Scott had tried everything short of surgery to repair a running injury in his foot—physical therapy, chiropractic manipulation, special shoes, boot immobilization, acupuncture, massage therapy, Motrin, electrical stimulation, and so on. After struggling for years and finding no relief, devastation set in when this lifelong runner and former track captain heard these words: “Maybe you just shouldn’t run anymore.” But Scott loves running, and it was also those words that made him determined to find a solution…one that didn’t involve surgery.
The very last thing you want to hear if you’re a runner is a huge snap coming from one of your feet. But this is exactly what happened to lifelong runner Scott. Normal life changed drastically at that moment as he could barely walk or stand, let alone do what he loved most…running! Having tried all he knew to try, the worst case scenario was looming before him, as each and every doctor he saw said the same dreaded words…the only option was surgery!
That horrible snap was Scott’s flexor hallucis longus (FHL) tendon, but there was a lot more going on. In addition to the FHL damage, the MRI showed small holes in the plantar plates in the second and third metatarsophalangeal (MTP) joints (toe joints). It also showed evidence of arthritis in his first-through-third MTP joints which explained why his toes had become very painful.
The FHL (Flexor Hallucis Longus Tendon), highlighted in yellow, is on the bottom of the big toe. Its purpose is to flex the toe and stabilize the ankle along with other tendons. It’s quite a unique structure and has several different functions.
To understand what was going on in Scott’s foot, you first need to understand the relationship between the FHL and the Plantar Plate (PP). Residing on the bottom of the big toe and other MTP joints, the Plantar Plate is a fibrocartilage plate which helps protect the joint from the forces of impact like it would experience in running, very much the same way the meniscus protects the knee. In the picture we see how the FHL tendon attaches to the plantar plate like other foot flexor tendons associated with MTP joints attach to their respective Plantar Plates.
But in addition to that, ligaments play a big roll in this section of the foot as well. As seen in the image, at the side of the toe MTP joints there are two ligaments, the accessory collateral ligament, or the ACL of the toe heading downward shown in red, and the proper collateral ligament or PCL heading upward shown in blue. Because of it’s function of stabilizing the Plantar Plate and holding it in place, the ACL is important in this instance.
Scott decides to try corticosteroid injections, and his experience is best communicated in his own words:
“The theory behind them is that they dull the pain, but they don’t really work because what they’re actually doing is just killing the tissue. I think I actually got my second injury under the toes because the muscle under my arch was so weakened that it prevented me from actually exercising the muscles under my toes and caused that second injury. So I don’t think that cortisone shots actually work…they work in that they kill your muscle tissue, but that’s not really a great solution to the problem.”
I’ve been covering the toxic effects of these corticosteroid injections on this blog for years, and here are a handful of the issues I’ve shared regarding these injections:
It’s clear to see just from this small sample of side effects why Scott’s experience with his cortisone injections didn’t work and why these injections are just an all-around bad idea.
Scott’s resolve to steer clear of surgery solidified when his chiropractor shared the story of her bad experience following the same foot surgery. His determination led him to Regenexx where, in March of 2015, he was treated by Dr. Centeno in Colorado with with a precisely placed (using ultrasound and fluoroscopy guidance) same-day stem cell injection procedure (Regenexx-SD). This patented process involves harvesting the patient’s own stem cells and reinjecting them back into the patient’s body.
No words can express Scott’s success with his stem cell treatment better than his own:
“After the procedure, I walked out. I got on a flight shortly after that, and my foot was really sore for about a week. But about a month later, I hiked up Mount Kilimanjaro. Three months later, I was on a trip in Europe and actually went out in Paris and ran along the river and was able to do six miles. It was the first time in three years I was able to run without any pain…So now I’m at the point where I can run eight, ten miles with almost no discomfort, and I’ve got back the thing that I love. I can run again!”
The upshot? It’s an amazing feeling to watch our patients succeed in their treatments and return to the activities they most love. Scott was just seeking relief from his long-term and debilitating foot pain and wanted the ability to run again. We treated his flexor hallucis longus tendon pain, toe joint arthritis, and plantar plate injuries with stem cell injections, and not only is this lifelong runner up to 10 miles two to three days a week, but now he’s climbing volcanoes! Wow! Talk about a come back!
*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.
Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…