How To Treat Sesamoid Fracures

[@marielaS1622]

I got a fracture for a while but recently diagnosed. Glad I found your video bc it has helped more than my podiatrists advice! Thanks!

[@drblakeshealingsole]

Mariela, so happy to help you!! Rich

[@laurarhodes7193]

Thank you so very much for making these videos and especially for addressing people's personal situations in the comments. Reading people's stories and your responses is very helpful. I was told that there wasn't much anyone could do to help me but you've given me some new ideas. I have a bipartite medial sesamoid and second plantar plate tear (confirmed in one foot and suspected in the other). It's been 3 years, 2 podiatrists, 2 pairs of custom padded orthotics, thousands of dollars. Physiotherapist told me to stop wearing orthotics if they were painful and go for super soft but stable shoe with a rocker. I've ended up with hoka one one Bondi 6 shoes (great shoes for anyone wondering about them) with a high support insert and a small rectangle of padding under the insert between the arch and ball of my foot. This is better than the orthotics but I still can't walk or stand without pain. I have been walking on the outside of my feet for a year and now have fluid in joints from poor biomechanical function. Do you think the dancers pads are suitable for someone with a tear behind their second toe? Padding in that spot tends hurt. I have knee injuries and if I reduce the padding too much there, my foot tends to roll in. I don't want to make the tear worse. What is the likelihood of any improvement on such an old injury? Thank you again for your amazing videos, Richard.

[@elenigkritsi828]

Hello Dr. Blake, I have been dealing with a sesamoid fracture since Nov 20th 2019. I had some pain in my foot for a few weeks, so I went for physiotherapy (yes, without a diagnosis). After 6 hours I woke up in agony, the pain was unbearable. I did an xray and an MRI and showed a broken medial sesamoid. I am located in Athens, Greece and I have visited 6 doctors (2 specializing in athlete injuries), and I have to tell you, I have learnt more from your videos and your blog than from any of them. The last doctor (who seemed to be the most knowledgeable one out of the lot) told me I have to do physiotherapy to help it heal (deep oscillation therapy and magnetotherapy). I have done extensive internet research, but I can't find anything solid, let alone on the effects of such therapies specifically re a sesamoid fracture, and I was hoping to hear what your opinion is on that? I have had it in a walking boot for nearly 2 weeks, then switched for a walking shoe (I even sleep in it). I have stopped going to work so weight bearing is at a minimum (I even shower sitting down), and I ice pack 4 times a day, and I keep doing some strengthening (floor) exercises to ensure my legs don't atrophy, still, I feel as if I got my injury yesterday - zero betterment... I am traumatized from my first experience of physio, and I know it is going to be a long process to get it healed one way or another, I am so scared to do anything that will worsen it, and given you have become my somewhat virtual doctor and the one I seem to trust the most even if I have never met you I thought of asking you... thank you

[@drblakeshealingsole]

First of all, nice to meet you. I have been conversing with a new podiatrists in Athens so I will try to find someone for you. It is best if you write me an email through my blog at www.drblakeshealingsole.com to get my involved with this. In my estimation, people usually are dealing with a 6-12 month adventure to get this better with the first 3 months creating that 0-2 healing environment primarily in a boot and some sort of off weighting padding. You can get pain from the mechanical pressure, from bending the toe, from the inflammation, and from the nerves that protect it. I have had patients float the sesamoid 1/2 inch off the ground and still have a hard time with pain, and that is from the latter two causes. Ice just controls the inflammation, contrast bathing or prolonged soaking is much better in that beautiful Aegean Sea of yours. Massage it with lotions three times a day to desensitize the area for 2 days. The massage has to be painfree. See what you can do to get the pain down to 0-2 over the next month consistently. Hope this starts the process for you. Rich

[@drblakeshealingsole]

Her is the email for a wonderful podiatrist in Athens, Greece. [e-mail]

[@elenigkritsi828]

@@drblakeshealingsole oh my god! Ecstatic to (virtually) meet you! Thank you so so much for replying! I will do so, thank you thank you thank you!

[@drblakeshealingsole]

@@elenigkritsi828 Welcome!

[@chrisbeveridge3066]

,,

[@douglang5568]

Great video. Thank you for taking the time to do this.

[@drblakeshealingsole]

Thank you. Please also see my blog on sesamoid issues. The website is www.drblakeshealingsole.com. Rich

[@georgezasadil4820]

I saw an x-ray of my tibial sesmoid. It was broken. It didn't appear as if the two pieces of bone were touching each other. When I immobilize, will those bones have a chance to come together and heal, or is a tiny screw needed to put it back together?

[@debbie4321]

Hi and thank you for the very informative video. Question: if I do all of this for my fractured to be sesamoid, is it possible that I could be pain-free without having surgery for mal-union fracture? How do I know if I should continue with these conservative measures in your video versus have surgery for removal of the bone?

[@nicolenazos]

Do you start the magazine strength training even in the first 3 months?

