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Searching file 26

Message Number 261584
Re: Sesamoiditis? View Thread
Posted by Dawn70 on 10/27/09 at 22:11

Diagnosed with sesamoiditis and the bone is bipartite. Got round 1 of cortisone...not fun but I am supposed to have therepy 3 times a week and in 2 weeks another shot. 2 weeks after this I get shot #3. he says I don't get a fourth shot. Next step is surgery. I think patients should be told that the stick from the needle doesn't hurt, but the fluids going into the toe feels like your foot is being blown up like a water balloon til it's ready to burst. At least that's how it is for me. He told me to stay off of it, but no shoe or boot so I guess I keep doing what I have been :(

Result number: 1

Message Number 261481

Re: Sesamoiditis? View Thread
Posted by Dr. DSW on 10/23/09 at 19:07

If you are really concerned and your foot is in pain, the smartest thing to do would be to completely rest the area/keep weight off the area until your evaluation by the specialist.

The best way to do this is to simply get a pair of crutches and ambulate with that foot off the ground in the interim. That is the only way to assure that you don't do any more damage IF there is a serious problem.

Result number: 2

Message Number 261480

Re: Sesamoiditis? View Thread
Posted by Dawn70 on 10/23/09 at 19:03

Thanks for the info. I have an appointment scheduled Tuesday with a specialist that is highly recommended for foot/ankle injuries. My main concern between now and then is not doing any more damage...

Result number: 3

Message Number 261479

Re: Sesamoiditis? View Thread
Posted by Dr. DSW on 10/23/09 at 18:39

You really need to be evaluated by a foot specialist. The textbooks will state that there are two 'sesamoid' bones below the first metatarsal which is the 'norm'.

However, there is a normal variant that many patients have which is called a bi-partite or multi-partite sesamoid. That means that one of the two sesamoid bones can be in two pieces or less frequently in multiple pieces from the time it developed. This can occur on only one foot or on both feet. It is NOT always symmetrical.

When there is an injury to the area, it can get very confusing. When an inexperienced doctor takes an x-ray, he/she will immediately make the diagnosis of a 'fractured' sesamoid, when in reality there is the possibility of a bi-partite or multi-partite sesamoid.

It is often difficult to differentiate whether there is a fracture or a bi-partite/multi-partite sesamoid when there is an injury. There are many ways for an experienced doctor to help make this determination, but sometimes even in experienced eyes it can be difficult.

If the only way your doctor is basing his/her decision is by comparing x-rays of your other foot, that is NOT a valid method. Bi-partite/multi-partite sesamoids are not always symmetrical/bilateral.

If there is concern, there are other diagnostic tools such as bone scans, CT scans or MRI's to help make a more accurate diagnosis. I personally prefer an MRI if there is a question, because it always visualizes the soft tissue structures in the area, including the tendons that encompass the sesamoids.

However, the first thing you need to do is make an appointment at a foot/ankle specialist as soon as possible for an expert opinion.

Result number: 4

Message Number 261476

Sesamoiditis? View Thread
Posted by Dawn70 on 10/23/09 at 13:55

I injured my right foot about 6 weeks ago. Stubbed it pretty hard but can still walk on it. After about a week the pain and swelling went away. Fast forward and I now have at times extreme pain in the ball of my foot that comes and goes with no obvious trigger. Went to my chiropractor and he took xrays and thought he could see a crack in the metatarsal but also said I have 3 sesamoids in there (ha any anatomy book I have ever seen shows we have 2!) so I took my films and called a specialist... Could the sesamoid he is seeing as '2' actually be a broken one?? Like I said the pain goes from dull to excruciating about once a week from the time I hurt it. I don't go in for several more days and because of fear of pain returning at full force again I tend to walk on the outside of my foot which is causing all of my right leg to hurt or even cramp at times... I'm not an athelete, but a mom of 3 so I do have to be mobile! Any thoughts??

Result number: 5

Message Number 260738

how to diagnose inflammation View Thread
Posted by Robbie on 9/21/09 at 16:14

if you have inflammation will it show up on a MRI? even if at cellular level?

I had a MRI several weeks ago and the results were normal. My doctor still immobilized me for sesmoiditis as the pain i have in that area has not responded to other treatments (orthotics, anti-inflammatories, reduced activity). pain for 3 months total now.

I asked why the inflammation did not show up and was told the inflammation was probably at a cellular level. My question is, if you had sesamoiditis - shouldn't it show up on a MRI? The next step is a cortisone shot, which I'm hesitant to do if no inflammation is showing up.

Would love your input.

Result number: 6

Message Number 260554

Re: Immobilization for Sesamoiditis and Morton's Neuroma View Thread
Posted by Dr. DSW on 9/14/09 at 06:07

Your question is case dependent. In some cases six weeks may help, in other cases 6 weeks may not be beneficial and in some cases a patient may need more time in a cast. Unfortunately, there really is no single answer to your question since every case and every individual is unique.

Result number: 7

Message Number 260546

Immobilization for Sesamoiditis and Morton's Neuroma View Thread
Posted by Robbie on 9/13/09 at 18:13

My doctor put me in a cam boot for sesamoiditis and mortonís neuroma and said no weight bearing for 6 weeks. I am removing the boot several times a day to ice and am taking 5 days of anti-inflammatories to hopefully jump start the healing process. Iíve had these problems for about 4 months now.

I suffer from other foot problems (arch pain for 5 years) and wanted to treat this aggressively. Before the boot we tried rest, ice, physical therapy (ultrasound and iontopheresis), custom orthotics Ė all this right at the beginning as I didnít want another chronic foot pain. None of these helped and the pain continued to get worse.

Question, is 6 weeks long enough in this boot and a treatment for sesamoiditis and morton's neuroma? Should I be doing something else besides resting and icing? Does this treatment have success for these issues? I should add a MRI was done to confirm a fracture did not exist. I do realize when I come out of the boot I will need to continue with shoe modifications to avoid this problem again (problem is not from injury). I did ask these questions of my doctor, but would like the opinions of the doctor's here too.

Thanks for your input.

Result number: 8

Message Number 260151

Sesamoiditis and MRIs View Thread
Posted by Robbie on 8/28/09 at 13:57

will sesamoiditis show up on an MRI? I guess what I mean is will the actual inflammation show up?

I've been dealing with pain in my sesamoid area for about 4 months now and just had a normal x-ray. I'm going to ask for a MRI at the doctor's on Monday to see if it's sesamoiditis or a possible stress fracture, but wasn't sure if sesamoiditis would even show up? Or is it just that you have pain in that area... your sesamoid must be inflamed?

If you do have a normal MRI and there is pain in that area, does that mean that there might still be inflammation, it's just too small to show up?

I'm a long time (5 year) foot sufferer (arch pain) and trying to nip this newest problem in the bud if possible. Thanks for your help!

Result number: 9
Searching file 25

Message Number 259403

Re: Sesamoiditis/Bursitis? View Thread
Posted by MaryW on 8/05/09 at 11:04

I have had the same problem and went through all of the doctors getting new and increasingly expensive orthotics because they didn't like my old pair. The carbon insoles basically just keep your foot from bending. Theoretically it should work, but I found that they exacerbated my sesamoiditis by reducing the range of motion of my toe and making that joint extremely stiff.

Result number: 10

Message Number 258932

Dr. Comfort shoes View Thread
Posted by LaurieY on 7/18/09 at 11:52

What do you think of Dr. Comfort shoes? Would you recommend them for someone with ball of the foot problems (sesamoiditis/bursitis)?
Thanks.

Result number: 11

Message Number 258566

Re: Pain in the head of the 5th metatarsal (distal metaphysis) View Thread
Posted by Dr.DSW on 7/02/09 at 20:47

I thank Dr. Wedemeyer for his input and deferring for my comment, but I'm afraid my friend may have read the question wrong!! The question involved the 5th metatarsal head and not the FIRST metatarsal head, therefore I doubt if a sesamoid fracture or sesamoiditis would be the cause or answer.

There are several things that do come to mind. Some patients can have a small accessory bone at the area of the head of the 5th metatarsal, but this should be evident on x-ray. This can sometimes become injured, and if there is atrophy of the plantar fat pad, this can become painful and symptomatic. This small accessory ossicle is often over-looked and thought to be innocuous, but it must be clinically correlated to see if it's significant IF it is found on your x-ray.

Additionally, you did not describe the type of pain you are having. If x-ray findings are all negative, you can have a nerve entrapment causing your lingering symptoms, you can have a chronic inflammation of the joint capsule, you can have a small ganglion/cyst at the plantar aspect of the joint, etc. You may have an injury to the plantar structures of the joint including the flexor tendon apparatus.

Dr. Wedemeyer's suggestion of a 'dancer's pad' for the first metatarsal is a great idea to off-load weight if the pain is below the first metatarsal, but since your pain is below the 5th metatarsal the concept is exactly the same and you would use a 'reverse dancer's pad'. It's basically a thick pad that 'floats' the area below the 5th metatarsal head to off-load the weight. This can be incorporated into any of your existing orthotics.

If your pain persists, you really have two choices. A bone scan can be performed to determine if you have a stress fracture that hasn't appeared on x-ray. However, a bone scan is very sensitive, but not very specific. What that means is that it will 'light up hot' if there is any metabolic activity in the bone since it's sensitive, but it is not specific for the cause of that activity. It can be a fracture, arthritis, tumor (don't worry, I doubt if you have a bone tumor that didn't show on x-ray), infection, etc.

On the other hand, an MRI will show if there is an injury to the bone such as a bone bruise, fracture, etc., and will ALSO show if there is any injury to the tendon(s), plantar structures, whether there is inflammation of the joint capsule, injury to the joint capsule, a ganglion or cyst present, etc.

Therefore, I would first see if a reverse dancer pad added to the orthotic helped, and if not I would highly consider an MRI.

Result number: 12

Message Number 258519

Sesamoiditis View Thread
Posted by bmomF on 7/01/09 at 14:06

What is the best solution to this problem?

Result number: 13

Message Number 257536

Sesamoiditis/Bursitis? View Thread
Posted by LaurieY on 5/15/09 at 21:02

I've had pain in the ball of my right foot for over 5 years. It was originally diagnosed as sesamoiditis. I'm on my 3rd pair of custom orthotics (each ordered by a different doctor who didn't like how the previous pair was made). I've had cortisone shots and tried physiotherapy. However, none of this has helped. I just had a second MRI done by the latest doctor who says I have bursitis in the ball of the foot. He has recommended immobilizing the foot with carbon insoles. I've tried reading on the internet to find out more about this approach but have not had much luck finding any relevant articles. Would appreciate your take on this approach. Thanks!

Result number: 14

Message Number 257123

ESWT Sesamoiditis View Thread
Posted by Erica on 4/24/09 at 21:25

Has anyone out there tried ESWT for sesamoiditis? I have been in pain for over a year and a half and I am willing to try anything to avoid surgery. I have already tried rest, shots and inserts. Thoughts and experiences are much appreciated.
Thanks!

Result number: 15

Message Number 256979

Re: Post ESWT View Thread
Posted by Dennis on 4/19/09 at 08:55

I have had Sesamoiditis for 13 months. Seen 10 podiatrist. All different opinions. Thinking about trying ESWT. May go here: http://www.podiatryinfo.com/office.html Hope this helps.

Result number: 16

Message Number 250852

eswt locations in MA View Thread
Posted by RIsa on 10/05/08 at 23:32

I have both plantar fasciitis and sesamoiditis and need to be able to walk again...I can't seem to find where eswt is done near in central to western MA. Anyone have any referrals? Would also go to the Hartford area.Help!! Thanks

Result number: 17

Message Number 250174

Re: Sesamoid Pain View Thread
Posted by Dr. Z on 9/14/08 at 15:16

PS- I agree with Dr. Wander. An MRI would really help as a starting point to find out what your problem is. Again there are MANY effective conservative treatments for sesamoiditis before surgery. I have found that ESWT in my opinion is one of them. Good luck and get an MRI

Result number: 18
Searching file 24

Message Number 249028

Big toe pain in teenage athelte View Thread
Posted by lmeadski on 8/07/08 at 20:14

My son, a 17 year old football and basketball player, has been suffering from big toe pain. He stubbed/jammed his toe in a football game two years ago and the toe has been sore ever since. Other foot began hurting within 6 months. Xrays and MRIs show no fractures but all of his sesamoids are bipartite. Now his big toes are very stiff and they hurt when he walks or runs on them. Docs diagnosed him with sesamoiditis and he is on his 5th set of orthotics.Cortisone shots have limited the sesamoid pain but his big toes are still very sore. Chicken and egg question: has the stiff toe caused the sesamoiditis or vise versa. And, what say any of you of regaining flexibility in the big toes and alleviating the pain. He has already missed all of last years basketball and will be watching this years football team. It's killing his mom and me. Thanks for any comments.

Result number: 19

Message Number 248547

Re: Sesamoiditis Surgery Needed View Thread
Posted by MarieD on 7/17/08 at 20:47

I had the surgery 3 weeks ago...my surgery was on a Friday and I was back to work on Tuesday. Tomorrow is the 3 week mark, and I am going to he dr to hopefully be able to start working on walking again with the help of a walking cast. I had problems for over 5 years, so I really think in the long run this will help. Best of luck

Result number: 20

Message Number 248245

Re: Sesmoiditis, ScottR View Thread
Posted by Dr. Ed on 7/06/08 at 08:56

Dennis:

I awaiting a library listing for the term, sesamoid; perhaps adding sesamoiditis. Until ScottR has a chance to do that, here is some info. from a recent post:

davids:

You did not state which sesamoid bone but since you used the term 'medial' I will assume that you are referring to the medial hallucal sesamoid (sesamoid bone under the big toe joint). The hallucal sesamoid bones are almost always present, with other sesamoid bones in the foot being variable in existence. The variable bones are termed 'accessory' bones and may or may not be contained within a tendon.

A sesamoid none is a bone within a tendon. For example, the kneecap is a sesamoid bone as it is largely contained within the patellar tendon. Sesamoid bones generally exist to provide 'leverage' to the action of tendons and thus strength to the actions they assist. It would be hard to extend one's knee without a kneecap. The hallucal sesamoids aid in propulsion (pushing off) so we usually try not to remove them when possible.

A bipartite sesamoid means one that exists in two portions. One can be born with a bipartite sesamoid or, often, there is a fracture of the sesamoid which does not heal so the bone functions in two portions.

