Sesamoiditis (sesamoid inflammation)

Discussion in 'Fencing Discussion' started by Streamthief, Oct 13, 2018.

  1. Streamthief

    Streamthief Rookie

    Oct 13, 2018
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    A little bit of information about me: I'm in high school, and have been fencing for just shy of two years competitively. I go to practice for two hours twice a week. I fence sabre. In late June of this year (2018) I began to experience some dull pain in the ball of my right (leading) foot. It felt just like a bruise, and when it didn't go away immediately I assumed it was a bone bruise since I've had one on my foot before and it felt the exact same. A week or two after this started I starting have pain in my right knee while fencing and going up and down stairs. I bought a brace to wear on it while I fence, which helps significantly. I believe that the knee pain (and pain in my back knee) came from altered gait while walking with my foot injured. When my foot didn't heal after two and a half months I went to the podiatrist who told me I had sesamoiditis, which is the inflammation of one of two small bones in the ball of your foot. She gave me a dancers pad to wear, and told me to come back in three weeks. The pad helped keep pressure off my foot while I walked, but there wasn't any noticeable improvement. At my follow up she told me to continue wearing the dancer's pad for another three weeks, and if it wasn't better by then we could try other options such as a cortisone injection. I've been taking a break from fencing since then, but have noticed only negligible improvement in my foot. I have an important tournament coming up next week that I do not want to miss. My appointment is three days before the tournament. After that tournament, fencing season will start up hard and fast for me, and I'll be competing regularly. Have any of you ever struggled with sesamoiditis? How long did it take to resolve, and what treatments did you use? And if anyone has ever had a cortisone injection did it work well, and for how long? I've been training hard for this season for months, and don't want to have to miss any tournaments if I can help it, but with my foot I don't know if I'll be able to attend them all. Is there any way for me to fence without irritating it further, or a way to heal it faster than Wolverine? It's now October, five months after this started, will it ever heal?
  2. jjefferies

    jjefferies Podium

    Dec 16, 2005
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    First off I'm not a MD so any comments are strictly anecdotal. My understanding is that it depends on your body. I've had cortisone injections for other issues and they didn't work for me over the long run. Within a couple of days it was back to where it was before. Friends on the other hand have reported complete cures. IMO it depends to a degree on how much you believe. As an aside I've been in a similar situation with some mystery pain that's been with me for 10 months now. Initial guess/diagnosis was a pinched nerve in the lumbar region. I've seen a number of specialists including a podiatrist. The only ones to have come close to helping with the problem has been my acupuncturist and podiatrist. Suggestion, there are several modalities, i.e. approaches to fixing these sorts of things. I've been trying them all while remembering that some, acupuncture, chiropractic and physical therapy, are more art forms than sciences. That doesn't mean they won't help. Moreover they are much less invasive than surgery or some of the other treatments. After nine months of various specialists, found an acupuncturist who identified a possible cause and has been treating based on her divination and training with some success. And during that strange journey worrying about a pinched nerve, my right foot started having problems. (The pinched nerve/mystery pain was on the left side.) My podiatrist looked at it and recommended physical therapy with electro-stimulation. One of the office of physical therapists told me that they didn't believe in electro-stim (Period). I informed him that my Podiatrist, while she is only 4'9", is a former paratrooper and looks to be the sort that could perform a sex change operation on him sans sharp instruments or anaesthesia. He rethought the proposition and applied electro-stim which wonder of wonders worked quite well. The reason for my telling this is to point out that you have to take charge and sometimes when you get a doctor to propose things insist that the rest of the medical community go along. Much of the lost time was spent bouncing between specialists each of which took 2 weeks to a month to get an appointment with.

    Almost impossible for us to diagnose/suggest what to do at a distance over the inter-net. I would get a conversation going with your coach and your primary care physician and possibly try other approaches such as acupuncture and physical therapy. As a high schooler you probably can bounce back much quicker than 74 year old me. One conversation should be how hard to push the envelope with your foot in its current state.
    Best wishes
    Last edited: Oct 14, 2018
  3. jdude97

    jdude97 Podium

    Apr 10, 2013
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    I definitely give the standard approach of talk to your coach/trainer/sports medicine doctor. I haven't had this specific diagnosis but I have had a variety of heel pains. They were solved with a mix of custom orthotics for my running shoes and semi-custom SuperFeet inserts for my fencing shoes, heel cups (look it up), and most of all, rest.

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