[@drblakeshealingsole]

You start nonpainful strengthening as soon as you can. Start with simple active range of motion, then begin isometric in the first 3 months

[@DirkKessler-ko5zi]

Hallo Dr. Blake, Ich leide seit 3 Monaten an einer Sesambeinfractur. Da kein Röntgenbild gemacht wurde wurde der Bruch des Sesambeins anfangs nicht erkannt. Nach 7 Wochen habe ich dann auf ein MRT gedrängt. Der Befund vom MRT ergab dann die Fractur mediales Sesambein. Auf den Bildern ist ein deutlicher Riss zu erkennen. Dieser klafft an der äußeren Seite auf und beträgt an der äußeren Stelle ca. 3 mm. Der Orthopäde hat mir einen Vorderfussentlastungsschuh verschrieben. Ich mache mir sorgen nie mehr normal laufen zu können. Ich bin jetzt seit 4 Wochen zu hause. Ich soll drn Fuß ruhig stellen. Ich habe dass Gefühl, dass eine absolute Ruhigstellung so nicht gewährleistet wird. Muss die Ruhigstellung nicht mit einem Air cast Walker durchgeführt werden? Sehen Sie Möglichkeit, dass ein 3 mm klaffender Bruch wieder zusammnenwachsen kann? Für eine Antwort bin ich Ihnen sehr dankbar. Vielen Dank. Grüße dirk

[@drblakeshealingsole]

A 3 mm gap can heal, but typically is treated with immobilization in bike shoe with embedded cleat for 3 months, a electrical bone stimulator, and contrast bathes 1-2 times daily. The shoes need off weight padding for the sesamoid! Rich

[@DirkKessler-ko5zi]

Hallo Rich, Vielen Dank für deine Antwort. Es gibt mir Hoffnung:) Was ist das für eine elektronische Behandlung? Ist dass das Exegon Gerät? Ich überlege ein Magnetfeldtherapie-System zu besorgen. Ich habe in vielen Büchern und Berichten gelesen, dass damit der selbstheilungsprozess vom Körper angestoßen wird. Wie ist deine Meinung und Erfahrung? Dann habe ich eine Frage zum Schuh. Ich trage jetzt seit 5 Wochen einen Vorderfuß entlastungsschuh. Nachts trage ich den aber nicht. Ich merke keine Verbesserung. Ist das noch zu früh? Gestern Abend war mein Zehgelenk dick und im hinteren Bereich des medialen Sesambein verspürte ich schmerzen. Durch Abtasten konnte ich die Stelle lokalisieren. Vielen Dank vorab. Gruß dirk

[@jhanov43281]

Thank you so much for the knowledge in this video. This is the best video I’ve found on this topic. I first felt pain in my big toe October of ‘19 but I didn’t get it checked out until January of this year. I was put into a boot for more than a month and after that was in custom orthotics with a dancer pad until now. I still haven’t run or stepped foot on a soccer field in this time and after walking for awhile I’ll feel slight discomfort/pain probably around 2-3 level. My questions are these: My podiatrist didn’t really recommend any icing at the time, but would I benefit at all at from contrast bathing at this point? Is it doing any use if I continue to rest and try to heal the bone at this point or is it too late where any healing that could have happened is done? I’m not sure at this time how much activity to reintroduce into my life.

[@drblakeshealingsole]

James, thanks for your questions. There is so much I do not know. What did the MRI show? Did you have an MRI? How did it start? I would invite you to email me at [e-mail] with as much detail. I will put on my blog www.drblakeshealingsole.com Names are kept anonymous. I can be more thorough possibly. I photo of any images would also be nice. Rich

[@naheca12]

Hi James, did you completely recover from this? Unfortunately for me it was until 6 months later that I found out that I had a sesamoid fracture. No boot, but wearing a very stiff insole. What has it helped?

[@tonyshapiro5610]

Dr Richard. Sesmoid fracture that was never treated 40 years ago. Both bones. Now arthritis set in. Other complications. Told by Cedar Sinai Top Surgeon 8 years ago to get surgery. I am in my 60’s. What a mess. I can barely walk but have no choice to keep moving. I am screwed.

[@drblakeshealingsole]

Go to my blog and see if there are some treatment helps. Www.drblakeshealingsole.com

[@alibezz1]

Hi Dr. Blake, thanks for your great video and materials in general. An MRI states that I have a stress reaction in both of my sesamoids in the right foot (worse in the fibular one). I feel very little pain, but don't want them to fracture! My podiatrist put me in a CAM boot but, even wearing an evenup on my left foot, I'm experiencing hip pain. I don't want to further injure myself, so was wondering if I could do anything instead and for how long. Any suggestions are welcome! Maybe my Hoka Bondis with spica taping and Dr. Jill's 1/4 dancer pads, plus icing / elevation / daily contrast baths? Any ideas on how long healing from stress reactions usually takes is also welcome!!

[@alibezz1]

Also, any ideas as to whether or not I can go for walks, and how long they can be, would be much appreciated. I am basically bedbound right now because I don't want my bones to break and am feeling hip pain with the boot...

