Can I run in Vibrams with a broken sesamoid?
Yes, many of my patients are running with broken sesamoids, but No, not in Vibrams.
Here’s how to get from a broken sesamoid to running without pain. There are two free floating bones under the big toes in our feet called sesamoids. These bones are vulnerable for anyone walking extensively or running barefoot. The primary cause of a sesamoid injury is due to inadequate support in the arch area of the foot. This collapsing arch problem is called pronation. Running in Vibrams, Skechers and minimalist shoes are also more likely to injure these bones because they are not strong running shoes. Cushioned shoes and sometimes even motion control shoes may not provide enough support for an over pronator, resulting in arch pain, heel pain, achilles tendinitis or sesamoid pain. Sometimes experienced runners provoke sesamoiditis by putting too many training miles on their feet, running on hard surfaces and even a road race can trigger sesamoid pain or brake a sesamoid.
The good news is that these broken bones rarely need surgery, since many of us have already broken one of ours. Frequently, young athletes break a sesamoid as teenagers when their natural endorphins are abundant causing symptoms to usually be no worse than being described as “hot.”
There are a few techniques to minimize foot pain even with a broken sesamoid or reducing the sesamoid pain if it is caused from overuse or misuse. Broken sesamoids can best be treated by off loading the forces putting pressure on the big toe and sesamoid bones when walking or running. The first factor to consider are the shoes; stability and motion control running shoes are a must! Now is the time to definitely avoid cushioned and minimalist shoes, including Skechers and Vibrams like the plague! The second factor in pain free running with broken sesamoids is using my special foot pain taping technique for immediate pain relief. This foot taping is also good for other over pronation symptoms including plantar fasciitits, achilles tendinitis and shin splints. This foot taping works because better arch support is an essential part for foot pain relief. Along with stability and motion control shoes, it promotes landing more towards the outside of the foot when walking or running, reducing the forces on the arch of the foot, heel, big toes and broken sesamoid bones. My foot taping is actually better than most of the over the counter orthotics like Superfeet, Sole Insoles and Dr. Scholls.
My most important recommendation to continue walking and running with a broken sesamoid or sesamoiditis is with custom orthotics. These orthotics work two to three times better than my foot taping technique by supporting the feet, forcing the person to toe off the 2nd, 3rd and 4th toes when running and walking and allowing the big toe to basically float during normal gait mechanics. A reality rarely discussed by professionals in the foot and shoe industry is that feet gradually get flatter through life as we put thousands of miles yearly on them and average 200,000 miles in our lifetime. My custom orthotics correct abnormal foot alignment and uneven leg length differences, which is why foot, leg and most musculoskeletal symptoms are rarely symmetrical.
Many doctors are not willing to say they are against barefoot running and minalimist running shoes; the patient flow from their use is very profitable. I prefer my patients to be informed, not in pain and live without foot fractures or other disabling injuries in the first place. A broken sesamoid with symptoms usually results in an orthotic patient for life, but as Benjamin Franklin said, “An ounce of prevention is worth a pound of cure.”
Dr. Paul R. Copeskey, D.C., C.C.F.C.