There are a number of reasons that a sesamoid can hurt:
1) The area between the two parts of a sesamoid can cause pain (painful non-union); a scenario that is more common with a sesamoid that fractured as opposed to one that is present at birth.
2) The articulation (joint surface) between the sesamoid and metatarsal head may be damaged/arthtritic/scar tissue etc. The best way to attempt to see this is to do a motion study under sonography in my experience.
3) Hallux rigidus / hallux limitus. Read the library entry on this.
4) Forefoot valgus foot type/deformity with a rigid plantarflexed first ray.
5) The sesamoid is hypertrophic (enlarged). This is generally treatable by the right orthotic prescription although a surgical alternative is sometimes termed 'tibial (medial) sesamoid planing' in which the seasmoid is reduced in thickness but not removed.
6) Flexible forefoot valgus with a hypermobile first ray in which there is jamming at the first MTP joint in propulsion. Generally treated by the right orthotic prescription (that is, not just any 'orthotic.')

At very least your treating physician must discuss at least the above six items with you as they may pertain to your case.

The hallucal sesamoids are contained within the tendon of the flexor hallucis brevis muscle which attaches to the proximal phalanx (base of the toe) in two parts, one laterally and one medially. The flexor hallucis longus muscle runs through a groove in the FHB to attach to the distal phalanx. Both FHB and FHL muscles act in propulsion. Since the FHL attaches to the distal phalanx, it flexes the big toe downward but the toe would simply buckle if the proximal phalanx was not also pulled downward. So, when both sesamoids are removed it is necessary to fuse the distal and proximal phalanx as the action of the FHB is significantly weakened. If only one hallucal sesamoid is removed there is some but less weakening of FHB. Since the part of FHB that attaches to the base of the big toe (proximal phalanx) is associated with the tibial (medial) sesamoid and the lateral part of FHB is associated with the lateral sesamoid, there is something else to consider. The medial sesamoid aids in pulling the big toe medially (away from the lessor toes and the lateral sesamoid aids in pulling laterally (toward the lessor toes) removal of one sesamoid does potentially result in an
imbalance. When the tibial hallucal sesamoid is removed the big toe is progressively pulled toward the lessor toes and a hallux abductovalgus deformity results (bunion deformity). That is something that may take several years to occur although I have seen it occur in only a few months after tibial sesamoid removal in individuals whose foot biomechanics predisposed them to that issue.

Result number: 21

Message Number 248132

Re: Big Toe Pain View Thread
Posted by Ann on 6/30/08 at 11:50

Just to add to my post, I don't think it is sesamoiditis - my pain is more on the top of the toe joint. It hurts more if I flex my toes up, than if I bend them down. Thanks!

Result number: 22

Message Number 246586

Re: Crutches for Sesamoid Fracture? View Thread
Posted by Chris L on 5/06/08 at 07:48

My doctor is vague on weather crutches would make a difference. He also said that icing wasn't necessary, but I could do it if I like.

I'm writing to get another opinion. I trust him, but I do feel that he has been a bit indecisive at each stage of treatment (5 months long). I started with X-rays (somewhat inconclusive due to possible biparted), then took anti-inflammatory drugs, then tried physical therapy, then tried cortisone shots and he finally sent me for an MRI, at which point he decided it was a break and not sesamoiditis.

Now, I'm trying to do everything I can to be the model patient and avoid surgery. For example, he said to wear the boot for 3 weeks. I suggested 5 and now I'm going for 8. It is a huge sacrifice as a parent and a physically active person, but I'll do it if it helps. The only thing I'm not doing is keeping weight off of it. Your opinion would be most appreciated.

Result number: 23

Message Number 246501

sesamoid injuries View Thread
Posted by wayne p. on 5/02/08 at 16:07


I hope you have a chance to read this. I have been having sesamoid issues for a year and a half and it would help to bounce ideas and information off of one another as I get so many different opinions from different doctors/podiatrists.

I had a fractured tibial sesamoid in the R foot and had a partial sesamoidectomy after 6 months of conservative treatment failed. The surgery was over a year ago and I am still unable push off the forefoot and am now having pain in both sesamoids in the R foot and may have developed a post-surgical neuroma or tendonitis between the 2nd and 3rd metatarsals.

3 weeks ago I developed acute sesamoiditis in the other foot (left)and after 3 weeks of non-weight bearing and aggressive heat/cold therapy, NSAIDS, etc. I am still unable to get the pain and swelling under control. I now cannot bear weight on either foot and have no idea what to do next.

Some docs want to remove all sesamoids in the R foot and fuse IP and/or MPJ joints and remove neuroma. Other docs want to remove sesamoids only. Some think I should do nothing and learn to live with the disability. I would like to hear your thoughts and also about the opinions of your doctors on your injury.

Thanks... Wayne

Result number: 24

Message Number 246500

Re: sesamoidectomy - both sesamoids, same foot View Thread
Posted by wayne p. on 5/02/08 at 16:06

Mercy and others with sesamoid advice,

I hope you have a chance to read this. I have been having sesamoid issues for a year and a half and it would help to bounce ideas and information off of one another as I get so many different opinions from different doctors/podiatrists.

I had a fractured tibial sesamoid in the R foot and had a partial sesamoidectomy after 6 months of conservative treatment failed. The surgery was over a year ago and I am still unable push off the forefoot and am now having pain in both sesamoids in the R foot and may have developed a post-surgical neuroma or tendonitis between the 2nd and 3rd metatarsals.

3 weeks ago I developed acute sesamoiditis in the other foot (left)and after 3 weeks of non-weight bearing and aggressive heat/cold therapy, NSAIDS, etc. I am still unable to get the pain and swelling under control. I now cannot bear weight on either foot and have no idea what to do next.

Some docs want to remove all sesamoids in the R foot and fuse IP and/or MPJ joints and remove neuroma. Other docs want to remove sesamoids only. Some think I should do nothing and learn to live with the disability. I would like to hear your thoughts and also about the opinions of your doctors on your injury.

Thanks... Wayne

Result number: 25

Message Number 245349

Do you ever agree with archilles lengthening? View Thread
Posted by Kathy H on 3/31/08 at 15:45

I have been to a top notch podiatric surgeon in Dallas, TX. One podiatrist mistakenly diagnosed me with a fractured sesamoid. This top notch podiatric surgeon has digital xray equipment(the other did not) and says there is no fracture. I definitely have sesamoiditis though.

The top notch surgeon says my first metatarsal bone(hallucal?)has dropped and is recommending raising it. I believe he thinks this will relieve the pressure off the sesamoid.

He is also recommending archilles tendon lengthening. Do you ever agree with this surgery and does scar tissue usually go back in where they have lengthened it?

Result number: 26

Message Number 244801

Re: orthotic for sesamoiditis View Thread
Posted by Dr. Wedemeyer on 3/20/08 at 16:56

The simple solution is a shoe that does not flex as much in the ball area. The orthotic can be revisited after the sesamoiditis issue is resolved.

Beyond that there are a lot of accomodative materials that can be adhered to the orthotics, Poron is a good choice.

Result number: 27

Message Number 244789

orthotic for sesamoiditis View Thread
Posted by Kathy H on 3/20/08 at 13:12

Hi,

I have just found out that I have sesamoiditis. I didn't know why it what so hard to walk on the balls of my feet. I had an old orthotic that was rather thick, and when I went in to have a new orthotic made, the podiatrist cut a hole in the old orthotic in the sesamoid area because I complained that it hurt there. Well, that helped things quite a bit.

The new orthotic is not as thick and does not accommodate the sesamoid area liked the podiatrist hoped it would. He has tried to build up around it, but it is just not enough of a drop down to accommodate the sesamoids. How do you accomplish this problem? Sould I have another orthotic made that is thicker like my first one so they can make a drop down hole under the big toe deep enough so that I am comfortable? Being as I will not be putting any support on the ball of my foot under the big toe, do you add more support at the toes and the rest of the ball of the foot, or should your natural foot imprint be enough support for this situation?

Result number: 28

Message Number 244709

sesamoiditis View Thread
Posted by Gordon F on 3/18/08 at 08:23

Hello,
My pain on right foot initially started with a gout attack on the great toe, this was 6 -8 weeks ago. X-rays have confirmed that the gout has subsided, but i am left with a often tender and swollen big toe (pain is worse and throbbing at night while lying down). ROM on big toe is approx. 20-25 degrees. Podiatrist prescribed a medrol dose pack, which did absolutely nothing. I am scheduled for PT for hallux limitus. I am told the treatment for hallux limitus and sesamoiditis is different. HELP!!!

Result number: 29

Message Number 243953

And the Clyde goes to ..... View Thread
Posted by Jeremy L, C Ped on 3/01/08 at 08:57

In running the risk of facing consternation from my governing body by creating my own awards named after the 'Father of Pedorthics', here are winning I came across at the most recent spring shows:

Best Return to Classic Construction

For several years I had been dismayed by the erosion of quality midfoot support construction, which Lowa had been exhibiting in their technical products. They weren't alone. Scarpa and other historically excellent brands also succumbed to short cuts in product integrity, one could only assume in the hopes of boostering margins and volume. Lowa has now returned to the form I once knew them in the past, most notibly with their trekking collection. The Pinto and Jannu are low top walking shoes possessing quality of construction uncommon in the last 30 years. Full length nylon shanks and blown PU midsoles make these light and incredibly supportive and sturdy. Asymmetrical upper lasting/construction and the use of visco foams in the collar assist in providing excellent fit for those with narrow heel dimensions. Wake up, Merrell; this is what you used to make!


Best New Import

Arcopedico has been distributed in the US for a number of years, and although they are light and flexible, they had limitations for those with significant foot support maladies. The US company that imports this brand now has two new offerings that have little compromise: Dromedaris and Caminhar. The former graphically looks much like Dansko, but has greater pedorthic versatility. Most of their products feature well-made, removable inlays. Although the soles have that similar chunky look, their heel pitch is less severe, making them more appropriate for those with forefoot maladies and lateral support issues. pricing is also competitive given the quality of their upper materials and construction. The latter is what comfort is about, providing versatile fit with a soft, conforming footbed. The brand is not what would qualify as broad under any definition, but what they offer is exceptionally made for the price. They have various footbed shapes to accommodate various foot types, and all use a denser-than-usual visco foam in their footbeds, covered with soft suede. No compromises were made in support, as all their models possess steel shanks.


Best Use of Classic Construction in a New Category:

Fit Flop is one of many brands trying to make footwear double as an exercise regimen through simply wearing them. Although I still have a trusted tester seeing how effective they truly are, I have reason to believe they are a credible contender. What's most interesting is that their flipflops use classic California insole construction to provide excellent rearfoot control, with a soft and flexible metatarsal area, finished with a firm toe space to aid in propulsion. Couple that with a sole profile that should accelerate and aid in gait physics, and there is reason to be optimistic in a 'healthy' thong sandal. I'll provide more functional results as I have them.


Most Intriguing New Construction:

This is a tie for me. Asgi is a women's dress and casual brand developed with the input from a podiatrist. 'Doctor approval' does not always excite me (more on that in another post), but there are reasons to like this brand. One is that they consider themselves a fashion house, which helps younger (or those wishing to act and dress young) consumers find comfortable shoes that don't look 'old' or orthopedic. It's not so good for many pedorthic retailers who may find difficulty restocking successful or preferred styles. Their claim to fame is two-fold. All their models possess a modern variation on the old Avia cantilever outsole. This helps stabilize and cushion the gait. Of perhaps greater interest is the insole, which offers good fit and support. More interestingly, the underside of the device has a TPU Morton's extension. The combination of everything makes these shoes a possible winner for women with weak midtarsals, bunions, and plantar fasciitis that is secondary to forefoot supinatus deformity. Women with heel inversions and/or any type of forefoot valgus/first metatarsal drop/sesamoiditis should avoid the brand at all cost, except in cases where a knowledgable fitter properly modifies the insole.

As I wrote last year, I was extremely apprehensive regarding Crocs' acquisition of the Bite brand. Bite always had well made products, and a responsive customer service team. Being a small and dedicated company, they could truly adapt themselves to their base. One of my fears is realized: Bite is seen almost as an afterthought by the Crocs customer service department, who must be accustomed to being volume order takers. What has improved is the freedom to develop by the founder of Bite. Not having to share time with normal business details, he has been left to do what he does best, and most of the results are extremely promising. All Bite products now offer a footbed similar in nature to Crocs clogs; however, they are a much higher quality, and more supportive, polyethylene. There is a new construction in their golf line which should again allow those with more narrow foot shapes to enjoy the brand. For those with opposite foot shapes, their Orthosport lasted shoes still exist. New golf models are using an interesting EVA outsole, which ridiculously reduce weight. I'll have to see how much durability and playability may be compromised. Do NOT even consider their 'golf clog'. This thing is a monstrosity that must have been a pet request by Crocs' management. I don't care what they say in their slogans or other marketing; simply placing spikes on a foam clog does NOT make it a golf shoe. How embarrassing. I really like the new casual sandal models. In addition to still permitting the use of prescription orthotics, they have convertible uppers that can change from slides or thongs to more fully supporting configurations.

I've had a love-hate relationship with Spira ever since their days as the Springstep brand. No single cushion technology inspired me as much as their Wavespring (except for a Hytrel technology developed by Reebok that was sadly never released) in reducing impact shock without sacrificing stability. Like most brands, they had growing pains in their product integrity, and what they introduced last year was their best so far. That is now changing, again. Although their new visible technology looks impressive, what's really interested me was its ability to FINALLY produce a seamless flex across the metatarsal springs. The new product will not be something suitable for those with extreme motion issues (whether in heel eversion or inversion), but it's an extremely foot friendly technology, and works well with prescription orthotics. Good work, and keep up the product improvements!


Special Achievement Award:

In these days of manufacturers shifting manufacturing to substandard facilities in the need of eking additional margin, it's gratifying to see a handful of brands sticking to their messages of product integrity and durability. In addition to the continued work from Ecco, I would especially like to recognize Neil M for their hard work. They used to make some of the finest OEM merchandise for other, previously credible brands, and continue to manufacture some of the finest, and best value men's shoes in the world. They also added a new last to accommodate more shape needs. Thanks for keeping the faith in real shoes!

Result number: 30

Message Number 243615

Re: What do I ask before getting custom orthotics? View Thread
Posted by Dr. Wedemeyer on 2/23/08 at 21:49

Alice I'm not sure how dispensing you orthoses prior to having the rx is in your best interest.

Feet change over time and it could well be that a new pair were indicated, but considering your past history of metatarsalgia, PF and sesamoiditis I feel that a more appropriate course would have included a carbon fiber plate in your shoe to limit flexion in the ball and possibly a toe rocker.

Couple that with the appropriate orthoses and you could experience a great deal of relief. you should ask your pod for a referral to a pedorthist so that both can be addressed.

Result number: 31

Message Number 243584

What do I ask before getting custom orthotics? View Thread
Posted by Alice G on 2/23/08 at 10:15

I've had plantar fascitis, sesamoiditis, and metatarsalgia for years.