[@RichBlake]

Aline, There is no magic to heal and you have the right thought process. Keep the pain for 3 months down to between 0-2. Does not seem you need the boot unless you are having difficulty with the pain level. Get your Vitamin D checked, as low bone health can cause poor healing. Do you think it was running? Stress reactions mean that biomechanically you are over stressing this tissue. Bondi with spica taping and Dancer's padding sounds wonderful. Cross train if you can not run with swimming and bike. If you feel you are protected, and you do not go up on your toes, you can do an elliptical. Stay flatfooted. Do contrast bathes for deep bone flushing 3 evenings a week. Hope this helps. Rich

[@alibezz1]

@@RichBlake Thank you so much! It wasn't running: bad kitten heels one afternoon and then a week ignoring it. :/ Can I walk for like 5 to 10 blocks with the Bondi/ spica / dancer's pads setup? I mean, as long as I don't feel more pain of course. Thanks!

[@drblakeshealingsole]

@@alibezz1 for sure, casting and activity modification is to control pain.

[@alibezz1]

@@drblakeshealingsole You are an incredibly informative and generous person. Thank you very much for this info! And btw I am really enjoying your book!

[@felicialeone850]

Hi Dr. Richard, 3 weeks ago I was diagnosed with a displaced sesamoid fracture on my left foot after something heavy fell on it. The sesamoid essentially broke in half, so two pieces. I was told to immobilize it for 2 weeks then see if walking is painful. It is, so I’ve continued to stay off it. The more I read the more nervous I get. Can a displaced sesamoid fracture heal? Two doctors (not podiatrists) who looked at the X-ray were optimistic but I’d like your thoughts. Is continuing to non-weight bear a good idea?

[@ashleytrevillyan1558]

I went 6 months on a fractured sesamoid without knowing it because it was misdiagnosed at urgent care. I then went a year trying the non-invasive treatments (post op shoe, full cam walker, bone stimulator and custom orthotics) before having the sesamoid excised. Now I’m about 2 months post op and I have reduced mobility in my big toe and numbness around the scar and the inside of my big toe near the web. Is this something I’ll have to learn to live with or can I do some specific exercise to gain more mobility and feeling?

[@drblakeshealingsole]

Ashley, I just answered on my blog. Www.drblakeshealingsole.com Hope it helps. Rich

[@naheca12]

Hi Ashley, did you completely recover from this? Unfortunately I have a similar experience and just 6 months later that I found out that I had a sesamoid fracture. What has it helped?

[@elijahmayorov596]

Thank you for the video. The exercise you showed must be done with or without shoe? And may be some information about the "dancing pads"?

[@drblakeshealingsole]

Either shoe or barefoot, whatever you feel most comfortable with. Dancer's padding is made by podiatrists and also called "Reverse Morton's" pads. However, Dr. Jill's company online sells the best gel dancer's pads. I have my patients get the right and left sides and 1/8 and 1/4 inch sizes. The stick is on one side and sometimes you are putting it on your foot, sometimes on top of the insert or sometimes under the insert of the shoe. If you use 1/8 inch on your injuried side only, technically you do not need one for the other side, but some people just feel more balanced. If you need 1/4 on the injured side, you have to put at least an 1/8 inch pad for balance on the other side. Hope this helps. Rich

[@elijahmayorov596]

@@drblakeshealingsole thanks a lot!

[@debbie4321]

What do you mean by put another pad on the other side? Do you mean directly across from the pad surrounding the metatarsal head on the same foot? Versus … you mean the other foot but you’re just saying the other side?

[@christineamador6508]

Hello Dr. Blake. I fractured a sesamoid in my left foot in January. In my stubbornness I didn't get diagnosed and start treatment until June. It has been almost two months in my boot and I just started using Exogen. However, I have the hardest time staying out of the gym. My podiatrist says I can't even use the recumbent bike. Working out is a big part of my mental health treatment. Can I still workout with this injury and while I am in my boot?

[@drblakeshealingsole]

Christine, first of all your podiatrist has to have the final say. In general, you try to create a 0-2 pain level for good healing. You need to avoid impact and toe bend. Typically, some form of swimming, and stationary bike with the weight on the heel is fine. As you get better, you can start adding elliptical but do not use the arms--you want to stay flatfooted. The boot should have dancer's padding inside, and you can do for leisurely walks, as long as the pain stays low and does not increase in the walk. As long as you stay flatfooted there are tons of exercises in the strength room to work on. I hope this helps. Rich

[@christineamador6508]

@@drblakeshealingsole Thank you so much for your response! Oh my goodness you have given me hope in being able to do something for my physical fitness! My boot does not have dancers padding but I can buy dancers pads. I appreciate your response and your help! Thank you so much

[@drblakeshealingsole]

@@christineamador6508 You are welcome and good luck

[@amyrogers8959]

Thank you for your earlier reply - Also, Do you think bone stimulator stilll worth it? Bone is almost healed on xray... Thanks for your input!

