Followup Email in a Sesamoid Fracture Patient

Hi Dr. Blake,

Just and update on my foot progress.

1. I continue the running program. I had a couple of set backs, the flu (off for 10 days) and swelling in my knee (off for 7days). I am not a runner so as part of this I am conditioning my cardio vascular health. I am taking 5 times on each stage, instead of 3. And I have added a couple of shorter durations in the middle, so this is taking me a little longer to complete. Yesterday was my first time running 6, walking 4. Completed without incident.

2. I continue to ice after every running session. Just to keep everything in check.

3. I am still using the bone stimulator daily. But since the company reset it, the time has been a little off so some days it records 2 sessions and some days none, but I try to do it the same time every morning.

4.  I am still taking 600 mg calcium and 4000iu d.

5. I foam roll and stretch for 20 minutes after each run. Keeps the legs from cramping up. I did mention that I am not a runner and this is all new for me.

6. I am still wearing the hokas with all the special foot padding.

As for pain, there has been very little, so I think things are moving along nicely. I couple of times about 2-3, but I took some motrin, iced and laid off for a day and it was fine.

I did have a little shin pain around stage running 3 minutes. I just backed off the intensity of the running speed (from between 5.6-6.0 to between 5.2-5.5) and that all went away. I really don't need shin splints while trying to heal my sesamoid.

So for now, that is about it. Is there anything else I should be doing? Or do we need another visit?

Let me know, and thanks for getting me back on my feet.

Dr Blake's comment: 2 MRIs so far have documented delayed union in the sesamoid injured. Imaging is only part of the decision making. We are seeing if the patient can gradually return to activity (which strengthens the bone if the pain does not escalate). So far, so good. She was told to email me in 2 months, since her last physical exam 3 months ago was essentially negative. You can tell by the email that she has mechanical protection, is working on bone health, and is controlling inflammation.