How to Treat Sesamoiditis with Paul Marquis PT

[@R.m.laughin]

Great video. I've dealt with Sesamoiditis for YEARS and everything you said is spot on. Looks like I need to go back to the specialist asap

[@OrthoEvalPal]

Glad it was helpful Riley!

[@PIuggo]

Bro if you been dealing with it for years just get it taken out

[@Nsobloo]

Dudeeee same, I’m 23 and had it for years and it hurts so bad some times!! But growing up I always walked on my tippy toes and that’s probably y

[@R.m.laughin]

@@PIuggo I don't think it works that way

[@R.m.laughin]

@@Nsobloo Years ago a doctor took me out of work for a month and put me in a walking boot. Helped tremendously. I work in a paper mill and wear logger boots all day so it's unavoidable for me

[@davidattaochu5969]

Where can I get the sole thing from, I been dealing with this pain for almost a year now

[@rt193682]

I really like your videos, you get right to the point with great info.!

[@elenahoade5888]

I just developed sesamoiditis today. Ouch! Thank you for the information.

[@OrthoEvalPal]

Best of luck!

[@hens13]

I’d suggest getting Dr Jill’s dancers pads to offset the area and Hoka Bondi shoes.

[@zhaochenli761]

Hi, did you recover from it already? Thank you!

[@joavg5851]

How did the pain appear? Very fast?

[@MovementScience8]

Thank you for the video it was really helpful!!!

[@OrthoEvalPal]

You're so welcome!

[@MichelleKohlerArt]

Do you have a video treating this issue after it has worsened? I’m not responding to orthotics and I need help pls.

[@OrthoEvalPal]

Have you seen a podiatrist Michelle? There could be more going on like a fracture or ligament tear between the sesamoids if it is sesamoiditis

[@MichelleKohlerArt]

@@OrthoEvalPal I definitely have sesamoiditis. Haven’t been back to the dr since I’ve been trying to heal.

[@MichelleKohlerArt]

@@OrthoEvalPal so we had more mri’s done and I definitely have sesamoiditis. No fractures. Some edema and now I’m dealing with an inflammatory response disease that mimics reunauds phenomenon. Please send me some guidance. I still isn’t improving.

[@ankitamisra7203]

Can you please tell me where can I buy this? I have very bad pain n trouble in walking.

[@GINGER_KING_]

I hate it I started getting this yesterday and I feel it in my leg now. All I did was walk and bam thanks lol

[@raleighnoel]

My sesamoiditis hurts on the same spot as her but on the top of the foot. Trying to figure out how I can maintain my lifestyle without it breaking again.

[@zhaochenli761]

Hi, did you recover from it already? Thanks!

[@lkotrosa8265]

How do you find someone in your area to help with this? I've been to two foot doctors, and they had nothing helpful to offer. Mine is more halux limitus.

[@OrthoEvalPal]

Here is another related video. kzbin.info/www/bejne/jpq4ZpVodqh8grc

[@lkotrosa8265]

@@OrthoEvalPal Thanks! Just seeing this.

[@matdamon471]

Orthotics is the treatment? No stretching or exercise?

[@steelcurtain3746]

What if sesamoiditis has gotten so bad from running on a treadmill that I can't hardly even walk. Been like this for 5 days now.

[@tonybrinkworth6452]

Where are you located for an appointment?

[@jefferyhenley2540]

I’ve had this for many years on the same foot, same spot.

[@slaws2279]

I think I have this, but thankfully, I don’t have pain when I walk. I only really notice it when I’m laying down with my feet stacked on top of each other. That area of my left foot is VERY tender when I rub my feet together.

[@adrianriverosanz384]

Both my big toes have very less stretching capabilities. It is more. I cannot stand on tiptoes properly and standing on my toes hurt. Any advice? thanks!

[@joavg5851]

Hello, I wanted to ask you. I have a very sharp pain in my big toe. The area of ​​pain is right, but I also see that it could be gout. How does Sesamoiditis appear? Is it a sharp pain? What differences does it have with Gout?