[@drblakeshealingsole]

AMY ROGERS probably okay without stim

[@teddytheoz4225]

Seems like everyone is scavenging for answers pertaining to this injury as we all suffer from it. I have had my sesamoid in my left foot fractured for 5 years now. I wear custom orthotics and the hoka cliftons. I still suffer from it. Is there any hope for me or am I stuck with this forever?

[@drblakeshealingsole]

Teddy, sorry to hear. If you want to know what is going on, you have to have a CT scan to see if there is bone fragmentation or bone density issues. Surgery is recommended in those situations, but you also may just need to perfect the orthotics, get a bone stim, learn dancer's padding and spica taping and fluffy wedges. Rich

[@SolitarySoldier]

Richard Blake what happens if i have avascular necrosis of that broken bone? I got an mri but my podiatrist said to not get surgery being this young (22 years old). What do you think I should do❓

[@georgel.materniuc]

@@SolitarySoldier hello. how you are with your sesamoid?

[@magnificentnews-abouttoris961]

I never had problems with sesamoid stress until after my big toe fusion. Is there hope?

[@drblakeshealingsole]

Magnificent News - About To Rise You must use dancer’s padding to protect the sesamoid. Rich

[@magnificentnews-abouttoris961]

@@drblakeshealingsole Thank you so much for your response. I will do.

[@debbie4321]

Would it be a mistake to put on a ski boot and ski when I’m five months out from A non-union tibial sesamoid fracture? Other words, if I decide to go skiing, could this possibly set me back in my recovery? Thank you.

[@nancyangel450]

Please help me. I had great toe arthritis for years and it got to the point the injections stopped working; it was bone on bone. I heard about the Cartivia implant and my podiatrist did the surgery. Within 2 weeks post op, I knew something was wrong. After X-Ray it was clear it was a failure. I had researched and knew of the Arthosurface Hemiimplant. My doctor did not feel I needed the total implant. That there was not enough damage on both sides. It was a great sucess,: however, after 6 weeks I noticed an awful burning on my sesidemoid area and pain when walking in addition to pain in the outside of the toe , the distal phalanx. I went back to doctor and he gave me Meloxicam. I wanted him to take an X-Ray but he didn't . I have been taking this for two weeks and it's still very painful. I've read about dancer pads but I never had this pain until the Cartiva failed. I've read this is not uncommon with failed Cartvia. I'm heartbroken because the joint pain is gone but now I'm having such pain with the mentioned areas.

[@gracegosling5767]

Hi Dr Blake! Your videos have been so so helpful, thank you so much. I was diagnosed with a fibular sesamoid stress fracture in July and I wore a boot for 8 weeks. I’ve managed to successfully wean out of the boot and can weight bear comfortably now and have regained good balance. That being said, I am still experiencing some tenderness on the sesamoid with weight bearing/walking etc, is this normal? The pain has significantly improved which seems to be positive but I know how fickle this injury can be and my doctors aren’t giving me much advice... any advice you can give will be much appreciated! Thanks, Grace

[@drblakeshealingsole]

Grace, glad you are doing better. Yes, the sesamoid is very sensitive, even when healed, for months. You have to continue to protect it with Dr. Jill's Gel Pads in all shoes (by left and right and both the 1/8th inch and 1/4 inch. Sometimes you will put on your foot and sometimes you will put on the insert. This is why you need both sides since the adhesive sometimes needs to be facing up and sometimes down. Daily ice pack 1-2 times to keep working on the inflammation for 10 minutes. Also do 2 minutes twice daily of non painful massage to desensitize the tissue. I hope this helps some. For more, see my blog at www.drblakeshealingsole.com

[@gracegosling5767]

Hi Richard, thanks so much for taking the time to reply, I really appreciate it. Relieved to know that this is a normal part of the process. I’ve been struggling also with inflammation as I think I had chronic sesamoiditis before the fracture occurred so it’s all still very sensitive as things readjust. That’s great to know about the pads, I do already have some of the Dr Jill’s ones and will follow your recommendation. Great to know about icing and massage too. Thanks so much once again! It’s nice to hear some positive guidance around this injury, keep up the fab videos! Grace

[@zhaochenli761]

@@gracegosling5767 Hi Grace, just curious, when you say you are still feeling tenderness, did it get inflamed/swollen? Last week I felt the pain is almost gone when walking barefoot, I put myself in a newly bought hoka shoes without the orthotics. I walked around for maybe 3k steps without sharp pain, but I felt really hot/swollen after got home with some tingling pain even when resting. Is it normal? Thank you!

