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Wednesday, May 23, 2012

Post Sesamoid Removal

I hope we can follow Mark following his surgery in April 2012 to remove the fibular sesamoid. Bob and I had some correspondance before he went under the knife. He made the right decision. Here is his initial comments in the long road ahead. In 2 years he will have the power back into his foot. This first 3 months post op is for initial scar reduction and elimination of swelling. Then there are small gains from 3 to 9 months as initial strength is regained, activity gets back to some level of normalcy, and the pain level is controlled by daily icing, orthotics, shoe selection, some activity modification. From 9 to 12 months, the body's nature process occurs and more scar reduction occurs (the interior and external scar looses water content and the scar tissue thins). This sets the stage for a fast or slow recovery of more strength (more power, more endurance, or speed of contraction). So, it is in this second year, the true time when athletes get back to where they were pre injury. But, everyone has a slightly different time line. 

Hi Rich,

One month post-surgery update -
Excised fibular sesamoid was larger than expected, arthritic, and developing a spur.  
I was in a walking flat shoe first week or so.  No even up strap on leveler needed (no cam boot prescribed).  Doc said it was ligament healing, not bone fracture healing, no need for a cam size boot.  No problem.

So after a month, much improved.  No pain in ball of front area, some odd nerve/tendon feeling at tip of big toe but, absent that, uneventful.  
Occasionally sore after long period of walking and flexing foot, otherwise ok.
Incision site at side of big toe, gone.  No scar.

So far it looks like a great decision and I remain active and optimistic.

Regards, Mark

Mark, Thank you and I will post on my blog so people can see that there is life after sesamoid surgery. When you see the blog post, if you could continue to update your progress (probably a few ups and downs), that would be wonderful. Rich If you were given any post operative instructions specific to this surgery, could you send along. When were you told you could start lite running? What is your workouts now? Bike? Swimming? Do you have your orthotics to protect the area? 

Here is Mark's original email with my response. You can see this problem had been going on for quite awhile.

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.