[@OrthoEvalPal]

Yes, sesamoiditis is fairly sharp and pinpoint to the bottom of the ball of the big toe. Gout is painful throughout the whole joint and painful with all motions and usually swollen throughout the joint.

[@joavg5851]

Thank you so much. For example, gout usually also hurts on top of the big toe joint. Really thank you very much for answering.

[@joavg5851]

@@OrthoEvalPal I have boy problems with the footprint. Can that cause sesamoiditis?

[@antoniocavalli5474]

Hi, im currently bed ridden for past week with sesamoiditis flare up.. Pain is severe. Can anyone please advise me what is best NSAID for sesamoiditis healing? Im using Prednisone 20 mg every morning and 3x daily 400mg ibuprofen or 3x dexketoprofen 25mg. I believe it is going away slowly now after 7 days. But I believe I will still be needing another 10 days to start mooving properly. Thns everyone.

[@karenk4013]

My podiatrist diagnosed me with sesamoiditis a couple of years ago and it got better, now I'm having the same issues but with also a lot of pain on the top part of my big toe when I walk. I thought maybe my shoes were tied too tight so I loosened them. What can I do to alleviate the pain on the top when I bend my big toe when walking?

[@OrthoEvalPal]

Hi Karen, I like to stretch the calf on a slant board, occasionally do a custom orthotic and I love to use the HOKA sneaker for this particular problem amzn.to/3aMRH4J (Amaz Affil)

[@karenk4013]

@@OrthoEvalPal Oh, thank you so much!!!! I didn't expect a reply, you are awesome!

[@hens13]

@@karenk4013 Try dancers pads as well to offset the area

[@josephjostar6165]

i have sesamoiditis on my left foot and i play soccer do i just have to let it recover? if i keep playing on it will it get worse? do i have to wear an insole?

[@OrthoEvalPal]

If you continue to play, you will probably aggravate it unless you wear an orthotic with a cutout and a soften spot underneath.

[@josephjostar6165]

@@OrthoEvalPal so all that is going to happen is just make it hurt more will i still recover if i keep playing on it?

[@OrthoEvalPal]

@@josephjostar6165 It will take longer.

[@zhaochenli761]

Hi, did you recover from it already? I am active in soccer as well but been suffering from it for months!

[@Mizzlibrarian83]

This mam sais nothing

[@lori986]

I have this in left foot. It acts up here and there especially if I do anything where I bend my foot a lot like yoga or running. What works for me is jsut wearing a hard boot for a couple weeks so no pressure on foot and then it calms down. It seems like to me once you have it, its a reoccurring issue you have to manage rest of life.

[@OrthoEvalPal]

If you can rest for long enough, it could heal. Wearing a solid rocker bottom shoe like a Hoka Bondi or Gaviota can also be helpful and orthotic with a drop off to take the pressure off. The sesamoid can also be helpful.

[@swiss6253]

Ok. I'm trying to find out why my big toes hurt so much. The actual toe. Not the toe joint, not my foot, the actual toe. If you were to take a print of your big toe, that's the part that hurts. Why.

[@ankitamisra7203]

Hey can you please tell me where can I buy this support? I need that as I have bad pain

[@OrthoEvalPal]

This support is a custom orthotic. Made for each individual. I am working on a product for the general consumer.

[@tina-hw1ui]

@@OrthoEvalPal Are you providing this orthotics to patients out of state from your location?

[@athegrl17]

Any recommendation for those who do not wear shoes in the house?