I had a pair of orthotics made 8 years ago that helped a lot for PF. Rigid, high arches. The guy who owned the shop offered lifetime adjustments. The last few times I went to see him, he said there was newer technology that would help me.

I moved and then got metatarsalgia and a hip injury. I got a little pressured into buying new orthotics from the physical therapy place. Softer, low arches. I think the met pad on the smaller foot was put in the same place as the larger foot and it was uncomfortable. The PT place gave the impression that I was stuck with the orthotics as is.

I'm now in physical therapy for the hip again. The place was highly recommended and is helping a lot more than previous rounds of PT.

The hip had kept me extremely inactive. As I recovered and increased activity, my feet started flaring up. The PT said to go see a Dr. about the feet because it will keep the hip from healing.

So I went to see a podiatrist I'd seen about other things. I meant to ask about a variety of things - night splints, physical therapy, just buying new shoes... But we ended up going off discussing orthotics.

My physical therapist, who previously had mentioned orthotics in passing, also said they made orthotics.

So I want to know what makes a person qualified and experienced to measure/prescribe orthotics effectively.

I'd like to know what they do to prescribe the orthotics other than take the cast and send it off. Don't know what the right answers would be.

I know there are places that manufacture orthotics in house, but I don't know if they are tied to one type of orthotics.

I'd like to find someplace that will do adjustments in house, rather than a doctor or therapist sending them back maybe one time at the beginning.

What should they take into account? The last place said I had flexible arches when I stand, so I think they asked the makers to go to the lower standing height. Didnt' work well.

This is probably something where getting a second or third opinion might offend people who put a lot of effort into measuring me.

My physical therapist has also recommended that I stop looking up medical information on the internet because I could end up getting confused and/or misdiagnosing/mistreating myself. She gave the example of someone who had lost a job due to this. This is actually the PT assistant, not the PT who would be measuring/making the orthotics.

Any thoughts?

Result number: 32

Message Number 243374

Re: cheilectomy recovery timetable? View Thread
Posted by Whitney H on 2/19/08 at 21:05

Hi Everyone

I'm not replying to any particular post, but just looking for some counsel and advice. I am 21 years old, and I have been dancing since I was 3. I am about to graduate with a bachelor of fine arts in Dance, ready to pursue a career in professional dance, choreography, teaching dance, movement research, etc. I have been dealing with off-and-on right first MTP joint pain for most of my college career (including some sesamoiditis). This entire year, my pain has severely increased and my mobility has greatly decreased. I have pain every day. Custom orthotics (I've gone through two doctors and four pairs to get ones that really 'work' for me) alleviate much of my pain while walking, and I gave up high heels last spring. Who needs em? The pain is, of course, much greater when I dance. I am mostly a 'modern/contemporary' dancer now, though I still train in ballet as well (I gave it up this semester in hopes that I could see more foot improvement).

A little over a year ago, I had a couple corticosteroid injections in the joint for what was then mostly a sesamoiditis issue. They gave me very little relief for a very short period of time. I did physical therapy all last semester for the toe-joint. Nothing helped all that much. I've been getting acupuncture once a week for 5 weeks now. I've had massages. I've iced and heated. I've used every 'icy-hot' type thing you can imagine. I have modified some of my dance technique to accommodate the foot.

Ready to graduate, I am now considering having surgery so that I can lengthen my potential career and simply be able to do what I love again without pain. My podiatrist is talking about doing a 'clean-up' of the joint, which I have come to realize is probably the cheilectomy procedure.

I guess I just want a straight-up answer about whether or not I will have proper, FULL foot function again. I do not need to walk in high heels, but if I am going to do this surgery, it is imperative that I am able to dance fully afterwards. My doc has said about 8-10 weeks to recover, including a lot of physical therapy. I am fine with taking the entire summer to rehabilitate myself, but I want to know that after I pay my 3 months of inactivity, I will be back on my (relatively pain-free, more mobile?) feet and able to dance at a professional level.

Also, I am concerned about my age. It seems as though many people on here are in their late 30s or older. I don't want to do surgery at 21 and then need to fuse my joints when I'm 35! I still want to be dancing, teaching, and making movement when I am that age. I have spent a lot of my life dealing with moderate amounts of pain. If this surgery isn't going to help in the long run, then I guess I will continue to bear daily pain and do as much injury maintenance as possible.

I know everyone is different and 'my doctor knows best', but I am just looking for some opinions.

Thank you so much. I appreciate your help.

Result number: 33

Message Number 243126

ESWT for Sesamoiditis View Thread
Posted by Erica on 2/12/08 at 14:23

I have been suffering from sesamoiditis for around 6 months. I have tried rest, ice, oral steroids and steroid injections. Nothing has helped. I have been looking for a doctor in my area (PA) who will use ESWT for sesamoiditis but everything i am finding is for Plantar Facitis. Is ESWT commonly used for sesamoiditis? Does a doctor have to be certified for specific conditions (sesamoiditis) or just in use of the machine in general? Any advice would be greatly appreciated.
Thanks.

Result number: 34

Message Number 243098

My suggestion for exercising with PF View Thread
Posted by Alice G on 2/11/08 at 22:21

I already posted this buried deep in a thread, but thought it might be beneficial to other people.

Since getting Plantar Fascitis and Sesamoiditis 8 years ago, I've gained 80 pounds. A big part of that is that I can no longer go running or do most forms of weight bearing exercise very often. I missed the endorphins because I got runner's high very easily.

For various reasons, I really need to exercise now, and have found deep water running useful lately.

I'd recommend deep water running as exercise to any PF sufferers. Heat up in the hot tub first. Do a little bit of stretching, but nothing that yanks the fascia on the bottom of your foot (spoken from experience).

Then put on a flotation belt, go into any water over 6 feet or so (don't try this if you don't know how to swim) and start jogging, doing a stair climber routine, bicycling both arms and legs, cross country skiing, jumping jacks, rowing motions, etc. I've had better results with this than swimming. I'm a lousy inefficient swimmer, and the motions of swimming tend to be repetitive use of muscles exerted in one direction. I have found that using the foam barbells adds to the exercise, but antagonizes my wrists so much that it is not worth it.

The pools at the local parks and recreation centers have a lot of this equipment from their water aerobics courses. At least in my area there are a lot of indoor pools.

You'd be surprised how good a workout you can get. Try moving as fast as you would in a full out sprint downhill. However, I'm going to start bringing along a heart rate monitor wrist watch so I can figure out if I'm going to get a heart attack from the exercise. :-)

Result number: 35

Message Number 243095

"Slippers" for plantar fascitis.... View Thread
Posted by Alice G on 2/11/08 at 20:48

I'm finally recovering from a hip injury and am attempting to get active again. I've re-activated the plantar fascitis, sesamoiditis, and metatarsalgia.

I'd also gotten in the habit of walking around barefoot at home and need to break this off.

I got new orthotics 1.5 years ago. The technology is better and they are softer on my feet, but they don't have as good arch support and can even increase the PF symptoms.

So I have an old pair of customized Birkenstocks that are a) aimed to match the old high arched orthotics and b) too short and narrow for me now.

I wear about an 8 2E depending on the shoe.

Does anyone know a good slip-on shoe to use as an around the house alternative to going barefoot? My guess is that even Birkenstocks might be too narrow.

I'd love to see something that was cushy, high arched, wide.. but haven't seen anything appropriate.

I've tried buying Reebok athletic mules, and putting insoles in them, and also taking flip flops and putting arch cookies into them. They are ok, but I don't usually remember to put them on.

I'd like to have that same slipper feeling of comfort that makes me want to put on the shoes when getting out of bed or when slipping off my regular shoes at night (my feet are really hurting now)

Result number: 36

Message Number 242733

Arch (not heel) Pain........please help! View Thread
Posted by Linn on 2/03/08 at 13:51

I have had arch pain (not heel pain) going on about 6 weeks now....and I don't want it to progress or become chronic and last for years...In late Nov. I stumbled (not fell) and had Sesamoiditis...the ortho. wrapped and padded and gave me a post op boot. The padding was poking a bit in the sole, but he said it would to take pressure off the sesamoid..well, about 5 hours later because of that post-op boot throwing my mechanics off, I wrenched my back. I immeditaly threw out that post-op boot. No problems with my arch at this point.,..fast forward to 2 weeks later,..... I was kneeling on a hard floor with just my slippers on, and I remember pushing myself off and up with my left foot only from a flat on the floor position. I didn't feel anything at all the rest of the night, but the next morning is when I noticed a bit of swelling and tenderness. I iced, rested it, etc for about 10 days, then went to a doc as it was still there. For me, at this point, I am still with inflammation (even though I have tried NSAIDS and a Medrol Dosepak, both of which gave temproary relief), my arch is painful to the touch and also pain (ripping feeling) when I walk. Originally it wasn't this bad but was all made worse with phonophoresis/elec stim/and 2x/day theraband exercises (first doc prescribed this all without using orthotics or taping...). I am on to a new doctor...who has prescribed OTC insoles (Spenco)to start, but I haven't gotten them yet..but fear the pressure on my arch from them......but, to walk without support...that's when the ripping sensation comes in....aaarrgghh! Even his wrapping and padding my arch hurt. x-rays normal, MRI said 'thickening of central plantar fascia cord, consistant with interstitial plantar fibromatosis'. If anyone can relate and share, I would sure appreciate it!

Result number: 37

Message Number 242106

Re: Sesamoiditis Surgery Needed View Thread
Posted by Dr. DSW on 1/17/08 at 17:51

Once again I will refer to my standard answer. ANY and ALL questions regarding your surgery and the post operative recovery should be addressed to the surgeon that is going to perform the surgery.

Each surgeon has his/her own post operative preferences. Some allow patients to walk with a surgical shoe, some prefer a walking cast, some prefer non weightbearing, etc. Therefore, please contact YOUR doctor for his/her answers to your questions, since that is your absolute best resource, not this site and not the internet.

It is your doctor's obligation to make sure you are informed PRIOR to the surgery, not after.

Result number: 38

Message Number 242080

Sesamoiditis Surgery Needed View Thread
Posted by CelineH on 1/17/08 at 09:03

I've had 3 cortisone injections for sesamoiditis and the MD recommends surgery. What is the recovery time and how long will it be until I can walk? I will have to take unpaid leave from work and want to return to work as soon as possible after the surgery. Also, any websites with detailed info about the surgery would be helpful. I can't seem to find anything online with detail. Thanks!

Result number: 39

Message Number 241245

Re: Feet Docs/Peds/Pods in SF? View Thread
Posted by Dr. Wedemeyer on 12/26/07 at 18:07

Denise I recall that you had a lot of trouble with you 1st MTP joint and that several of us had suggested some modifications based on your doctor's evaluation. If you are still having trouble I would suggest that your current orthotics need modification.

Whoever made the orthosis should be willing to try a few modifications as no orthotic is perfect 100% of the time on the initial fitting.

A simple Colman block test performed by your doctor or pedorthist would probably go a long way towards clearing this up and helping you (assuming that you indeed have a plantarflexed 1st ray). Did any of your doctors have you stand on a wood block with the big toe hanging over the edge?

Again you could be suffering from a hypermobile & plantarflexed 1st ray, capsulitis, degenerative arthritis, sesamoiditis or a combination of the above. Unfortunately it is impossible to know over the internet so hopefully someone can lead you to a good doctor in your area.

Result number: 40
Searching file 23

Message Number 239124

Re: sesmoiditis View Thread
Posted by Ted on 11/07/07 at 15:54

It is possible sesamoiditis originated from chemical exposure to disenfectants in a locker room facility. If you notice skin damage (loose skin) that is very abnormal for your age, then this could be the culprit.

Result number: 41

Message Number 238993

chilectomy and sesamoidities View Thread
Posted by annb on 11/05/07 at 08:59

I had a chilectomy five weeks ago. The incision has heeled nicely but the ball of the foot is very inflamed and painful when I step down on my foot. The doctor tells me it is due to a drainage of blood to that area and there is a touch of sesamoiditis. Is this normal and what is the approximate recovery time?

Thanks.

Result number: 42

Message Number 237524

Re: ATTN: LarryM View Thread
Posted by larrym on 10/11/07 at 14:20

Other than the motion of overpronation being restricted, what other 'motions' are you referring to? At the same time can you give me an example of motions that need to be 'encouraged' according to symptoms?
...............................

This is my main sticking point with your theories. You dont feel there is any 'bad' motion other than pronation. The purpose of an orthotic is to limit excessive bad motions and encourage good motions. Not to over-simplify, but lets assume a person is symptomatic due to too much or too little motions. The term pronation is grossly over used and ambiguous in many cases.

Far too many people label every problem pronation and ever solution is to control pronation THAT is one of the fundamental reasons there are so many failed orthotics out there because too many people use that narrow idntification process then follow it with a rigid device with a built up arch to fix it.

You yourself say that a foot should be guided through proper motions, yet your device doesnt have a rearfoot post and zero forefoot post. You are relying on floating the foot via a chamber filled with fluid

Some of the bad motions that a cavus or rigid foot will present with ( I will use the term under-pronator so it may sit better with you)

Subluxed Peroneal
5th met fx
4th met fx
sesamoiditis
jones fx
lateral column overload
peroneal avulsion
peroneal tendonitis
lateral/inversion instability
ITBS
Medial (knee) compartmental oa
Just to name a few things that you rarely find in a 'pronator'. I say pronator loosly because there are also too many out there that wouldnt know an under-pronator if it kicked them in the arse. I see many of these patients that have several devices that didnt work because the person that made them had pronator goggles on and though jacking the arch up will fix everything.

To better illustrate my point, google 'coleman block test' and tell me what that test is doing and what good and bad motion is it affecting

Result number: 43

Message Number 237190

oops ignore the above post View Thread
Posted by Dr. Wedemeyer on 10/04/07 at 23:54

Denisea,

1st met joint mechanics are very complex. I understand your thinking, to bolster the action of the 1st met but actually quite the opposite is true if your 1st ray is truly hypermobile. Many hypermobile 1st MTP joints are plantarflexed and require a reverse Morton's extension or first ray cutout. This works extremely well with a plantar-flexed first ray, hallux limitis, sesamoiditis, and severe forefoot valgus deformities.

You could also have sesamoiditis and should be evaluated by a professional to rule this out. A hypermobile 1st ray can cause concomitant sesamoiditis and PF especially with a varus forefoot. The resulting supinatory action of the forefoot during gait is murder on the plantar fascia. Your provider may also consider a 2-5 bar modification to the orthotic.

There is also the relationship of the rear foot to consider and a deep heel cup and additional posting may be necessary to make the aforementioned modifications work.