[@gracegosling5767]

@@zhaochenli761 Hey!! I had long forgotten about this comment which hopefully tells you how successful my recovery has been! I definitely found that it took a considerable amount of time to improve, but little by little it did and I can honestly say I am 99% without pain. There are times that it becomes a little sore if I have worn heels for a prolonged period or perform a new activity very suddenly, but I find this settles very quickly. Obviously I am not a doctor so would always recommend a medical professional if you need help. But i found that being guided by my pain and resting and stretching my calf muscles regularly were game changers for me. I really think it is a lot of patience!! I remember using ice and anti inflammatories during recovery too which helped. Hope it feels better soon

[@zhaochenli761]

@@gracegosling5767Thank you for your reply and I am real glad you have healed! Ya I think throughout these months I figured patience is really important:’)

[@MMSanchezNY]

I have a new podiatrist who told me I had bi partite seismoid and a bone spur on one, but did nothing or suggest nothing but surgery. What can I do to heal and get better without surgery. Should I get a boot? MRI , New podiatrists.

[@drblakeshealingsole]

You have to do what you can to create a 0-2 pain level environment. Usually that is with a 3 month boot and EvenUp on the other side. Check my blog for other information at www.drblakeshealingsole.com. Rich

[@megtinsley4569]

Hi. I have been given a diagnosis of a likely AVN sesamoid bone. There was no fracture, or particular injury, but rather a more gradual pain situation. Would Exogen bone stimulator treatments possibly revitalize the bone?

[@drblakeshealingsole]

Yes, if you have a possible avn, you need a CT scan to accurately document the bone size and shape, and you need to do Exogen bone stim, contrast baths daily, and acupuncture can improve healing. Hope this helps. Rich

[@megtinsley4569]

Thanks for your response. Do I go to a doc's office for the bone stimulator, or buy one? Also, I am in a walking boot bc there was a small tear in a ligament near the sesamoid. Is that recommended? My MRI showed a dark area where the sesamoid is, so I don't know if there is any hope for revival? I swim regularly and am trying to keep exercising to keep blood flow going.

[@drblakeshealingsole]

Yes, back to your doctor, talk about the CT scan to start. Many times the MRI looks like avn because the ligaments that cover the bone make it look dark. The CT scan takes the ligaments out of the picture so we only see the bone. Rich

[@eunicereyes8188]

Do Dr's know for sure that Insurance don't cover the Exogen bone stimulator?

[@drblakeshealingsole]

Many insurances cover the Bone Stims but sometimes you have to wait 3 months after the fracture. We give the info to our Exogen rep, and he finds out all the info for us and for the patient. Rich

[@eunicereyes8188]

Richard Blake Thank You!

[@drblakeshealingsole]

Of course not!!

[@amyrogers8959]

18 yr old xc runner with sesamoid fracture - currently weaning out of the boot (he has been in it for 11 weeks), sesamoid fracture is healing according to xray, and he has been casted for orthotics. Still swollen and there is some pain (less than before). Would contrast bathing help him? We know this is a long process. Just want to get him out of boot and back to some activity (not running - yet) Thank you!

[@drblakeshealingsole]

Yes, contrast each evening and ice pack 10 minutes twice daily. Have him get 1/8 inch right and left Dr. Jill's Gel Dancer's Pads, can be even worn on top of an orhtotic. Massage with hand lotion twice daily the area without pain to desensitize. Rich

[@Kellabunga]

Would you recommend trying prolotherapy for a sesamoid fracture? I was in a cam walker for 4 months, asymptomatic for 4 months after that but the pain has returned (though the pain seems to be closer to the big toe joint now/ not as close to the sesamoid as it was). Thank you!

[@drblakeshealingsole]

apmspineandsports.com/diagnosis/prolotherapy/ Kelly, the link above talks about prolotherapy for joint instability, not to help heal fractures. Please go on my blog and look at the many posts on sesamoid fractures and treatment. Rich www.drblakeshealingsole.com

[@Kenitra59A]

I had a surgery removed half of the sesamoid so you think if I go back to my job which is unload the truck push a heavy two wheels and drive it that s main a lot of action going in my job you think it my effect my oder part of the sesamoid

[@sharminachowdhury8476]

Hi ,I am suffering from a sesamoid fracture for over a year and still have some inflammation and lot of pain on my foot. Ive seen many orthopedic surgeons for opinions but every time I lose hope. I don't know what to do and where I should go for proper treatment. Please help me out.

[@drblakeshealingsole]

Sharmina, thanks for your comment. I know it is scarey. Read the info on my blog, and see what you have done and not done. There is a place to leave comments also. Www.drblakeshealingsole.com Rich

[@sharminachowdhury8476]

@@drblakeshealingsole I'll definitely take a look at your blog. Thank you so much for taking the time out of your busy day to reply, I really appreciate it.

[@drblakeshealingsole]

Sharmina Chowdhury you are welcome

[@19mrmrm87]

Thank you so much for the video. I had a fibular sesamoid removed and now my tibial sesamoid is causing me pain (not broken). My doctors are going to inject me to see if that helps but they said that later on we might consider removing the tibial. What happens when you lose both sesamoids? Are the any big risks I should be aware of? Is this something normally done?