[@hens13]

Wear shoes in the house

[@mubystubuff764]

very helpful! I was diagnosed w Sesamoiditis several years ago, by a podiatrist.... was a moderate runner, 3 - 4x/week doing very unimpressive (i.e. SLOW n easy) 5Ks. I feel much discomfort (in fact avoid when possible) walking barefoot, but shoes with an arch, or insert as you mention, definitely off load the pressure and help. However, I am NOT sure it IS Sesamoiditis, as there is no sensitivity or tenderness to the touch underfoot as you demonstrated, AND I am able to run in VERY HIGHLY CUSHIONED hoka bondis withOUT discomfort -- and most of my other shoes I fit with an insert, as well. HOWEVER, I love your custom orthotic recommendations, and may return for another visit, perhaps with another doctor, and suggest/ask that he prescribe them. If I am not in constant pain, but chronic, often uncomfortable, occasionally very localized pain, should I request an xray/mri to see if there might be a fracture? I am older, ahem, and have inflammation /auto immune issues causing instances of tolerable arthritis, and have also had recent blood panels showing ANA positive, and high ESR .... Any thoughts would be appreciated. And again, thanks for the very informative video!

[@loganmims8259]

Hello Muby, I have sesamoiditis as well. I have actually had it for some time now and just got put in a boot for it a couple of months ago. The location where he is describing the pain did not actually hurt me either for a long time. It mostly really hurts me when my big toe bends up as I am stepping off. However, I have noticed some pain there here recently as I feel my sesamoiditis is becoming worse. So it may not be that you do not have it, maybe it is just not as irritated as hers. My doctors could not tell I had sesamoiditis for sure until they actually did an MRI. They did several x-rays before that and nothing popped up. Anyways take care and try not to irritate it further!

[@zhaochenli761]

@@loganmims8259 Hi, did you recover from it already? Thank you!

[@loganmims8259]

@@zhaochenli761 sort of. I received PRP injections and started wearing zero drop shoes, that helped out a ton.

[@zhaochenli761]

@@loganmims8259 Hi, thanks for your reply! I am curious tho why does zero drop shoes help? Because I thought usually shoes with better arch support and good cushioned insoles can help with the recovery?

[@loganmims8259]

@@zhaochenli761 shoes that are zero drop do not raise my heel any, allowing there to be less pressure on the ball of my foot. Also, my altras have a wide toe box so that my toes have room to move naturally. I think these shoes can have arch support but I didn't really look into as I have a medium arch and several altras shoes have worked for me now. I've been through the whole orthotics thing with new balance shoes. All of that was a waste of time and money for me.

[@atrealwilliampoole5853]

I find that I aggressively dorsiflex in my sleep. It’s almost like my equivalent to grinding teeth. Any advise?

[@thekaylaslater]

I do this too! I didn't know how to explain this to my family, but it hurts and I wake up!

[@lori986]

Thats how I originally got it I think. I got a really, really bad foot cramp one night and my foot majorly dorsiflexed. I had to wear a hard boot for 5 weeks to fix it that time and been managing it without too much issues for 13 years now.

[@lauraforshee5327]

What kind of shoe do you recommend for Sesamoiditis that led to lateral foot pain/bursitis of the 5th Metatarsal?

[@OrthoEvalPal]

I like and use the HOKA a lot. click.linksynergy.com/link?id=to9J2MgOlk4&offerid=618234.19844170400&type=2&murl=https%3A%2F%2Fwww.hoka.com%2Fen%2Fus%2Fsale%2Fclifton-8%2F195719200343.html&LSNSUBSITE=LSNSUBSITE">

[@cmb52]

Great video! I have had toe joint replacements in both of my great toes. I thought they were failing until I found this video. I'm off to see my doctor Wednesday!

[@ygbodybuilder3023]

Did your pain go away

[@xtyna100]

My sesamoids have been hurting since February, haven’t been to the doctor Bc of the pandemic? I only have pain when resting not when I step on it, is it sessmoiditis?

[@OrthoEvalPal]

Not likely. Sesamoiditis always hurts with weight bearing.

[@xtyna100]

@@OrthoEvalPal thank you so much! So if it is not too much to ask, what could it be? It hurts when resting and I feel (if I touch it too much) like tingling on the big foot, like ants walking on it. Thanks in advance

[@OrthoEvalPal]

@@xtyna100 Would need to be evaluated. Anything from Tarsal tunnel syndrome to a Morton's neuroma to neuropathy

[@xtyna100]

@@OrthoEvalPal thank you so much for your answer! I appreciate it!