What this all means is that there is help but trying to modify a device or manufacture one on your own could be disastrous to the health of your foot.

Have you seen a foot specialist or been referred to a Cped?

Result number: 44

Message Number 237189

Re: Speaking of MTJ..... View Thread
Posted by Denisea on 10/04/07 at 23:53

Denisea,

1st met joint mechanics are very complex. I understand your thinking, to bolster the action of the 1st met but actually quite the opposite is true if your 1st ray is truly hypermobile. Many hypermobile 1st MTP joints are plantarflexed and require a reverse Morton's extension or first ray cutout. This works extremely well with a plantar-flexed first ray, hallux limitis, sesamoiditis, and severe forefoot valgus deformities.

You could also have sesamoiditis and should be evaluated by a professional to rule this out. A hypermobile 1st ray can cause concomitant sesamoiditis and PF especially with a varus forefoot. The resulting supinatory action of the forefoot during gait is murder on the plantar fascia. Your provider may also consider a 2-5 bar modification to the orthotic.

There is also the relationship of the rear foot to consider and a deep heel cup and additional posting may be necessary to make the aforementioned modifications work.

What this all means is that there is help but trying to modify a device or manufacture one on your own could be disastrous to the health of your foot.

Have you seen a foot specialist or been referred to a Cped?

Result number: 45

Message Number 234514

Re: sesamoidactomy then bunionactomy now more pain-help View Thread
Posted by Dr. Wedemeyer on 8/16/07 at 16:24

Dog (sic), it very much depends on the position and flexibility of the 1st MTP joint how the orthotic should be designed. I typically find a 1st ray cut out (your doc will know what this is) is very helpful if your hallux is plantarflexed or hypermobile, with or without sesamoiditis.

The fact that you have had the sesamoid removed and now a bunion forming would tell me that your first ray may be becoming rigid in which case depending on your foot morphology, controlling pronation may be all that is needed (posting + good shoes)

Result number: 46

Message Number 233625

RE: chronic sesamoiditis/taping question View Thread
Posted by William C on 7/27/07 at 09:02

I've seen taping recommended in conjunction with sesamoiditis recovery. Can someone describe how to tape up the big toe for this?
Also, in the meantime before my next foot doc appt, if I purchase and use a common foot pad insert, should I cut out the big toe area and leave an indentation for it to rest in?

Result number: 47

Message Number 233544

Re: RE: Persistent Big Toe Synovitis View Thread
Posted by William C on 7/25/07 at 10:22

Thanks for the responses.
I'm assuming cavus feet to possibly mean high arched feet. I would say that, yes, I have high arches. Not abnormally so, but somewhat.
I will engage the topic of a bone scan w/ my foot doctor during my next appointment. Pardon my naivete, but I admit to having difficulty accepting non-injury related changes in my feet that may require orthotics. I added bicycling to my regular activities a few years ago, but other than that, I'm not really aware of any noticeable changes in my lifestyle that would have resulted in these new foot issues that I've dealt with since last August. That is, except just simply growing older, which, I suppose, I am left with placing much of the blame upon. I remain a bit incredulous about it, but I guess I just have to accept that things wear out and break down, etc.

Were this particular problem to, in fact, be some kind of stress facture or chronic sesamoiditis, is an orthotic the only measure to address it with? I ask not so much because of skepticism about orthotics, but rather because it has been so resistant to ice/heat, shots, and a week or two in a compression boot. I don't like sitting around, and I'm sure I continue to aggravate it with my active lifestyle, but if a month's worth of whatever convalescence was recommended would aid recovery, I would certainly do it.

Result number: 48

Message Number 233519

Re: RE: Persistent Big Toe Synovitis View Thread
Posted by Dr. Ed on 7/24/07 at 21:09

I suspect chronic sesamoiditis or a sesamoid stress fracture which a bone scan is more likely to show than MRI. In the end, it is likely to be a biomechanical etiology as Larry suggests which may be treated via a
specialized orthotic.
Dr. Ed

Result number: 49

Message Number 233464

Re: RE: Persistent Big Toe Synovitis View Thread
Posted by larrym on 7/24/07 at 12:47

Dr Ed's response is good. You also indicated you have peroneal inflamation. The long peroneal, if tight, can help plantarflex or pull your great toe downward and subject it to greater pressure and stress. (I often see the GP's make a dx of gout, when it is in fact, not gout at all) This is usually seen in cavus feet, this can cause sesamoiditis and it is very rare to get that in a flat or pronator type foot

Result number: 50

Message Number 232441

Re: Sesamoid removal and mpj fusion? View Thread
Posted by Laura D on 7/03/07 at 15:00

Dr. Ed:

Thanks for your reply. It began with localized pain in the ball of my left foot that was worse when I was training/walking and better when I quit. You'd think I'd take the hint but I kept trying new shoes, insoles, etc. I didn't realize that it was anything that serious. Eventually I also had occasional debilitating shooting pains into my toe. My primary care doc didn't think enough of it to send me to a specialist until it had been going on for some time and she tried treating me with Mobic, which nearly gave me an ulcer.

She finally sent me to a podiatrist who specializes in sports medicine. X-rays didn't show anything at that point and he dx'd sesamoiditis. We tried off-loading with pads in my shoe, which didn't help, steroid injections, and finally an aircast on that foot. It got slightly better, but my right foot then became very painful. I'd also had to go home for a couple of weeks to care for my mother who'd had shoulder replacement surgery, which put alot of stress on my feet. By that time my right foot was in as much pain as the left and he ordered an MRI which showed bone contusions severe enough on all sesamoids the radiologist read them as stress fractures and also bruising of the head of the first metatarsal on my right foot.

In the past five months they have gotten a little better, then a little worse, little better, little worse. Overall slightly better than when it was at its worst. I may be mistaken about the exact type of fusion, I just know that he is taking about fusing something in that joint, if not the whole thing. I will be quizzing him in-depth when I see him this Thursday.

My medical history is such that I never, ever do anything in the normal, expected, manner. It's got to be as difficult and complicated as possible - hence both feet :-)

Thanks again!
Laura D

Result number: 51

Message Number 230089

Re: Uncurable Sesamoiditis..the dangers of tango dancing View Thread
Posted by Anna B on 5/17/07 at 19:56

Dear Dr. Goldstein and Dr. Ed,

Thanks for your invaluable insight and advice. Iíll definitely speak with my podiatrist to see if these modifications can be made to the orthotics. Should he still insist with the cortisone shot should I go ahead? Are there any potential drawbacks for the muscle and bone? It may not have been clear from my message, but itís been since March 2006 that this condition has been going on .

Finally, if this is possible, could you recommend a good podiatrist in the Washington DC area?

Again many many thanks!
Anna

Result number: 52
Searching file 22

Message Number 229929

Re: Uncurable Sesamoiditis View Thread
Posted by Anna B on 5/15/07 at 19:22

Dear Dr. Goldstein and Dr. Ed,

Thanks for your invaluable insight and advice. Iíll definitely speak with my podiatrist to see if these modifications can be made to the orthotics. Should he still insist with the cortisone shot should I go ahead? Are there any potential drawbacks for the muscle and bone? It may not have been clear from my message, but itís been since March 2006 that this condition has been going on .

Finally, if this is possible, could you recommend a good podiatrist in the Washington DC area?

Again many many thanks!
Anna

Result number: 53

Message Number 229798

Re: Uncurable Sesamoiditis..the dangers of tango dancing View Thread
Posted by Dr. Ed on 5/13/07 at 20:33

Anna:

One posiblity that need be looked into is a sesamoid stress fracture considerign the length of time you have been in pain. A bone scan may be in order.

A number of orthotic and shoe modifications may take pressure off the seamoids: first met head cut out, forefoot valgus posting (provided forefoot valgus is found), placement of a viscoelatic pad in the area of the first met head aperture, distal rocker sole applied to the shoe...

Dr. Ed

Result number: 54

Message Number 229762

Uncurable Sesamoiditis View Thread
Posted by Anna B on 5/13/07 at 12:58

Dear DR.,

I have been suffering from sesamoiditis in the right foot for more than a year. The pain occured last March as a result of too much tango dancing, and since then I have consulted 2 podiatrists, wore 2 different kind of orthotics, took anti-inflammotory medication, did acupuncture, and even tried reiki (I admit, I was desperate!). All of this has managed to reduce by 80% the swelling of the foot, but there is still pain at the very border of the ball of my foot (almost were the ball and the arch of the foot starts), and that is what I seem to be unable to get rid of. I suggested to my podiatrist if an MRI could help shed some light on the situation, or if I could do some physical therapy, but he seem to be more in favor for a cortison shot and (if that failed) surgery. I definitely would not consider surgery, and I am bit suspicious about cortison shots (how effective are they? what are the consenquences for the bone and muscle if you do more than a couple? A friend of mine did cortison shot for the same condition and it didn't really help and she is still battling sesamoiditis), what else could be done to address this problem? Are there any other alternatives? Also are there any modificiation or different kind of orthotics that could be made? I have a high arch foot, could that also be a possible cause? I kept bringing this up with the dr, but they didn't seem to take much notice of it.

Thanks for all your help and any advice you may have!

Result number: 55

Message Number 223414

Re: Hiking shoes View Thread
Posted by AliceG on 2/22/07 at 21:53

Warning on hiking boots from my experience ......

New Montrail hiking boots were the beginning of the end for me.

From what I have seen, a lot of "serious" hiking boots do not have good insoles built in. Hiking stores seem to sell Superfeet or other insoles that people put in to suit their feet better. They also don't have very much cushioning. I had a pair of "light hikers" (maybe from Merrell?) and wore them to a concert because I had forgotten to bring other shoes with me that day. Jumping up and down/dancing made my feet really hurt. I think the rubber is designed for traction as opposed to shock absorption.

I bought a pair of new Montrail boots on a Saturday, and went out for a 5+ mile hike on Sunday. On ice. Had a bit of an adrenaline/runner's high, so I came back and went for a 3 mile run/walk in my beat up running shoes.

That night I had excruciating pain in my toes and couldn't sleep because I couldn't stand sheets or the footboard of my bed. So that was the beginning of my sesamoiditis.

About 6 months later I did more hiking on ice in the same boots, now with semi-custom inserts, and developed plantar fascitis.

8 years and 80 pounds later, I have chronic plantar fascitis. Now if I make sure to wear large enough shoes and my orthotics, I seem to be much better. And don't forget about stretching...

About the comment about Montrails being wider: I once came home for Christmas, and found out that my sister (who also has wide feet) has the exact same boot, just 2 sizes smaller.

Result number: 56

Message Number 222102

Dressier support shoes for intensive dancing... View Thread
Posted by AliceG on 2/10/07 at 17:25

I've had plantar fascitis/sesamoiditis for 7 years. Part of this was due to inflexibility from undiagnosed fibromyalgia. I mostly had a remission when I started taking the subway everywhere and lived ~5 minutes walk from the station. Enforced mild exercise does wonders.

5 years ago I started swing dancing, and have done varying amounts depending on my free time and work/grad school schedule.

What I usually did was to take tennis shoes and glue suede or leather on the bottom. That was pretty common. I used solid black or white to be a little more fashion conscious.

For this style of dancing you tend to have your weight on the balls of your feet most of the time, often with your knees a little bent. My calves can really get tight after this.

Now I'm trying to figure out what shoes to wear if a) I'm in something approaching formal dress or b) I'm doing a dance style where a heel helps, but preferrably in a wedge style.


I bought one of the P.W. Minor 'Fashion' style name shoes off of e-bay that has a T-strap. It turned out to be a little big when I thought I was just going to wear it for dressy occasions.

Instead I decided to convert it to a dance shoe by gluing massive toe cushioning in.

What I found was that because the shoes were a little too big, they bent a little further forward on my feet than would have been best. I also couldn't bear weight on my midfoot well (which would normally be where I spin) because of not having the support there. And I pronated a lot more I think, because I didn't have the support to keep my foot from wobbling.


So, with the constraints of:
a) can be worn with a skirt without looking stupid
b) has very cushioned sole
c) no separate heel and toe
d) wear with an orthotic
does anyone have any suggestions?

I am considering a propet mary jane.

Result number: 57

Message Number 221289

Re: Sesamoid View Thread
Posted by larrym on 1/31/07 at 21:39

Actually Dr G makes a good point. 98% of the cases of sesamoiditis I see have a plantrflexed 1st ray or it is prominant. Most orthotics dont address this. Think of a device tht is semi rigid and supports your entire foot but has a hole the size of a quarter under your sesamoid that may be filled with some soft cushion material. Placed in an athletic running shoe or light wt hiking boot and you should do ok. I have gotten patints back to activity with the right orthotic/shoe and they have had fx sesamoids.

Result number: 58
Searching file 21

Message Number 213165

All-purpose good non-athletic shoe? View Thread
Posted by AliceG on 10/12/06 at 22:35

I had sesamoiditis 7+ years ago that went away, and have had PF for almost 7. The PF went away mostly. I walked barefoot on hardwood floors and walked about 30 minutes a day. Brooks Ariel, orthotics and medication/exercise for fibromyalgia helped.

Now I've got metatarsalgia from accumulated short-term overdoing it. PF has come back. I don't wear my custom birks as often as I should, and they have become a little small for my foot that has gained in size. I've also gained lots of weight, which hasn't helped.

What I want to know is: What is a good all-purpose shoe that doesn't look like an athletic shoe? I wear a lot of black pants and tan pants to work. I used to wear Brooks Addiction walkers because I could get them in black, but bought some New Balance 925's but have only worn once. Need a smaller size.

I liked the Ariel because it ran wide/deep without their insole, and fit my orthotic. I've found more sources for wide shoes, and have found that no normal width shoe works anymore.

I like deep toes - the pedorthist #2 said it would help with the metatarsalgia and it seems more comfy.

NB 1122 from pedorthist #1 - too shallow toe - felt like it might be aggravating the quasi-sesamoiditis and this is before the metatarsalgia kicked in.

I seem to have a blunt/square foot - Birkenstocks are too pointy for me. I have a high arch and pronate severely - that is confirmed by many people. I'm on my second pair of orthotics (soft) - designed for metatarsalgia instead of PF. The guy at the physical therapy office designed them before getting the prescription from the Dr. They have much less aggressive arch than the rigid one I had before.

The shoes that seem to work well for me now are the brooks ariel, PW Minor central park, and drew lori/bloom (worn only a few times). I ordered the Aravon Dane (on sale) but found the toe too shallow. Brooks Turin also too narrow/shallow.

My main question: What is a good all-purpose orthopedic shoe that will work as well as a tennis shoe?

Mainly for me, but also for others. Ugliness doesn't matter much, just whether it comes in appropriate colors to semi-match my clothing, such as black, navy, some sort of light tan/bone/white..