[@drblakeshealingsole]

No, you want to preserve the remaining sesamoid. It protects the joint and helps you move naturally through your foot. Treat the tibial as if it has a hairline fracture. Create a 0-2 pain level with orthotics, dancer's pads, boots, whatever it takes. Read on my blog drblakeshealingsole the many posts on this subject. Good luck. Rich

[@lo9273]

Hi Richard. I've had pain on my right foot for 6 years now and have had to quit all running activities. MRI shows that my medial sesamoid close to my big toe is in three parts and also shows edema. I have done conservatives treatments but none have worked. A doctor has talked about doing a bine craft to it, but another doctor suggested Mober Osteotomy in case a ENMG doesn't show sings of nerve damage on the foot. Is this info helpful for you to be able do give me some direction?

[@drblakeshealingsole]

Rakel Jefremoff Rakel, sorry I am not sure what these procedures are!

[@coldfire420]

if you don't have any visible swelling and the pain subsides after 2-3 days is it still a possibility you have a sesamoid fracture? The pain was only minimal to begin with and I could still bare weight and walk on it. It comes and goes for me usually after a long run or if I step directly on a rock on the sesamoid region but it always goes away completely and I don't feel anything anymore after about 3 days.

[@themovingdance2744]

This is so useful as I can do the well for the feet ❤

[@abigailcarlson7835]

I have had a fractured sesamoid in my big toe for well over 5 years. It was originally thought to be a bunion due to an unclear x-ray so I missed the window for immediate treatment. I have since tried ultrasound therapy and to no avail, there is still pain and the fracture remains. I wear custom orthotics that help float the sesamoid in both shoes since my other big toe has had problems as well. I have been told removing the bone leaves little chance of a full recovery and results in a bunion (which I already have). My doctor has told me that I should simply wear these orthotics in all of my shoes for essentially the rest of my life as there is not much else to be done, noninvasive wise anyways, to help get rid of my pain. I'd love to hear what you think about this.

[@drblakeshealingsole]

Abigail, sorry to hear about your foot. Of course we try to save the bone, but the removing it when the disability is great for the patient has been a good option. Patients do fine. 85% success rate as long as you work with orthotics for your athletics and get physical therapy afterwards. 5 years is a long time, and surgery too high success rate to wait. Rich

[@yomama1169]

It got a bruise, then it kinda hurt now it's so so I can't walk could it be broken thanks

[@Jamespave]

Do you know of a doctor you would recommend in nashville Tn. I am on my 3 rd sesamoid problem in the past 9 years.

[@Mahlaqaubed123]

Have you used vibram five finger shoes???

[@Mahlaqaubed123]

Also I have been using many types of pads but they didn't work except one I just bought from decaklan

[@tina-hw1ui]

Hi, just curious if who's your podiatrist here in Nashville,TN?

[@jenniferegan5835]

I have a fibular sesamoid fracture with avascular necrosis. I tried a PRP injection almost 3 weeks ago, however, still feel pain, especially when walking. I am miserable from walking around like this for months, especially since I am a very active person. In your experience, how successful is PRP for this type of injury? I am ready to give up and have surgery to remove it as I feel like it is the only thing that will help at this point. Does removal of sesamoid have a high success rate?

[@drblakeshealingsole]

Jennifer, I am so sorry for my delay in answering. Sesamoid removal has a very high success rate. So, in my patients that do not improve with conservative management, removing is a good option. All the things that are tried to prevent surgery, will help protect the joint afterwards. Rich

[@dachawnhorton478]

What if my big toe not flat on the ground what should I do next??

[@drblakeshealingsole]

You can try cluffy wedges and spica taping. Go to my blog for specifics. Rich www.drblakeshealingsole.com

[@Otterbandana]

My podiatrist told me I could do nothing to heal the sesamoid fracture because we could not determine how it happened and it likely had been fractured awhile. I am not convinced of this but want your opinion

[@drblakeshealingsole]

Thanks for your comment. Sesamoid fractures can be very related to complex foot biomechanics like plantar flexed first rays and abnormal pronation, poor bone health with even very transient low Vitamin D, or can be a misdiagnosed bipartite sesamoid that is only bruised. My blog www.drblakeshealingsole.com is full of sesamoid discussions that can help. If it is a sesamoid fracture, an MRI can be very helpful. Contrast bathes, bone stimulation, dancer's padding, Hoka One One shoes, etc can be very important tools to help with the healing. Good luck!! Rich

[@Otterbandana]

Richard Blake Thank you. I will go to your blog. In my case the podiatrist told me to buy Hokas and we put an indentation in the orthotic where the sesamoid bones would be. Problem with the Hokas: I soon learned after seeing a PT who specialized in feet, is that my foot structure and the poor heel elevation and lack of stability in the Hoka shoe created an even more painful problem. I developed perineal tendinitis and could not stand or walk. The PT had me get New Balance 928 (13 mm heel lift), most of the tendinitis pain was going away after 12 hours of wearing those. I had been icing and stabilizing the foot first, of course. Because of that experience, knowing the podiatrist had looked at my feet and taken x-rays and yet did not recognize what the PT saw in less than 5 minutes, I am afraid to go back to her. And this is why I am exploring here - not feeling trust that I can get the help I need without a lot more education and self advocacy once I understand more. I wanted to tell you this also since Hokas do make sense if the focus is only on the sesamoid and the whole foot is not looked at. Makes sense to offer that sight unseen. So people should get the whole foot looked at and be a little careful about a shoe with little structure/stability, and be aware that heel lift - even if slight - seems to matter. I’d be curious on your opinion