[@Iris_Sunset]

I definitely think this is my issue. I have pain in the exact place. I got it suddenly and Ive never had it before. The pain is so severe and it’s been tender so I can’t walk, tried a walking boot yesterday which was day 5 and tried to walk today slowly and after getting back up I can’t walk again. This is so discouraging, I’m only 18 and all I did was my normal light workout and a 20 minute walk. I want to be normal and be able to walk without all this stuff again. Everyone in the comments seems to have had this for years and never gets better or it never went away. Will I ever be able to walk normally again?

[@ChristofferAndersson-gm2nb]

How did it go? I'm 30 with this problem on my right toe 😢

[@Iris_Sunset]

@@ChristofferAndersson-gm2nb So eventually it got back to 100% but it was a very slow process: It lasted months and after it hadn’t been improving, I went in and they said soft tissue joint or tendon injury and inflammation. I got a steroid injection to help. Within 2 weeks (and while still in a boot), the ball of my foot no longer had sharp pain, but my toe still did. I also got the full range of motion back. After this, I got orthotic shoes and they helped so much and took a lot of weight off that part of my foot. My toe still felt pretty off for a while but eventually did get completely back to normal. It’s been fine for months since. They told me to stay in the boot while it was recovering, and I think I was in it for 6-8 weeks. I wasn’t able to run or jump for like 3 months or walk without some sort of support. The worst part about the recovery was slowly learning how to walk normally again without support and hesitating with every step. My balance and strength had to be rebuilt too as expected. Can’t believe how much trouble those tiny things caused. I hope yours gets better soon, it will eventually! Even if it’s not Sesamoiditis, the best thing is rest and time.

[@treesandmore4453]

I have a desperate issue with ongoing pain and inflammation over my sesamoid area in both feet (more in the right than the left) I have had x-rays, and an mri which showed no issues with the sesamoids, tendons, plantar fascia, or muscles. I stopped working two months ago to rest, and after one month in airboots I have been going to physical therapy and trying exercise and diet changes, but the inflammation has not changed. I've met with a rheumatologist and they ran tests, but there's nothing in the results that show a problem. My physical therapist has done ultrasound, electricity, massage, and exercise but it's all very painful, and there have been no changes. I have specialized orthotics from my podiatrist as well as Hoka shoes. Has anyone else had a similar situation? Or is there something i am missing? My wife is due to give birth in the next few weeks and I want to be able to provide for her and the baby. Thank you for any input, I am at a loss for where to go next!

[@eduardoramirez4768]

I'm having similar issues toe pain and such have no known diagnoses's of anything have gotten blood test revealing nothing wrong still no mri's or x-rays but the pain feels real. I just saw a podiatrist today and got my foot taped up the podiatrist said my foot was over arched I just pray things get better

[@MichelleKohlerArt]

Hello, I have almost exactly the same experience: I’ve tried all the healing modalities, shock wave, cold needles, electricity, acupuncture you name it. I’m almost 2 years in now with no healing whatsoever. It’s gotten worse over the years . I’m 37 and I’m now developing severe back issues because I’m limping. I can’t even go for a walk without swelling and when I shower my foot turns blue. It’s so bad and so painful.

[@oscarharrison5891]

Did you ever resolve your problem? My story matches identically to yours. Even down to the same shoe brand I've tried..... The specialists I've seen are completely stumped as all my scans and bloodwork are normal.

[@etre.francais]

Thank you so much Paul. Im only 13 and have had sesamoiditis for almost 5 years now. Ive used ice, orthotics, special trainers, and rest but its still not fixed. Im a dancer but did take a break for 2 years when it was really bad but i was just wondering if you have anything else i could do? Many thanks

[@Nsobloo]

Hey, just wanted to comment on how beautiful your grammar is and how well put your sentence is! I’m impressed kudos 🙏🏼

[@samanthabarron8481]

I thought you were going to address ACTUAL treatments, not orthotics.

