Hi Dr. Paul,
I recently was browsing the Internet looking for advice on the best type of shoe to get when running with a sesamoid fracture. I saw that you recommend stability and motion control shoes. Currently I am recovering from a fractured sesamoid, though my x-rays indicate the bone is still in half, it feels significantly better than when I broke it in February. I have been doing Step class, biking, jogging, basketball and lifting heavy weights with little pain. However, in my running shoes, Asics Gel Nimbus, I notice significant pain in my ball of my foot.
I have not begun running on the streets as I would like to, and I was wondering if there is a specific shoe that you recommend? My basketball shoes are very wide and I wear those almost all of the time with little pain, and I was thinking the wider the shoe the better, which is why I have been looking at the Altra Instinct Running Shoe which has zero heel drop, and is extremely wide. I was wondering your thoughts on getting this type of shoe or looking into a different shoe?
Thank you so much for your time,
After seeing your doctor, I would advise a three part plan to achieve running without pain after a broken sesamoid. First, is offloading the forces putting pressure on the big toe with proper shoes. These include stability and motion control running shoes and avoiding your cushioned (Asics Nimbus) and minimalist (Altra Instinct) shoes. Second, is foot pain taping which promotes landing more towards the outside of the foot, supporting the arch of the foot, heel, big toes and broken sesamoid bones. Third, is custom orthotics that correct abnormal foot alignment and uneven leg length differences, why most foot, leg and musculoskeletal symptoms are rarely symmetrical.
For shoes, consider Brooks Ariels and Addictions, the Asic Evolutions and Foundations or Saucony Omnis. These all keep you from pronating and putting more forefoot and big toe pressure on the break. Just to be clear, offloading the forces from the broken sesamoid comes from lifting the arch, not just getting a bigger toe box. Lifting the arch straightens the toes, reducing the foot width and forcing normal foot strike to the outside of the foot.
The right running shoe is very important!
Lastly, you mentioned another factor that I believe needs to be addressed as well, street running. I would avoid running on the pavement and sidewalks for now. This running surface topic is an important enough issue to address in a new article I will post very soon.
Dr. Paul R. Copeskey, D.C., C.C.F.C.