Any thoughts?

Thanks,
Alice

Result number: 59
Searching file 20

Message Number 205823

Re: DR Goldstein(Sesimoids?) View Thread
Posted by dr nordke on 7/31/06 at 00:18

..the answer is no...the best thing for sesamoiditis is off loading, I usually inject the area, and by off loading I mean I take pressure off of the area with cushioning with orthotics. Hope that helps

dr nordyke

Result number: 60

Message Number 205373

more light therapy anecdotes View Thread
Posted by scott r on 7/26/06 at 14:20

chronic ligament sprain between 4th and 5th metatarsal in runner, causing mild neuritis. Used halogen twice and 36 LED. Impressed. Wants to buy 36 LED.

Plantar fibromatosis, 1.5" cut, caused scar tissue that appears to have led to neurogenic component. Notable pain reduction after 3 minutes of halogen.

bone bruise an acute sprain, 4th and 5th toes: pain from 5 to "3 or 4". From too much pain to stand to standable pain. 3 minutes of halogen.

neuropathy and ankle sprain: pain level went from 4 to 3 after 3 minutes of halogen

Diabetic ulcer, 3 mm long, 2 mm long. After 30 minutes of 36 LED, 3 mm long and 1 mm wide in 24 hours.

Chonic plantar fasciiis, 3 minutes halogen, no benefit.

Sesamoiditis, 3 minutes halogen, small decrease in pain.

Insect bite, 1 minute halogen, stinging pain eliminated.

Result number: 61

Message Number 203335

Re: Avascular Necrosis View Thread
Posted by Colleen K on 7/08/06 at 03:02

Hi-
I have been having pain in the balls of both my feet for over four months now. I wore a walking boot for 9 weeks with no improvement. I am no longer wearing the boot because it ended up causing more damage than good, hurting my hip and back. The recent bone scan indicated sesamoiditis, while the MRI indicated sinovial fluid in the metatarsal joints. No one has made a definitive diagnosis. My doctor just suggested several weeks off of work to rest my feet.

How did the doctor decide the pain in the ball of your foot was AVN? Does Feldene help the pain and swelling? I wish I had some answers for you. But unfortunately, I have no idea what's happening with me. No one has mentioned surgery yet.
Thanks

Result number: 62

Message Number 202725

Re: rigid orthotics View Thread
Posted by dr nordke on 7/02/06 at 02:18

If the orthotic fits well, and the casting is correct, this should not be a problem.

I have never to my knowledge have someone develop sesamoiditis from orthotics. But then, I almost always do a first ray cutout to avoid this problem, or in the case of a high arch, I do a reverse morton's, which means that the cushioning is slightly lower under the first metatarsal and big toe.

I always make full length orthotics so that I can add cushioning over the orthotics.

You should not make the decision on semi rigid vs semi flexible; your doctor should.

For what it is worth, almost all of my orthotics are semi rigid, which means that it has some flexibility to the orthotic but does not flatten out.

Dr Nordyke

Result number: 63

Message Number 202609

rigid orthotics View Thread
Posted by Kevin on 7/01/06 at 03:41

Some experts warn that rigid orthotics may cause sesamoiditis or benign tumors that form from pinched nerves.
How do you know what type that you have and is the best choice semi rigid or semi flexible???

Result number: 64
Searching file 19

Message Number 197666

Re: sesmoiditis View Thread
Posted by Mar on 4/18/06 at 15:38

What caused your sesamoiditis is different from my situation. The only thing that has helped me is time (years) and being very careful not to put too much pressure on it. My walking and standing are very limited due to chronic bilateral PF, so that has finally given the sesamoiditis a chance to ease. I only wear Clark clogs and sandals or birkis. Good luck with your problem. My heart goes out to you.

Result number: 65

Message Number 197589

Re: sesmoiditis View Thread
Posted by April on 4/17/06 at 07:04

To tag onto the questions you had for this person. I have just been diagnosed with Sesamoiditis from bunion surgery, they damaged my first met, by shaving to much of the bone off and they didn't align my big toe properly, so I have hardly any range of motion. They had no idea what was wrong with my toe and why I had no range of motion and they had sent me to months of excruciating physical therapy, where they pulled, tugged, pushed my toe in a million different ways. Then come to find out another doctor realized that the bone had not healed from the surgery and the physical therapy made the scare tissue worse and I had to wear a cast for 6 weeks and a walking cast for another 4 weeks. Now I still have no range of motion and I'm getting another opinion on what to do for treatment. They are telling me they cannot do surgery to help fix it and I have to get special orthotics inserts. Not sure if you have any suggestions.

Result number: 66

Message Number 194395

Re: Bunionectomies/Sesamoiditis/TTS/Arthritis/ PF View Thread
Posted by Dr. Goldstein on 2/28/06 at 18:52

I do not think that further surgery is the answer. There are different meds that may help. Do you take anything for depression. If not elavil is a good drug thatb helps relieve symptoms of TTS and is an anti-depressant. Cymbalta, Lyrica are new meds as well. Is your gout under control? are you diabetic? People with the type of problems you have often suffer from depression. the medical board guys will say no as they do not want to give you an excuse to file or collect disability. The will say no that is what they get pais to do. dr goldstein

Result number: 67

Message Number 194394

Re: Bunionectomies/Sesamoiditis/TTS/Arthritis/ PF View Thread
Posted by Dr. Goldstein on 2/28/06 at 18:51

I do not think that further surgery is the answer. There are different meds that may help. Do you take anything for depression. If not elavil is a good drug thatb helps relieve symptoms of TTS and is an anti-depressant. Cymbalta, Lyrica are new meds as well. Is your gout under control? are you diabetic? People with the type of problems you have often suffer from depression. the medical board guys will say no as they do not want to give you an excuse to file or collect disability. The will say no that is what they get pais to do. dr goldstein

Result number: 68

Message Number 194292

Bunionectomies/Sesamoiditis/TTS/Arthritis/ PF View Thread
Posted by Islandfun28 on 2/27/06 at 13:23

OK, so I got injured in the military, at 25 I had had 2 bunionectomies with 1 removal(metal screws) surgery and 1 sesamoidectomy. I refused to get any more surgery done. It's been 6yrs and I'm hurting worse than ever. I was told at 25 that the road ahead was just down hill and all they could do was try and manage my pain. I have used steroid shots, orthotics (5diff kinds) and meds, meds and more meds. I suffer from gout, arthritis and my DR said that the pain in my ankles is Tarso Tunnel Syndrome as a result from my foot injuries and the damage to my gait. How true can this be? My psych and my Pod. believe that my depression is related to these injuries, but my medical board DR.s dont agree. How can they explain that my knees are affected by my feet problems, but no my knees, does this make any sense? I need some HELP!! Please

MOM of 3

Result number: 69
Searching file 18

Message Number 189317

Re: First -time experience with Graston: ? View Thread
Posted by Robert J. Sanfilippo, DC, CCSP, ART on 12/08/05 at 21:59

My first question is how did you doctor come to the conclusion that you may have a neuroma or sesamoiditis? Those are significant conditions and should be ruled out first before further treatment is rendered because they could significantly be contribuing to your pain.

If he is a true Graston practitioner he would know that it takes a good 15 minutes to work on someone properly. Maybe his secretary scheduled someone incorrectly or there was an emergency. If you felt rushed then he was definitely rushing you if it took him that long to use the Graston technique on all those structures. The applicaton of heat is a good choice before using the Graston method. You should feel results within 3-4 visits. When the instrument runs along your plantar fascia you should feel and hear a "crunchiness" which is the scar tissue. You must start off light and as you heal go deeper and deeper with each visit. I call it a layering and you must start superficially and work within the pain tolerances of the patient.

As far as cost you are getting a very good rate. Normal rate is about 75 here in New York. Good luck and keep me posted.

Result number: 70

Message Number 189213

First -time experience with Graston: ? View Thread
Posted by Cyber on 12/08/05 at 00:19

I had my first visit with the Graston technique the other day. I called everyone that came up on the list in my area that performed the Graston technique. They were all chiropractors. I ended up going with the one who had been certified the longest, two years. He was doubled booked like most chiropractors and I gave him a brief history, leaving out a lot of information because he seemed rushed. He examined my foot and felt around, expressing concerned that I might be developing a neuroma or sesamoiditis. I was instructed to talk to my pod about this. He then let heat sit on my foot and calf for about 5 minutes. He came back, applied lotion and then used the three tools to rub up and down my calf, achilles and fascia. I experienced little to no pain with his movements and he only did it for a little over 5 minutes on one foot. He said that he would only do one foot at a time, each subsequent visit would be only be 15 minutes and cost $30. Is this how Graston works? What has others experience been with Graston practictioners. Please post.

Result number: 71
Searching file 17

Message Number 175810

Re: sesamoidectomy questions View Thread
Posted by Ron on 5/27/05 at 13:02

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12801198&dopt=Abstract

Return to activity after sesamoidectomy in athletically active individuals.

Saxena A, Krisdakumtorn T.

Department of Sports Medicine, Palo Alto Medical Foundation, Palo Alto, CA 94301, USA. HeySax@aol.com

Sesamoidectomy of the first metatarsophalangeal joint in athletically active patients may be indicated in cases of chronic sesamoiditis resistant to nonsurgical care or symptomatic displaced fractures or nonunion. Painful scar, hallux deviation, and delayed return to activity are all potential complications. These need to be considered especially when performing surgery in the athletically active individual. Twenty-six sesamoidectomies in 24 patients (21 females and 3 males) were reviewed for type of sesamoidectomy, incision location, time to return to activity, and complications. Mean age was 35.4 years (range, 16-68 years) with mean follow-up 86.4 months. Eleven athletes (defined as professional or varsity level sports) operated on had a mean return to activity of 7.5 weeks (range, 4-10 weeks), while 13 "active" patients had a mean return to activity of 12.0 weeks. This difference was statistically significant using the t-test, (p < .02). There were 10 fibular and 16 tibial sesamoids excised. Complications included one hallux varus and two cases of postoperative scarring with neuroma-like symptoms, all associated with fibular sesamoidectomy; there was one case of hallux valgus deformity with tibial sesamoidectomy. Despite the functional importance of tibial and fibular sesamoids, athletically active individuals can return to sports after a sesamoidectomy as early as 7.5 weeks.

Result number: 72

Message Number 175067

Re: Sesamoiditis - surgery View Thread
Posted by Liboralis on 5/15/05 at 07:34

Dr Z is right. What type of orthotic did he give you and what is the cutout under your 1st like? It should have lots of soft padding under it and a higher portion under your 2 3 4 5 met head area. If he didnt do that then I would go somewhere else asap. What is the nearest major city near you?

Result number: 73

Message Number 174943

Re: Sesamoiditis - surgery View Thread
Posted by Dr. Z on 5/13/05 at 15:51

Hi
This is a very tough situation. My first impression is that overlaying metatarsal heads are in a plantar Flexed position. This means are they pointed too plantarly and placing pressure on the feet. I bet you have a high arched foot?

Result number: 74

Message Number 174932

Sesamoiditis - surgery View Thread
Posted by Trish P on 5/13/05 at 15:16

I have sesamoiditis, both feet. It got so severe (terrible calluses, pain) that my podiatrist removed the one offending sesamoid bone in each foot, leaving the second. (I have had virtually no fat pads for years...since I was about 40.) NOW the second sesamoid bone in each foot is doing the same thing, callusing and causing great pain. I am sort of regretting having the surgery done (although I did have over a year of relatively pain-free walking)and wonder what I can do now to alleviate the problem, if anything. Is the new procedure for inserting gel implants successful? (My podiatrist says they don't stay where you put them.) Help!

Result number: 75
Searching file 16

Message Number 163455

plantar fac View Thread
Posted by cliff s on 11/10/04 at 13:27

could this be associated with standing with your weight on one leg all day with the other foot pushing a pedal which has resulted with plantar in my left foot and lateral sesamoiditis in my right also could these be a form of rsi......when away from my workplace for prolonged periods say a few weeks problems become less severe....when returning to normal working it takes less thn two days to begin the journey back to pain allday......

Result number: 76
Searching file 15

Message Number 155956

need some help View Thread
Posted by sherrie m. on 7/21/04 at 08:20

Hi, I need some help finding an over the counter orthotic for pf and sesamoiditis(metatarsalgia). I have been wearing over the counter orthotics or arch supports for around 5 years, i have had heel spur surgery and the eswt(which got rid of my heel pain) but now i am having forfoot pain which was diagnosed as sesamoiditis with tight flexor tendons in my big toes. I swithched the orthotics i was wearing and within a few days the pain shifted across the entire metatarsal area, metatarsalgia. I would like to find an over the counter othotic with a metatarsal arch already built in, any suggestions? Thanks

Result number: 77

Message Number 155345

Re: metatarsal arch question View Thread
Posted by Lynn M. on 7/13/04 at 15:56

Thanks to Dr. Z and Richard, I had the metatarsal bar put underneath my shoes for sesamoiditis in the big toe, i wore it for about 2 days and it irritated the sesamoiditis so i took the shoes off and put another pair on. Now 2 days later i am feeling pain under my 3rd and forth toes, maybe i irritated the nerve in between those toes. I asked about the metatarsal pad because i thought it might help both problems, i sure hope so!

Result number: 78

Message Number 154005

Arch support in my walking cast??? View Thread
Posted by AngelaC on 6/26/04 at 20:30

Would it be a good or bad idea to put a Dr. Scholl's Advantage arch support (over the counter) in my walking cast? After about 9 months, I was starting to get good, really good, improvement in my plantar fasciitis,but then got sesamoiditis. I continued to avoid pf surgery, but did choose to have, hammertoe surgery, thinking that it might knock out one of my foot problems and make me rest my foot a bit longer. At the first post-op visit, I found out that I had a stress fracture, and away went my surgical shoe, and out came a walking cast velcro shoe. Here's my question. I am very paranoid about losing any of my gains in pf improvement. This walking cast does not have much support in the arch. Actually, none. I don't have my regular orthotics, because those were taken to have some adjustments made. I just don't want to walk around for 3 weeks or so in a barefoot-like manner with no arch support, and start over. So I bought a pair of OTC arch supports, and it does feel good in the walking cast, but am I messing up what the walking cast is suppose to do in terms of shifting weight away from the 2nd metatarsal fracture? Thanks for any help with this; you have all been lifesavers!!!!
Angela

Result number: 79
Searching file 14

Message Number 148791

Re: Strassburg Sock View Thread
Posted by James C. on 4/12/04 at 20:44

I tried the Strassburg socks on both feet and the only problem I had was the cramping in my toes after about 1-2 hours of having them on. I am not sure what sesamoiditis is. I have tried the night splint as well and I guess my pf and tt was to far advanced for them to help me.I finally had to go under the knife after I tried EWST and all other conservative measures,orthotics(3 different types),cortizone injections,etc.I have talked to several people who said their orthtics worked for them.
GOOD LUCK
James C

Result number: 80

Message Number 148742

Strassburg Sock View Thread
Posted by Elyse B on 4/12/04 at 09:58

I posted earlier about night splints and was wondering if anyone heard of getting sesamoiditis from the Strassburg sock. I still have not ordered mine. Starting with orthotics first which are killing my arches but need to break them in longer I suppose (podiatrist says so).

