got it sorted quicker second time round. 

Doing the foot scrunch, stretches etc. and it seems to be helping already.