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The Force Is Strong In This One

By Andy Mouncey, Dec 8 2015 09:24PM

‘There are two things you’re now stuck with’ pronounces Dr Graham Theobald at www.thebodyrehab.co.uk ‘Two things we can do nothing about:

You have three sesamoid bones instead of two…’ (the two pea sized bones under the big toe and one of mine is in two halves, remember?) ‘and your first metatarsal phalanges joint is fused. ‘ (That’s the joint at the base of the big toe – the one that does all the push-off work. Nothing too important, then…).

‘Now we don’t know when the fusion happened – it could have just developed over time or it could be as a result of the seasmoid breaking – but short of surgery and pinning (outcome by no means certain) that’s it.

What it means is you have a key part of the left foot that wont take and distribute load and shock as effectively as a normal working joint, and it sits right on top of the sesamoids that are now a much weaker three part unit instead of a strong pair. If there’s one part of the chain that doesn’t work then the body has to compensate to take and absorb footfall impact as best it can – which means you’ll get a domino effect and likely problems elsewhere.’

Or to put it bluntly: I have a big solid lump where I should have a nice segmented chain that’s pushing straight into a crucial area of my foot that now has a dirty great fault line running through it. And because this bit ain’t working right the whole house of cards is wobbling.

I’m trying a new tack ‘cos I’ve been very close to throwing the towel in. And that’s after the kitchen sink, the toys from my pram and the baby and bathwater. It ain’t been pretty. The foot’s been aching pretty much continually regardless of what I’m doing – with spikes of more severe discomfort thrown in for good measure. Added to that my left quad has steadily tied itself in knots – a problem that flared in exactly the same way earlier this year on the same problem side.

I’ve cut holes in my insoles and tried everything I know to break this latest cycle and all to no avail. Momentum has dropped away – even on my bike – and confidence has taking an almighty kicking. The only positive of note has been that even with a drop in physical activity I’m still keeping the weight off after a sugar-cull from my diet, and my shoulder coped with a short test swim last week. It still feels and sounds bleedin’ awful but 3 months on it would appear I can at least get back in the water again.


So I’m back to the folks who did a remarkable job five years ago fixing my sprained ankle ligaments 10 days out from what turned out to be my breakthrough Lakeland 100 race. I need a new perspective and something to grab onto not least because I think I’m missing something here.

And I’d forgotten about the fusion – and hadn’t put this together with the fracture. Going over the scan reports again has revealed a new medical equation I suspect you wont find in the journals:

Fusion + Fracture = (Well and truly) F***ed

‘The goal, ‘continues Graham ‘has to be to reduce the ground reaction force on that foot. The only certainty is that if you continue to progressively load it through building up your running you’ll break it again. We have to change something or we’ll just get the same result.’

Yep – I get that.

‘There are four things we can try:

Change your running style so you move with minimal impact.

Look at your kinetic chain to make sure your ability to take, absorb and dissipate load and shock is the best it can be – so make sure everything else is 100% around and above the problem area.

Look at changing your shoes.

Look at orthotics in a pro-active and rehabilitative way.

Or any combination of all that lot that gets us results.’

Still with you.

‘Now the scientific way – and I am a scientist – is to change one thing a time which means this wont be a short process. We will need to use force plate measurements, video analysis and maybe even avatar construction to see exactly what’s happening.’


‘And there is absolutely no guarantee that it’ll work.‘

It doesn’t take a genius to work out that there’s a load of inputs required over a considerable time for a less than certain outcome. After 19 months of this already and no end in sight yet at what point do I consider whether it’s really worth it?

Why not just embrace swimming and biking and be done with the running thing?

Hell, I’ve had a good innings.

Why not indeed…

But I’ve come here for hope and a lifeline and Graham has outlined just that. I have to try this if he will.

‘Would you take this on?’

‘Well, some parts are outside my scope but I know a professor who might. He likes this sort of unusual stuff so if I can build a compelling case study he might just go for it. It also just happens that I’m getting a new piece of whizzy kit to test shortly that would be great for this. It would mean being a lab rat for a few hours – but it’s not like you’re doing anything else right now, is it?

Dec 9 2015 07:36PM by Fiona

Sorry to hear that, it sounds like something that would be very painful, as well as annoying. Good luck with the decision and I guess if you decide to take this on, you can't be any worse off than you are now. Nothing ventured, nothing gained. Apologies for the trite cliches...

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