Result number: 81

Message Number 146199

sesamoiditis View Thread
Posted by sandy h. on 3/06/04 at 08:54

I have been told I have this and the pain under my first metatarsal is the thing that is lingering the longest for me. it is a very niggly thing. forefoot posting on orthotics has helped to avoid the worst of the twinging pain when first starting to walk but left that area feeling a bit bruised. Any experts out there?
1

Result number: 82

Message Number 145784

Re: Need help here View Thread
Posted by AndrueC on 3/02/04 at 10:07

The medical terms she used were probably:

Plantar Fasciitis
and
Sesamoiditis.

The former is what this site is mostly about so read the heel pain book for some very useful information. PF is notorious for lasting a long time in some people and one year is nothing particularly unusual.

The latter is inflammation of (or around) the small bones under the ball of the big toe. This usually settles with appropriate treatment and now you know the spelling you can look that up on the web :)

One thing:PF can cause other issues because you start to walk funny in order to alleviate the pain.

Result number: 83

Message Number 144747

Re: COMPLICATIONS FROM SESAMOIDITIS SURGERY View Thread
Posted by Dr. Z on 2/19/04 at 20:44

I would have to see the foot and see the x-ray to give you my opinion.
Get a second opinion if you can

Result number: 84

Message Number 144741

COMPLICATIONS FROM SESAMOIDITIS SURGERY View Thread
Posted by CHERYL A on 2/19/04 at 19:03

I HAD ONE OF THE BONES REMOVED FROM THE BALL OF MY FOOT. IT HAS BEEN 5 MONTHS SINCE THE SURGERY AND I STILL CANNOT WALK PROPERLY. I CANNOT BEND MY BIG TOE. I HAVE A LOT OF PAIN IN THE SURGICAL AREA. IT IS AS IF I NEVER HAD THE SURGERY TO CORRECT THE PROBLEM. PHANTOM PAINS? I HAVE DEVELOPED A NICKEL SIZED KNOT ON THE SIDE OF MY FOOT JUST ABOVE THE INCISION AREA WHICH IS EXTREMELY PAINFUL EVEN TO THE SLIGHTEST TOUCH. THE INCISION ITSELF HEALED WITH NO PROBLEMS. I CANNOT WEAR BUT ONE PARTICULAR PAIR OF TENNIS SHOES BECAUSE IT HURTS MY FOOT SO MUCH. MY PODIATRIST HAS NO ANSWERS AS TO WHAT THE PROBLEM IS OR WHAT TO DO ABOUT IT. HE SUGGESTS CORTIZONE INJECTIONS. NO THANKS! DO YOU HAVE ANY SUGGESTIONS AS TO WHAT I CAN DO TO HEAL MY FOOT? I HAVE TO WEAR A BANDAGE OVER THE KNOT WHENEVER I PUT ON MY SHOE TO KEEP THE AREA PROTECTED, WHICH MAKES THE SHOES TIGHT AND MY TOES CONSTANTLY BRUISED. I HAVE TRIED LARGER SHOES BUT STILL GET NO RELIEF. ANY SUGGESTIONS YOU CAN MAKE WILL BE GREATLY APPRECIATED.

Result number: 85

Message Number 144740

COMPLICATIONS FROM SESAMOIDITIS SURGERY View Thread
Posted by CHERYL A on 2/19/04 at 19:02

I HAD ONE OF THE BONES REMOVED FROM THE BALL OF MY FOOT. IT HAS BEEN 5 MONTHS SINCE THE SURGERY AND I STILL CANNOT WALK PROPERLY. I CANNOT BEND MY BIG TOE. I HAVE A LOT OF PAIN IN THE SURGICAL AREA. IT IS AS IF I NEVER HAD THE SURGERY TO CORRECT THE PROBLEM. PHANTOM PAINS? I HAVE DEVELOPED A NICKEL SIZED KNOT ON THE SIDE OF MY FOOT JUST ABOVE THE INCISION AREA WHICH IS EXTREMELY PAINFUL EVEN TO THE SLIGHTEST TOUCH. THE INCISION ITSELF HEALED WITH NO PROBLEMS. I CANNOT WEAR BUT ONE PARTICULAR PAIR OF TENNIS SHOES BECAUSE IT HURTS MY FOOT SO MUCH. MY PODIATRIST HAS NO ANSWERS AS TO WHAT THE PROBLEM IS OR WHAT TO DO ABOUT IT. HE SUGGESTS CORTIZONE INJECTIONS. NO THANKS! DO YOU HAVE ANY SUGGESTIONS AS TO WHAT I CAN DO TO HEAL MY FOOT? I HAVE TO WEAR A BANDAGE OVER THE KNOT WHENEVER I PUT ON MY SHOE TO KEEP THE AREA PROTECTED, WHICH MAKES THE SHOES TIGHT AND MY TOES CONSTANTLY BRUISED. I HAVE TRIED LARGER SHOES BUT STILL GET NO RELIEF. ANY SUGGESTIONS YOU CAN MAKE WILL BE GREATLY APPRECIATED.

Result number: 86

Message Number 143497

what to do about sesamoid pain? does it get better eventually? View Thread
Posted by rekha on 2/02/04 at 17:19

Now that you mention it, when in 2000 my bilateral pf was extremely bad, they did an esr test and it was 3x the normal. meaning inflammation was very high. Since my sis had lupus, I did go see a rheumatologist. The rheumy did all of the tests and concluded that I did not have a rheumatological condition!

Could it be possible the returning fascia pain is due to biomechanical way that I am walking/pronating? I have been told eswt will take care of the inflammation, but biomechanical problems still needs to be adressed post eswt

I am now wearing the orthotics 100% of the time.

what is treatment for sesamoiditis? can you recommend anything? I am using a cushion under the area in my orthotics, what else can I do?

Result number: 87

Message Number 143496

what to do about sesamoid pain? does it get better eventually? View Thread
Posted by rekha on 2/02/04 at 17:18

Now that you mention it, when in 2000 my bilateral pf was extremely bad, they did an esr test and it was 3x the normal. meaning inflammation was very high. Since my sis had lupus, I did go see a rheumatologist. The rheumy did all of the tests and concluded that I did not have a rheumatological condition!

Could it be possible the returning fascia pain is due to biomechanical way that I am walking/pronating? I have been told eswt will take care of the inflammation, but biomechanical problems still needs to be adressed post eswt

I am now wearing the orthotics 100% of the time.

what is treatment for sesamoiditis? can you recommend anything? I am using a cushion under the area in my orthotics, what else can I do?

Result number: 88

Message Number 143495

what to do about sesamoid pain? does it get better eventually? View Thread
Posted by rekha on 2/02/04 at 17:18

Now that you mention it, when in 2000 my bilateral pf was extremely bad, they did an esr test and it was 3x the normal. meaning inflammation was very high. Since my sis had lupus, I did go see a rheumatologist. The rheumy did all of the tests and concluded that I did not have a rheumatological condition!

Could it be possible the returning fascia pain is due to biomechanical way that I am walking/pronating? I have been told eswt will take care of the inflammation, but biomechanical problems still needs to be adressed post eswt

I am now wearing the orthotics 100% of the time.

what is treatment for sesamoiditis? can you recommend anything? I am using a cushion under the area in my orthotics, what else can I do?

Result number: 89

Message Number 143440

Re: pf and sesamoid pain-please advise View Thread
Posted by rekha on 2/01/04 at 19:43

Oh Dr Z, how are you? I use to correspond with you a lot back in 1999 & 2000, and you are the one to give me the phone number for Dr Shapow's office in LA to get orby done back in 2000- back when not that many treatment centers existed.

I definitely have pf, all the classic signs, morning pain, pain after sitting, etc.

I am exhausted fighting this pain, and have spent so much money in the last 5 years on eswt, orthotics shoes, heelpads, shoes and more.

Like I stated, my pain always gets better after eswt but returns with a vengeance. I am trying to be compliant with the orthotics 100%. Just recently I had a setback with sesamoid pain!! I have never foot pain in metatarsal region ever! This had in turn made my heel pain worse.

I am just very frustrated, and want to return to a time when feet were not on my mind anymore....

I had an mri, showed a spur and inflammation. I have seen 6 different pod's . My pod at Kaiser was horrible and I have quit seeing them and pay for all pod visits out of my own pocket!

What is treatment for sesamoiditis? does it usually resolve itself? what can I do?

any input appreciated!

Result number: 90

Message Number 143433

pf and sesamoid pain-please advise View Thread
Posted by rekha on 2/01/04 at 19:01

hello everyone, I havent posted for ages. I usually check this site once or twice a week.

I have had pf problems since 1999 when I started posting on this site.

I had the orby done in 2000, then again in 2001, always relieved the pain, but somehow the pain always crept back sooner or later.

in Feb 2003 pain came back in right foot this time had ossatron done this time in March 2003, however this time around the pf pain has not responded
that well. I spent $3000 this time and cannot afford to keep on paying for these treatments. I did get better this summer, only to somehow get sesamoid pain from overcompensating, which was a setback and caused me to walk funny. Dr thinks that orthotics are the answer to my biomechanical problems.

With these two problems in my right foot (pf and sesamoiditis) what should be my next course/ I tried cortizone in the sesamoid area, and pain got better for a bit but returned.

do you think orthotics are the answer? please any doctor advise me

my doctor thinks I should try cryotherapy and ultimately surgery on my right foot for PF I have resisted surgery so far in 5 years, and do not want that, but my dr says all of his surgery patients are doing well, and he does a special type of surgery.

Please advise me....I am not sure how to walk anymore.

Result number: 91
Searching file 13

Message Number 137496

Re: sesamoiditis View Thread
Posted by Mar on 11/14/03 at 11:53

They say rest, flat shoes, ice. I have had mine for 2 1/2 years with no relief. Most people get better in a month or so though. Good luck. Mar

Result number: 92

Message Number 137028

sesamoiditis View Thread
Posted by sandy h. on 11/11/03 at 07:57

Can ESWT help treat this? It's the most painful and hard to get rid of part of a multiple collection of swellings I've got in my left foot.

Result number: 93

Message Number 137027

sesamoiditis View Thread
Posted by sandy h. on 11/11/03 at 07:56

How should this be treated. I got rid of most of my heel pain and am left with this pain under my big toe that seems to take longer to get rid of.

Result number: 94

Message Number 137026

sesamoiditis View Thread
Posted by sandy h. on 11/11/03 at 07:55

How should this be treated. I got rid of most of my heel pain and am left with this pain under my big toe that seems to take longer to get rid of.

Result number: 95
Searching file 12

Message Number 124704

Re: ESWT a suitable treatment for sesamoid problems? View Thread
Posted by Billie C. on 7/18/03 at 09:38

Thank you for your reply. In my case the sesamoiditis is caused by arthritis, and one bone would be removed. Would it be possible to use ESWT as a treatment, and are any risks?

Result number: 96

Message Number 121318

Re: Does anyone have this pain? View Thread
Posted by Mar on 6/08/03 at 17:26

I have sesamoiditis in that place -- pain and swelling -- mine was a result of bunion surgery and is surely related to the PF. Most sesamoiditis is treatable, I believe. Mar

Result number: 97
Searching file 11

Message Number 116497

Re: Os trigonum syndrome View Thread
Posted by Mar on 4/18/03 at 07:48

Docs -

Now what do you suppose caused the chronic sesamoiditis? The way i walked after the bunion surgery? The way the foot was repositioned after the surgery? Something done wrong during the surgery? What starts something like this? What prevents it from healing even without walking on it much?Now if I have more surgery to remove it, is there the possibility of something else becoming chronically inflamed so that I still would not be able to put full weight on the foot or even be able to walk at all? The idea of getting rid of this diseased and painful bone is so appealing to me but the possibility of further complications makes it almost impossible. The whole irony of the suggestion to remove the bone is not lost on me! I left my surgeon because he was eager to do more surgery (said it was his favorite part of being a pod- with a glint in his eye!) and now i may wind up right back in surgery! Mar

Result number: 98

Message Number 112090

Re: RE: Another ESWT question - just curious View Thread
Posted by Mar on 3/07/03 at 05:38

OK - now what about inflammation that continues and continues? Like the sesamoiditis and surrounding tissue inflammation that I have had for 2 years since bunion surgery. Is there no way to shut off that inflammatory response?

As to my PF - I still have some inflammtion according to the ultrasound I had a week ago. But what can be done to get rid of it or if there is no inflammtion, how do we get the body to heal again and stop the pain response?

Thanks for your explanations - they are very interesting and clear.

Mar

Result number: 99
Searching file 10

Message Number 104861

Re: Dr. Z. question View Thread
Posted by Dr. Z on 1/04/03 at 20:34

This has me baffled. That is why I want the both feet x-ray's . You may have a stress fracture that was there before the procedure or developed after the procedure. You could have a tear in the FHL/brevis tendon. I will love to beable to examine you but your are too far away. So my guess is one of the of the following
1. Tendonitis
2 Sesamoiditis
3 Stress fracture
4 Maybe RSD ( maybe
5. Joint capsulitis secondary to shifting your weight away from your heal.
6. May be a ligament, tendon tear.

Result number: 100

Message Number 103518

Re: Cam Walker View Thread
Posted by Mar on 12/18/02 at 20:26

Nancy and Pam --

Thanks to both of you. I'll work with this cam a few more days. I just tried putting my orthotic in it to at least relieve the heel pain a little. I'll wear it tomorrow that way to work and see how it goes. The leg is still bruised, but with a heavier sock and some more foam rubber, it is a little better. I want to try it a few days before complaining to the doc. I am a bit impatient with wanting things to work immediately! Yes, i too am using the cam on my worse foot. I fear that the other foot is going to become the worse one!! It already has chronic sesamoiditis and fibrosis in the ball of the foot in addition to the heel pain! I've been walking only when i absolutely have to and crawling in the house. Thanks for your support and suggestions, I'll let you know... Mar

Result number: 101
Searching file 9

Message Number 95880

Re: Post ESWT View Thread
Posted by Dale on 9/21/02 at 04:59

RE: My post about being worse after ESWT treatment.