[@Belikemiggie]

Orthotics are the best way to treat it since most therex and manual therapy is diminished by day to day foot strain

[@robynsmyth5270]

Hi Paul Thanks for the video. I’m very interested in the specifics of the flexibility program you mention. I’ve just ordered a slant board, can you offer advice on how much and how to use it? Are there any other flexibility tips? I’ve had sesamoiditis for over 4 years. Have custom orthotics like the ones you suggested and do lots of calf and shin release using trigger pt balls which helps but the pain still flares up.

[@hens13]

A slant board would make the sesamoiditis burn worse (I’ve made that mistake), try non weight baring calf excercises.

[@Naddafurry]

What about a stress fracture with sesiomotitis. I forgot how to spell it. Mb😂

[@OrthoEvalPal]

You can have an associated stress fracture around the area and even in the sesamoid bone

[@ngndnd]

reading these comments are making me scared. I just started working at ups and got this pain. I really hope its nothing too serious and that it doesnt last for too long because i miss doing leg days at the gym :(

[@MunchkinsMotivation]

Try to take care of it now ! I ignored mine ...now it's been months 😪 hurts every step

[@hens13]

@@MunchkinsMotivation Look into MLS laser therpay

[@zhaochenli761]

Hi, did you recover from it already? Thanks!

[@jamesbond-cx2uh]

I was diagnosed with bone marrow edema at the 1st MTP with acute sesamoiditis according to the MRI. Besides having pain at the sesamoid itself, I have pain at the big toe itself during toe off or when I apply an upward force with the big toe having resistance. Is this a symptom of sesamoiditis?

[@alexkoch_14]

Hey, checking in to see if you got any answers?

[@jamesbond-cx2uh]

@@alexkoch_14 Yes, I am able to run now. Took about 1 year of rest with a lot of physio.

[@alexkoch_14]

@@jamesbond-cx2uh thanks so much for the reply. What exactly did you do for rest? Was it active rest or complete joint immobilization? What did your physio have you do? I’d love to connect with you and hear your story over a call or something. Thanks 🙂

[@jamesbond-cx2uh]

@alexkoch14 Note that this is based on my personal experience. It might or might not work for you. So, if you do have this condition, please consult a well knowledge and passionate orthopedic who knows about this condition because I had an incompetent doctor at first who told me that physio was useless and to eat painkiller constantly. I had to consult another professional for this. My doctor had me going to the sports physio and podiatry. Depending on your pain, you may find that wearing insoles and proper shoes may help you in the early stage. For me, my pain was around 8/10, along with burning and electrical sensations. My doctor prescribed me with stiff rigid boots known as Dacros boot. I paired it together with a dancer pad to offload completely by avoiding contact with my sesamoids. Again, this might be subjective, I wear my boots only outdoors, but in the indoors, I wear Offos slipper. All these were done to calm down some of my symptoms. I worked together with my physio as well. My physio had me working on my lower limp strength. These are summaries of what he assigned me to do: 1) Calve/ankle strengthening with a resistant band. 2) Using a tennis ball to massage the arch of your foot. (I find this really useful) 3) Balancing. Wall assisted marching to single leg balancing for 10 seconds. 4) I was able to do squats without pain, so he assigned me with lunges and slowly progressed to split squat. I bent my affected toe only to the point where I feel no pain. 5) Swim or cycle if you are able to. I had a shoulder injury at that time so I could not do this. All the exercises done above were to promote blood flow and simulations for recovery. Note that the above exercises were done progressively over time. Besides exercises, he also provided me with shockwave and ultrasound therapy. This may be subjective, I didn't feel a difference after doing it, but it may have contributed to the overall recovery. On my own, I did daily contrast bathing, calf stretch, hip and glute stretch, quads stretch, hamstring stretch, and toe extension stretch. The turning point here was walking with proper shoes and insole. For the transitioning phase, I had a difficulty weaning out of my boots. I wore my boots for about 6 to 7 months of time. I believe I was afraid of the pain and discomfort (burning sensations), which makes me avoid wearing shoes for a long time. Once I felt I was ready, I visited podiatry for an insole and advice. He told me to get a shoe with rocker bottom, wide toe box, and cushioning. He recommended me HOKA. Depending on whether you need stability or not, I got the Hoka arahi 6. With proper shoes and insoles, I tried to walk with it. At first, the pain was 2-4, but it was not sharp, so I continued. As I walk, I have gotten used to the pain, and over time, I have managed to walk barefooted. When I said recovered, it does not necessarily mean that it is completely pain-free for me. To this day, I still have some sort of pain, but it does not stop me from performing my activity. Overall, I would say that this condition requires a lot of patience. You need to listen to your body. Do not hesitate to try. If it is just discomfort with pain that can be endured that you should be able to walk. I was also on the verge of surgery, but I kept trying until it worked.