[@drblakeshealingsole]

@@Otterbandana I see your problem. I am hopeful that the podiatrist would have seen the instability and then gone to the New Balance shoe, but who knows. I recommend shoes all the time, but when the patient comes back and I watch them walk, for one reason or another, it does not work out for them. Sports medicine is fun since the TEAM approach of podiatrist, PT, shoe store can make sure things go right for a patient. Believe me, most podiatrists do not know the Hoka, and since there are 20 different versions, all podiatrists have to leave getting the correct one that is stable for the patient to the shoe store in general. Nemaste!! Rich

[@elprofesor7872]

Hello. I broke my sesamoid a few days ago. As I am a footballer, I'd like to ask if return to this kind of sport is possible after this injury? And how long is a revovery usually untill back on a pitch?

[@drblakeshealingsole]

El Profesor The recovery can be 4-6 months or several years due to many reasons. If fracture is confirmed by MRI, many professional athletes with huge contracts consider removal. Us average joes can wait. And yes the expectation is complete recovery as long as good orthotic and cleat position change if needed!

[@elprofesor7872]

@@drblakeshealingsole Richard Blake it's very frustrating.. 3 months ago i returned to sport after hip surgery and again so big problem. I'm only 22... Nevertheless... Thanks a lot for your attention and answer. You must to be great doctor.

[@drblakeshealingsole]

@@elprofesor7872 Injuries tend to run together because the rest from one injury causes some de-conditioning!! Hang in There!! You will turn this around. Rich

[@elprofesor7872]

@@drblakeshealingsole Oh doctor.. i took a closer look at xray and i didnt see any fracture (im interesting in anatomy and physiotherapy). For that reason i visited another doctor today and its seems that my sesamoid isnt injured. Im so happy but now i dont know what is wrong with my foot. The doctor reccomended rest and wait few days. I hope the pain will disappear :)

[@miguelyanez8162]

How are you el profesor? you already feel better about your foot

[@kmhill1099]

I had a stress fracture of the fibular sesamoid due to low vitamin D levels. It was a nonunion that didn't heal on it's own. I had the sesamoid removed plantarly last November. I've started to experience very slight swelling around the healed scar and on the inside of my big toe. When pressure is applied to a specific area on the scar, there is a sharp pain and I feel tingles all the way up into the inside of my big toe. Could this be nerve damage that needs to be assessed by my podiatrist?

[@drblakeshealingsole]

Katie, thanks for writing. Sounds like a small branch of one of the nerves (as it is regenerating) is getting entrapped in the scar. This is common in post-op situations. Yes, see the podiatrist whom did the procedure. Common treatments are daily cross-frictional massage with Neuro-Eze (online product), neural flossing, and massage with Blaine surgical scar kit (purchase at Walgreens, etc)..

[@drblakeshealingsole]

Sometimes, Katie, the nerves get entrapped in the incision. Yes, someone needs to teach you about proper cross-frictional massage, neuro-Eze, Blaine surgical scar kits, possible novocaine injections to free up the scar, etc. Rich

[@TheRock0232]

Hello sustained a sesamoid fracture that was missed by first Dr so no immobilization for the first 2 months. 1 month ago properly diagnosed and put in a removal boot. X ray last week(after4 weeks in boot) showed little if any healing. Dr is trying to get permission for CAT scan although I requested MRI. Then hopes to get bone stimulator. Already talking about removal of not healed in eight weeks after stimulator. She has mentioned nothing about calcium or Vit D or padding to prevent stress on sesamoid. She talks about the delayed diagnosis and doubts it will heal. I am willing to do anything to save this bone if at all possible. Any suggestions?

[@drblakeshealingsole]

Hey, sorry for your dilemma. Like a lot of these injuries, they are treated by surgeons, and that is their vision. Please see all the information on my blog on sesamoid fractures. The blog is entitled "drblakeshealingsole.com" It will have most of my thoughts. Typically, people only have the sesamoid removed if they are anxious to get back to activity, or they have failed the long process of 9-12 months. This a bell-shaped curve, so hopefully, you are on the fast end of it. Good luck. Rich

[@drblakeshealingsole]

Rock, first of all, you can wait a long time for healing. If you are trying to save the bone, one year is nothing. I tell patients I want 9 months of the bone stim, and then another MRI 3 months after that. I have seen many heal even with delayed healing. Rich

[@hannahhoward1664]

Around April time I fell on my big toe doing my trampoline routine, my big toe became swollen and very painful immediately and I couldn’t walk . My X-ray showed a creak all the way across my sesamoid bone on my right foot. I was told it’s most likely ligament damage and he said it is normal to have a creak through a Sesamoid bone, is this true ? The doctor put me in a Boot for 4 weeks and I took 6 weeks off trampolining. 6 mouths on I’m still with the same swollen Sesamoid throbbing pain and shot in pain in the bone when I walk. What could this be ? And what should I do?