Sorry to be so slow to reply, I have had the flu & been off the net a while.
My last ESWT treatment (in a series of 3, 1 week apart) was July 3 so about 10 to 12 weeks.

I do have very high arches and this is no doubt the original cause of the problem, in the late '60 and early '70 I lived 3 years in Hawaii, never wearing shoes, only flip-flops, and some years later, I found my feet often felt very hot, and for many years would wear only sandals or very open shoes which had no support.
(I should say that some doctors have said I have a normal arch, and one even tried to tell me I had flat feet, but the consensis is 'normal' to 'high' arch.

No I do not have equinus as far as I know. I have full motion and flexibility in all my joints. I do, however, have tight calf muscles, even as a teenager I could never touch my toes with my knees locked. This too may be part of the problem. I am working on stretching my leg muscles, but it is not clear to me what exercises will really stretch the calf muscle and not also put strain on the planar fascia.
Since the planar fascia is inflamed, and over stretched already, the last thing I want to do is any exercise that would stretch it further.
How can I stretch the calf and thigh muscles without stretching the planar fascia? I see a lot of advice, but much of it is contradictory, and I am sure much is ill informed. The various muscles and the fascia are closely connected and so it is not a trivial problem to get it right.

RE limping in the morning: yes, a little, but more from caution than pain. I am aware that my muscles are tight in the morning, and I walk very carefully until I have stretched and loosened up a bit. There is some extra tenderness at that time, but not much. Stretching, by pulling back on the foot, while still in bed, seems to solve most of the problem.

Was what "confirmed by ultrasound testing"? That I have an inflamed planar fascia? A few years ago I had an MRI scan and it confirmed that there was a mild inflammation of the planar fascia. Nothing since.
One doctor in Canada, by pressing on the sesamoid bones, could show that that was a clearly extra painful spot, and suggested that I might have sesimoiditis, and said that I should have a bone scan to confirm it. Just what is a "bone scan" Specifically he reported, "Tenderness of distal metatarsal bones 2 to 4 bilaterally. There is significant tenderness on palpation of the lateral sesamoid bone bilaterally." He said, "X-ray of the right foot shows some mild fragmentation of the lateral sesamoid bones, no other abnormalities."
He recommended a "complete bone scan to look for possible sesamoiditis."

Any suggestions are appreciated.
Dale

Result number: 102

Message Number 95443

Re: sesmoiditis View Thread
Posted by Mar on 9/16/02 at 12:32

Dr Z --

Yes, I had bunion surgery (right foot)a year and a half ago (March 2001.) I was in a lot of pain and swelling. The pod who did the surgery kept telling me to give it time to heal so I went 7 months before he finally gave me a cortisone shot, which did not help at all. (No other treatments or exercises were prescribed this entire time.) Then he thought I had a stress fracture which I did not. I switched pods (November 2001), had a CT, and found that I had a bipartite sesamoid that was inflammed. I have been icing it since then (11 months), had 2 more cortisone shots there (no help), took medrol twice, accomodations in orthotics. I can't take NSAIDS or pain killers, except aspirin, which doesn;t seem to help. Basically the pain starts there and spreads all across the ball of the foot. Somedays the pain is not too bad, other days it is severe. Heat and humidity are not good. My pod says my fat pads are normal. My range of motion is pretty decent. He says the body is treating the sesamoiditis as a foreign object. I have bipartite sesamoids in both feet, but sesamoiditis only in the right foot. The PF pain is far worse however, and I am sure hoping to be able to resolve that first. My ESWT doc thought that the ESWT might also help the sesamoiditis. So far it hasn't helped anything, but I am remaining hopeful. Thanks for your interest -- do you have any suggestions????? I am so tired of being in pain and being leading a sedentary life style -- ok, I'll stop whining. Thanks Mar

Result number: 103

Message Number 95389

Re: sesmoiditis View Thread
Posted by Dr. Z on 9/15/02 at 21:09

Some comments about sesamoiditis. This will usually clear up with local steriod injection. Taping with padding. Plastizole padding. Very rare to have this both feet. Mar I believe you had foot surgery. Sesamoiditis from bunion surgery is usually due to damage to the sesamoid/ first met complex. Restriction of motion 2nd to bunion surgery or a first ray plantarflexion., Do you have anything like I have described above. Is yours both feet.? How is the range of motion of your big toe joint. What is the status of the fat padding under the sesamoid bones.?? What treatments have been used for your sesamoiditis ?

Result number: 104

Message Number 95386

Re: sesmoiditis View Thread
Posted by Mar on 9/15/02 at 20:32

I would get to a pod as soon as possible and get treatment for the sesamoiditis. I have chronic sesamoiditis because my original pod kept telling me to give it time to heal and did nothing for it. Now nothing seems to work to clear it up. It is constantly painful and along with PF that I developed trying not to walk on the sesamoid, I can hardly walk at all. So -- get help fast! Mar

Result number: 105

Message Number 95216

Re: Post ESWT View Thread
Posted by Dale on 9/13/02 at 01:59

I have a chronic case of PF possibly compounded by sesamoiditis in both feet. Soreness and tenderness in the fleshy part of both feet, and occasional sharper pain at the front of the heal.

After some years of trying various investigations (x-rays, MRI, nerve speed, circulation) and treatments, (many inserts, anti-inflammatories, stretching, etc.), I decided to try ESWT. I took the treatment, in 3 sessions, with a Sonorex machine, in Vancouver Canada.

It is now 6 weeks later and my feet are clearly worse than before!

Before treatment, my feet would recover if I stayed home and avoided standing and walking for a few days. Now they remain mildly but almost continually sore despite weeks of rest. They become very sore very quickly if I must stand or try to walk in a shopping mall or any other hard flat surface. Even sitting at my desk, with my feet on the floor causes them to become sore. Only by raising them in a recliner chair, or sitting on a bed, allows them to recover.

Has anyone else, who has tried ESWT treatment, had a bad result like this?
If so I would like to hear about it.

Swimming seems to help alleviate the discomfort somewhat, but just walking to and from the pool is a problem, especially because the floor is tile.

Also after so many years with this problem, I have concluded that there is only one really reliable treatment for me; that is to simply not walk for several weeks or perhaps months. And now I am not sure that even that will work.

Questions?
Is there anything that would keep all or nearly all the pressure off the planar facial, and the sesamoids? Something like a cast, but less drastic, something that could be put on and off. Any suggestions?

Does anyone know of some sort of health resort or spa, preferably in Europe, where I could go and stay a while in a situation where I could be completely off my feet, perhaps with a wheel chair, but have the opportunity to swim and otherwise exercise to keep the rest of me in good condition?

Any ideas or suggestions are welcome.

Can anyone suggest any other sort of treatment, anti-inflammatory drug or whatever that would reduce the inflammation and allow healing to begin?
[ I have tried ibruporfin (helps a little), Votarin, and Nifluril (no noticeable effect)] I am trying to avoid sugery and cortisone injections though I may have to find someone to do the injections if nothing else works.

Any other ideas?

Result number: 106

Message Number 92589

Re: Medial Column System; Rothbart View Thread
Posted by BGCPed on 8/15/02 at 16:14

Thepublications listed are not familiar to me. I dont know if they are peer reviewed and if so to what degree. There are many theories as to what causes the cavus foot. It is obvious that it is idiopathic in the majority of cases. There are also some "chicken or the egg" arguments as to what results, gets worse or changes from a structural standpoint.

Some examples are plantarflexed first met, hindfoot varus, tight heel cord, peroneal overdrive, tibial/genu varum are some of the more common. You could claim that some of these deformities create or enhance others. I dont buy the claim that these feet can be reshaped with a varus wedge under the 1st met. That type of correction could create more inversion instability, possible jone fx, sesamoiditis and jam up the lis franc as you mentioned.

I am not picking on the Dr but if you make some very bold claims as he has over a device that is simply a forefoot varus wedge it should be questioned. I also dont get the claim that it works for both pronated AND supinated feet, sounds to me like they are trying to catch eveybody in one net for the purpose of sales. The device the device that Dr Pryce patented is similar to a sorbotahne insert with a medial wedge running from the heel and blending in near the toe with the greatest elevation under the first met head.

Perhaps Dr Ed and some others can add to this

Result number: 107
Searching file 8

Message Number 88612

Re: Help choosing sneakers/shoes View Thread
Posted by Donna SL on 6/27/02 at 15:32

Hi Peggy,

I know Duke takes insurance. Degis was the last name I couldn't remember of the 3 in the group, but see Duke, if you must have the ins cover it. It's better not to wait. The sooner you get it taken care of the better, because things only get worse.

Also met pain can be from tight fascia, tendons, muscles too. My pod thought I had sesamoiditis, but nothing showed on x ray, or MRI. It was actually tendonitis from the abductor hallucis (I think) muscle, and when the chiro worked on that the mets got better. It's really amazing. He also worked on other areas like the adductor hallucis that helped the rest or the metatarsal pain. Art can get out even old neuromas most of the time. I just had one starting that the chiro took care of right away, and I have not had any trouble since.

Even If you have to pay out of pocket in the long run it will save you thousands of dollars in other medical cost, plus take away, or prevent futher pain, and problems. It saved me from Tarsal tunnel surgery, and god knows what else. It's worth every penny. Also ART practitioners that are also instructors should really be good. I think Defastano is an instructor, and also Schnieder, again I heard is the best, but you could start with the others who are good too.

You will be so impressed when you see how much they know about the feet, ankles, etc. They are trained extremely well from this ART course.

Donna

Result number: 108

Message Number 88084

Re: plantar fascia and metatarsal pain View Thread
Posted by Dr. John Cozzarelli on 6/20/02 at 05:28

Sesamoiditis will have pain directy under the big toe. On diret palpation pan will be present. Your foot wil hurt more with thin sole shoes.

Dr. John Cozzarelli

Result number: 109

Message Number 88083

Re: Persistent Plantar facitis, bone spurs, sesmoiditis View Thread
Posted by Dr. John Cozzarelli on 6/20/02 at 05:26

Hi Harriet:

Get a soft tissue scan (MRI or diagnostic Ultrasound) to confirm the fasciitis or sesamoiditis.

Dr. John Cozzarelli

Result number: 110

Message Number 88066

Re: plantar fascia and metatarsal pain View Thread
Posted by Josh T on 6/19/02 at 21:15

Dr. C,
Thanks for your help.
BTW: I do plan on seeing a Podiatrist this week for good measure. How would would I be sure that this symptom is not sesamoiditis? What are the key differences? Can one symptom lead to the other?

Result number: 111

Message Number 87486

Re: PT View Thread
Posted by Mar on 6/13/02 at 16:36

Oh -- I thought of a question. The front of my right foot where I had bunion surgery is still painful and sore -- sesamoiditis and who knows what else. Will the paraffin be okay on that? Right now I use heat on the heels (after ESWT) and ice on the ball of the foot. Thanks - Mar

Result number: 112

Message Number 87438

Re: Dr Ed -- Distal PF View Thread
Posted by Mar on 6/13/02 at 09:00

Ed --

Both he and my other pod feel that the pain around the big toe joint is from the sesamoiditis (bipartite sesamoid) and that the fascia may be pulling on it making it worse. Dr. W feels that the fascia will become more elastic after the ESWT on the heels and then not pull as much on the big toe area. As for the rest of the pain in the ball of the foot, I think both of them are not sure why this lingers. Dr. W feels I have thin fat pads, my other pod does not.

Mar

Result number: 113

Message Number 87323

Dr Ed -- Distal PF View Thread
Posted by Mar on 6/12/02 at 13:32

Ed -- I promised to keep you posted. I asked Dr. Wishnie about the distal PF (remember metatarsalgia and sesamoiditis) and he said it isn;t indicated right now and that the ESWT I had on the heels may also help relieve some of the metatarsalgia. Mar

Result number: 114

Message Number 86191

Re: Metatarsalagia View Thread
Posted by Mar on 6/03/02 at 19:26

I had ESWT on the heels with Dr. Wishnie 12 days ago. Dr. Z recommended him as he is closer to me than Dr. Z. So now I am waiting with hope to see the heel pain disappear. Dr. W said that when the fascia heals, it may also help the sesamoiditis as the fascia will not be as tight and not pull as much on the sesamoid area??? I think this is what he said! I sure hope so. Should the ESWT be aimed at the distal plantar fascia??? I'll ask Dr. W. when I see him next week for my 3 week follow-up. Mar

Result number: 115

Message Number 86060

Re: Metatarsalagia View Thread
Posted by Mar on 6/02/02 at 07:19

Docs --

I have been wearing custom orthotics almost exclusively since the end of December -- still have the metatarsalgia and sesamoiditis -- ice it regularly -- have ultrasound treatments twice a week. Had my first pair of custom orthotics last August but we could never get them adjusted right and they provided no relief for the ball of the foot. (They actually aggravated my good foot and started all kinds of problems there.) When I changed pods in Nov, he fitted me for the ones I currently use. Any other ideas??? I am beginning to think that this will never go away and I will never be able to walk much and be active again. Thanks -- Mar

Result number: 116

Message Number 85764

Re: sesimoid View Thread
Posted by Mar on 5/30/02 at 10:57

I am interested in that answer also. I have chronic sesamoiditis ever since my bunion surgery 15 months ago. Walking to protect it, I developed PF. Just had ESWT for the PF. I wonder if I will ever get rid of the sesamoid pain. Mar

Result number: 117
Searching file 7

Message Number 78700

Re: Forefoot Pain and 1st MTP joint. View Thread
Posted by Ed Davis, DPM on 4/06/02 at 16:04

Katharine:

We really need an accurate diagnosis before being able to look at treatments. Sesamoiditis (an inflammation of the small floating bones beneath the big toe joint) is treated one way and hallux rigidus/limitus (painful limited range of motion of the big toe joint) is treated another way. Your rheumatologist's interpretation clues me that there may be a functional "jamming" of the big toe joint. That can be treated via physical therapy and orthotics. The goal of the orthotic is to facilitate big toe joint motion and relieve jamming-- something your current orthotic may not be doing.

You may benefit from evaluation by a podiatrist with a strong biomechanical background. Where do you live?
Ed

Result number: 118

Message Number 78690

Forefoot Pain and 1st MTP joint. View Thread
Posted by Katharine on 4/06/02 at 15:15

My foot pain started about 10 years ago an occurred in spring and fall in my right big toe. As it would disappear after rest, and about a week, I never investigated. I've always noticed that if on my feet too long, they burn under the forefoot.

1.5 years ago, I went on a fitness craze, and began walking and cycling about 45 minutes daily. My big toe on my right foot began to hurt. I thought I could walk through it, bought new shoes, but eventually quit walking and cycling due to pain. The pain eased enough for awhile, but in six months I was in agony with burning throughout my forefoot. I this time I did not notice localized pain in the big toe. This was in May.