[@jamesbond-cx2uh]

@alexkoch14 Note that this is based on my personal experience. It might or might not work for you. So, if you do have this condition, please consult a well knowledge and passionate orthopedic who knows about this condition because I had an incompetent doctor at first who told me that physio was useless and to eat painkiller constantly. I had to consult another professional for this. My doctor had me going to the sports physio and podiatry. Depending on your pain, you may find that wearing insoles and proper shoes may help you in the early stage. For me, my pain was around 8/10, along with burning and electrical sensations. My doctor prescribed me with stiff rigid boots known as Dacros boot. I paired it together with a dancer pad to offload completely by avoiding contact with my sesamoids. Again, this might be subjective, I wear my boots only outdoors, but in the indoors, I wear Offos slipper. All these were done to calm down some of my symptoms. I worked together with my physio as well. My physio had me working on my lower limp strength. These are summaries of what he assigned me to do: 1) Calve/ankle strengthening with a resistant band. 2) Using a tennis ball to massage the arch of your foot. (I find this really useful) 3) Balancing. Wall assisted marching to single leg balancing for 10 seconds. 4) I was able to do squats without pain, so he assigned me with lunges and slowly progressed to split squat. I bent my affected toe only to the point where I feel no pain. 5) Swim or cycle if you are able to. I had a shoulder injury at that time so I could not do this. All the exercises done above were to promote blood flow and simulations for recovery. Note that the above exercises were done progressively over time. Besides exercises, he also provided me with shockwave and ultrasound therapy. This may be subjective, I didn't feel a difference after doing it, but it may have contributed to the overall recovery. On my own, I did daily contrast bathing, calf stretch, hip and glute stretch, quads stretch, hamstring stretch, and toe extension stretch. The turning point here was walking with proper shoes and insole. For the transitioning phase, I had a difficulty weaning out of my boots. I wore my boots for about 6 to 7 months of time. I believe I was afraid of the pain and discomfort (burning sensations), which makes me avoid wearing shoes for a long time. Once I felt I was ready, I visited podiatry for an insole and advice. He told me to get a shoe with rocker bottom, wide toe box, and cushioning. He recommended me HOKA. Depending on whether you need stability or not, I got the Hoka arahi 6. With proper shoes and insoles, I tried to walk with it. At first, the pain was 2-4, but it was not sharp, so I continued. As I walk, I have gotten used to the pain, and over time, I have managed to walk barefooted. When I said recovered, it does not necessarily mean that it is completely pain-free for me. To this day, I still have some sort of pain, but it does not stop me from performing my activity. Overall, I would say that this condition requires a lot of patience. You need to listen to your body. Do not hesitate to try. If it is just discomfort with pain that can be endured that you should be able to walk. I was also on the verge of surgery, but I kept trying until it worked.

[@nunyabiz334]

Doctors online are ridiculously confusing about sesamoiditis. Half of them say to tape DOWN the toe; the others say to stretch UP the toe. I have no help at all. Y'all are ridiculous. Either the one or the other!

[@hens13]

You never want to stretch up the toe for this issue, always down if you’re going to tape it for this.

[@tonybotchagaloop2925]

It's sort of good, but he spends more time talking about other problems with the foot. Stick to the subject!

[@Pete.Ty1]

👍

[@OrthoEvalPal]

Thanks Pete!

[@roeibenbassat6318]

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