[@drblakeshealingsole]

Hannah, thanks for your question. Less than 10% have a normal creak, so yours may or may not have been a fracture. They typically heal in 3 months of immobilizing, but symptoms can last longer. I would recommend another set of xrays and an MRI to really find out what you are dealing with. I think it is important to get the MRI to decide if it is still injured because it can still hurt due to inflammation even after it has healed. You can see my blog at www.drblakeshealingsole.com. But, we need a firm diagnosis first. Rich

[@danashah19]

Hi dr I need your advice plz I'm a rad technician but just 2 days bak I got fracture in right foot sesamoid and dr put plaster on it in er only fr 5 days will that help becz I'm suppose to return to my work after 5 without plaster but one other dr suggested to have it for Atleast 2 weeks to take off any pressure on sesamoid very confused as I'm working plz guide me as my sesamoid is split in two pieces now after fracture thanks plz reply

[@hmmmmmm289]

my foot started hurting after volleyball practice one day and my trainer told me to get it x-rayed so I did and they didn’t see any fractures or anything so I continued to play. a few days later I couldn’t walk on it so I got it re-x-rayed by a foot doctor and there was a split straight down the middle of my sesamoid bone and he thinks I was born with it but he’s not completely sure because it wasn’t on the other foot so he gave me a steroid shot which did more harm than anything and then put me in a boot for about three months. nothing was improving and he started talking about surgery so i left and I saw a sports medicine Doctor Who told me the boot wasn’t doing anything but making my ankle weak so she told me to go get shoe inserts made which I did and they’ve helped a lot and I continue to ice after i over use it and I use a NYNEX medicine machine that is basically shock therapy and it seems to help sometimes but it’s been over a year since I was put in the boot and I’m playing volleyball again with my shoe inserts and I tape my foot but I’m still having bad pain when I’m playing but I don’t wanna have to get off of it again because next year is my last year to play on a travel team, do you have any recommendations?

[@hmmmmmm289]

i’ve also got MRIs done and they said that it looks like I have bursitis in my foot around the sesamoid and it looks like there’s a lot of inflammation in the sesamoid joint

[@jtjoser]

Hi Dr Blake, I've had sesamoid pain for nearly 5 months. I've been to 2 different podiatrist but I don't see a change. My second doctor ordered an MRI and I'm currently waiting for the results from my MRI. However, I'm not sure I can trust the second doctor either. No doctor talks about examining the affected area, they just palpate the ball of the foot and say it's sesamoiditis. When I tried to explain to the 2nd doctor about me having a plantar flexed first metatarsal, he looked at me weird. He already talked about doing a sesamoidectomy. That scares me, I don't Wana go there, he also talked about steroid shots... I don't want aggressive approaches that could affect my life for ever. I was wondering if you do online consults? Could you review my MRI if I send it to you? I'm in southern California area. Please help me out. Thank you.

[@drblakeshealingsole]

JT, thanks for your comment. Yes I would be happy to do that. Email me through my blog at drblakeshealingsole.com and we can analyze everything. You can send me the MRI CD to Dr Rich Blake 900 Hyde Street San Francisco, CA, 94109 after we have made contact. Glad you are getting the MRI. Look at the blog for other sesamoid advice. Rich

[@sstyblo]

I've been pretty active on a sesamoid stress fracture for 3-4 mnths (without knowing it was fractured, just got a boot)..am I screwed for long- term healing?

[@drblakeshealingsole]

Since is more the normal situations with sesamoids than I like to think about, it should heal if you are good. Depends on the gapping between fragments, your rehab program, your overall bone health, your foot shape and prominence of the sesamoid. Good luck!! More info on my blog drblakeshealingsole. Rich

[@sstyblo]

Richard Blake Thank you! Good stuff.

[@FlyWithLove]

We’re you able to get your Sesamoiditis pain go away? I’m in a similarl situation of having that pain for months

[@sstyblo]

@@FlyWithLove I guess it's resolved? (at least for the time being); since wearing a boot back then I haven't had any recurring problems since. Good luck!

[@coldfire420]

@@sstyblo That's great and hopefully it stays healed! When you were active on your sesamoid stress fracture was their pain constant and you just stayed active on it or did the pain go away so you thought nothing of it and let it go on for 3-4 months until you found out it was fractured? I have pain every now and then on my sesamoids usually after long periods of trail running daily but the pain always subsides after 2-3 days and is very minimal to begin with as I can bare weight and walk on it. I just rest and ride my bike instead of running during those days then after it goes away I'm out running again but I think ill stay off of it a bit longer and get it checked out just to be sure.

[@shwimmy11]

👍

[@paulohenriqueferreiraferra5961]

Eae bolsonaro kkssksks

[@drblakeshealingsole]

I do not understand. Rich