Then, in August (4 months later), the general pain in my feet eased, but I was left with pain in my big toe joint. It hurt to but any weight on my forefoot big toe joint. I had gone to my doctor several times at this point, but he said nothing was wrong.

Finally, in Novemver, (4 months later), I went to my physician and insisted on X-rays. I was told I had osteoarthritis of the first MTP joint. I then went to a rhuematologist who looked at x-rays and said that my 1st MTP joint had no bony spurs and was rounded. I did have a small bump on the top of the joint, but this could be genetic he said. So, no reason why my toe shoud hurt apparently.

I went for another opinion to a podiatrist. He suggested possible sesamoiditis. I am on anti-inflammatories (Celebrex) and have been on them 1 month. They are helping mildly, but I cannot really walk properly. I've had orthotics made to distribute weight under metatarsal heads, but this helps only a little as well. I want to be fixed! I want to be able to bend. Right now I cannot go down steps, as it is painful. I cannot bend to get into bottom kitchen cupboard. My toe sometimes feels stiff, and an other times it feels like it is too limber and bends too far when I toe off. I would really like to confirm diagnosis. Do you have any ideas. Not being able to toe off is a really difficult problem.

Result number: 119

Message Number 72835

Would like doctors opinion on Dansko Shoes View Thread
Posted by rebecca h on 2/06/02 at 18:05

I've been diagnosed with plantar fasciitis, sesamoiditis and possible post tibial something. Pain is in inner ankle, inner arch and under big toe joint. I have tried many shoes. Would like your opinion on Danskos.

Result number: 120

Message Number 72246

Re: Q esp for docs re: TTS and irritating shoes View Thread
Posted by rebecca h on 2/01/02 at 18:54

This is a good question. I don't have TTS. Or at least I haven't been diagnosed with it, but I do have irritation in the posterior tibial tendon which is in the same area. I have had an seemingly hopeless shoe search. Some (like the Brooks Addictions) are good for sesamoiditis, which I also have, but irritate the post tib. I tried on some A N D 1 basketball shoes today and they felt really good. I almost bought them but because they bend in the middle of the shoe instead of the forefoot I didn't since I also have plantar fasciitis which is supposed to be aggravated by a shoe that bends in the middle. Birkenstocks feel good in the arch but hurt my forefeet. Other shoes were good for one problem but not another. I hope someday to find a shoe that is good for all the pain areas in my foot.

Result number: 121
Searching file 6

Message Number 69956

pain under ball of my foot - not while walking View Thread
Posted by vickip on 1/14/02 at 11:07

Dear Doctor:
I recently started a formal exercise plan with a personal trainer and am walking on the tredmil about 40 minutes a week. I have recently developed pain under the ball of my foot. It hurts mostly when I am not walking. Last time I had this pain, I went to a podiatrist, then an orthopedist who diagnosed me with sesamoiditis. It went away but I think it is back. Will orthotics help? What else can I do? I also had planter fasciatis in the past and wear special orthopedic-type shoes.

Result number: 122

Message Number 69000

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by rebecca h on 1/06/02 at 20:07

I am longing to be walking around. Part of my problem is that I have no shoes that are comfortable to wear more than two minutes at a time. I can walk around a little in my bedroom on very soft cushioned carpet. The rest of the house is "beautiful hard wood floors" HA! I'd give anything for ugly soft carpet! : ) I tried Birks. They don't seem to be for me, though. Still way too much forefoot pain in them. I tried New Balance but they didn't work either. Spent 140.00 on Zeetas sandals that have a metetarsal arch. The guy at the store was sure they would cure me. They are the only shoes I can wear for a few minutes at a time but still don't seem high enough or stable enough in the heel. Tried Easy Spirit Mesas. Even though they were Wides they didn't feel wide enough for my sensitive forefeet. Just ordered some Brooks they elliot recommended. I'm hoping... but trying not to hope too much. Seems like every time I've tried something that was supposed to be the answer it wasn't. So now my guard is up. This is so depressing! I do appreciate your posts and I know you're right about getting out of the wheelchair as soon as possible.

Result number: 123

Message Number 68893

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by wendyn on 1/05/02 at 23:28

Please try to get out of the chair ASAP. I know it's a great way to rest your feet - but you may want to just use it for the longer periods you'd have to spend on your feet.

Even if you have major surgery - they will get you up and moving as quick a possible...it just is not good for your bod to remain so motionless for so long. And you will be AMAZED at how fast your muscles will start to deteriorate from not using them.

I have had serious problems with my Post Tib tendon - so I do know it can be most painful.

I'm not trying to tick you off - but I am concerned..(best intentions)....

Does your doctor know you're using the chair?

Result number: 124

Message Number 68889

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by rebecca h on 1/05/02 at 23:17

Only one week. Getting really good at it too. It lets me stay active in the life of my family. I can go from one room to another, bark orders at the kids.... : ) Its hard pscychologically though. I always have associated wheelchairs with someone near death or permanently disabled. But it seems to be the only way I can really stay off my feet.

Result number: 125

Message Number 68845

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by wendyn on 1/05/02 at 16:11

Rebecca, I didn't realize that you're using a wheelchair.

I know that when my feet were really bad I considered using a chair all the time...but you can create new problems if you're in a wheelchair - very quickly your muscles can atrophy - and you will lose strength really fast.

If absolute rest is required, usually doctors will cast. (if it's only one foot).

How long have you been using the chair?

Result number: 126

Message Number 68842

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by rebecca h on 1/05/02 at 15:40

I don't only have sesamoiditis, but also have post tibial tendonitis. I have chosen to use a wheelchair because the doctor said my feet wouldn't get better unless I stay off of them. Thanks for the information. Its hard to believe ballet dancers can keep dancing with this. It hurts so much. Not that I don't believe you. : )

Result number: 127

Message Number 68769

Re: sesamoiditis...how long, in your experience...does it take? View Thread
Posted by Ed Davis, DPM on 1/04/02 at 21:40

Did you say you were in a wheelchair for sesamoiditis? If so, find a new doctor ASAP? Get out of the wheelchair.

Strict rest is rarely required to treat sesamoiditis--it is only required if there is a sesamoid fracture.

First--what was the cause of the sesamoiditis? Affecting both feet? The tibial sesamoid or the fibular sesamoid?

Tibial sesamoiditis is very common in ballet but it rarely slows the dancers down. A few drops of cortisone is placed around the tibial sesamoid and a "dancer's pad" applied which is an aperture pad for the sesamoid bone---the dancer then goes back to work. A similar treatment can be performed for non-athletes (works better for non-ballet people because they don't get right back up on their toes). The aperture can be applied directly to the skin, to the shoe insole, incorporated into an orthotic, etc.

Two other treatments include a metatarsal bar applied to the shoe which allows your foot to roll over the tender sesamoid or a rocker sole.

Despite the above, there may be some persisting tenderness for two to three months, but not the type of pain that would significantly interfere with one's activities if treated properly.
Ed

Result number: 128

Message Number 68717

sesamoiditis...how long, in your experience...does it take? View Thread
Posted by rebecca h on 1/04/02 at 15:20

I've been reading all these foot websites that say things like "to treat sesamoiditis a strict rest is required." How long, in your experience would it normally take to heal up. (I have it in both feet along with post tibial tendonitis) and have literally been off my feet for a week 24 hours and 55 minutes per day. But when I do walk a few steps (in shoes of course) the forefeet still hurt. Give me some hope here. I have five children to raise and I really don't want to live in this wheelchair forever but a week in a wheelchair feels more like a year...( I am being treated by a good doctor) Am I an impatient patient?

Result number: 129

Message Number 68486

Re: help me understand how cortizone works... View Thread
Posted by rebecca h on 1/02/02 at 22:07

I've been rackin' my brains trying to figure out HOW I got sesamoiditis.
Here are some possibilities I guess:

1.Bouncing babies on my knees too many times singing "ride a little horsie goin' to town.." lotsa pressure on forefeet...

2. Carrying loads of laundry up and down wooden basement stairs.

3. Helping out with a children's program last summer where we did alot of wild and crazy crouching down and running through tunnels of kids with their hands joined above our heads.

4. Line dancing in the kitchen with my husband. Sometimes while holding a child or toddler.

5. walking in an airport a long way in bad shoes.

Which one would you vote for as the cause?

Result number: 130

Message Number 68392

help me understand how cortizone works... View Thread
Posted by rebecca h on 1/01/02 at 19:35

I got a cortizone injection for sesamoiditis last Thursday.
Wow, so far it has really made a difference!!!!!!!!
My forefoot feels so much better!!!!!!!


I was just curious...

Is cortizone only a pain killer or does it actually help in the healing process?

What exactly does cortizone do?

Thanks for your time,
rebecca

Result number: 131

Message Number 68388

Re: a little more View Thread
Posted by rebecca h on 1/01/02 at 19:24

When it hurts: When standing or walking. Also at night the pain in forefeet wakes me up with throbbing. (Icing gets me back to sleep) Forefeet hurt most on Up Phase of walking. Standing on tip toes is really painful. Doctor said my feet won't heal unless I stay off of them. So I'm doing the wheelchair 23 hours and 55 min per day. Birkenstocks helped the arch pain but seemed to make my forfeet worse. custom orthotics made heel pain decrease but increased inner ankle pain and didn't help forefeet. Oh, we're talking about different doctors, by the way. The first two diagnosed PF. The third, and best, diagnosed Posterior Tibial and Sesamoiditis, which makes more sense to me. The second doc was the one who got me the dissapointing custom orthotics. I believe I am in better hands now, with the new diagnosis. Also he is the firtst doctor to tell me I really need to get off my feet to heal, which makes all kinds of since to me. And he told me I should ice 20 minutes every 2 hours which I am doing. Sorry this got so long and meandering. : )

Result number: 132

Message Number 68364

Re: what exactly are your symptoms? (nm) View Thread
Posted by rebecca h on 1/01/02 at 15:35

inner forefoot pain, inner arch pain, pain in heel or just in inner front of heel. was diagnosed by first two docs with PF. Third doctor says Post Tibial Tendonitis and sesamoiditis as well. Got cortizone shot in worst forefoot. Got soft cast on worst foot. Icing 20 minutes every 2 hours.
By the way, welcome back

Result number: 133

Message Number 68123

posterior tibial tendonitis shoes? sesamoiditis too... View Thread
Posted by rebecca h on 12/30/01 at 09:18

Is there such a thing as a shoe out there that helps both these problems?
I have tried so many different shoes... including New Balance and Arizonas.

right now I'm totally off my feet to help them heal. But after that, is there any hope that I will ever find the right shoe?

Result number: 134

Message Number 68024

new diagnosis View Thread
Posted by rebecca h on 12/28/01 at 19:10

Hi everyone!
Well....
after my appointment with Dr. Kosova yesterday I've learned that there was more to my foot pain than Plantar Fasciitis. My forefoot pain was from sesamoiditis (the little bones just under your big toe joint) and I also have posterior tibial tendonitis. It really hurt when he pushed on this tendon which runs around the inside of the ankle. I knew it had to be more than just plantar fasciitis. NOT that THAT isn't enough!! I got an MRI too which showed nothing remarkable. It's good to know I don't have any fractures or anything serious. I am now totally off my feet (well, except for maybe 5 minutes per day.)and icing for twenty minutes every two hours with soft fabric covered gel pacs. I now finally feel like there is light at the end of this foot pain tunnel. Even though it was an hour and a half from my house it was worth the trip . I would encourage you all to keep hunting till you find a doctor you feel good about. Hope you are all getting better.

rebecca

Result number: 135
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Message Number 55683

Nothing is Helping my Heel Pain View Thread
Posted by Anne D. on 8/06/01 at hrmin

Dear Doctor,

Two years ago, I was diagnosed with chronic sesamoiditis in my left foot. I got a pair of Alznner orthotics (Sept. 1999) and the metatarsal lift in them relieved the pain in the ball of that foot completely, so I kept on wearing them.

For a year I had no problems. Then, about nine months ago, I started having terrible heel pain in the other (right) foot. I went to see an orthopedic doctor. He took an x-ray and found some calcificationon the bottom of my right heel. He diagnosed the problem as plantar fasciitis and gave me a cortisone shot. It didn't help. That was in January 2001.

The pain got worse, so several weeks ago I started seeing a chiropractor, who manipulated my spine and neck and applied TENS therapy to my heel. It didn't help.

Recently, I was referred to another chiropractor who says it's not plantar fasciits, but rather a heel bruise that I keep re-bruising, since I'm not walking correctly on it. He said I'm over-pronating. He manipulated my foot and deep-massaged the plantar fascia to rid it of "uric acid crystals." He also gave me some new, more rigid orthotics from his office, which a higher longitudinal arch and more of a cupped heel, so my heel doesn't roll as much. It hasn't helped.

I don't know what I have, but I know one thing for sure, my right heel hurts like ****!!!

Can you please offer any suggestions?

Thank you very much,

A.G. Davis
Irvine, CA 92614
949-322-1967

Result number: 136

Message Number 52736

Re: sore feet View Thread
Posted by Dr. Marlene Reid on 7/11/01 at hrmin

There are so many things that can cause pain in that area that are usually related to foot structure and deformities and the problems they cause, such as bunions, bursitis, sesamoiditis, fracture, etc. Impossible to tell without an exam. If it keeps up, see a podiatrist.

Result number: 137
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Message Number 40702

Re: Pain in plantar surface of both big toes View Thread
Posted by Dr. Zuckerman on 3/07/01 at 10:50

Could be flexor tendonitis. Sesamoiditis these are the little bones that are below the big toe joint). Or it could be plantar capsulitis.


So what to do about this.

Rest. Take adavil three times daily for one week if you can take this medication. No bare feet. Avoid bending and placing full weight on the foot.

If this doesn't improve in the next few days go to your doctor and get an x-ray and a complete examination. of this area .

Result number: 138
Searching file 2

Message Number 28388

Re: bilateral toe pain View Thread
Posted by Dr. Zuckerman on 9/16/00 at 14:45

When we talk about under the big toe I am talking about under the first met head in the ball ov the foot. If this the case then the following could be the problem

1. sesamoiditis
2. Flexor hallucis brevis tendonitis
3. Distal plantar fasciitis.
4. Neuromal maybe but rare
5. Stress fracture of the sesamoind bones maybe but I doubt it.
6 Plantarflexed first met bone, which can cause the pain in the ball of the first met head.
7. Plantar first met head bursitsis and or capsulitis

So is this the area we are talking about.Result number: 139
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Message Number 3919
Re: pf PAIN on balls of feet & NOT heel?
Posted by Cathy on 1/26/99 at 00:00

I have the same symptoms and was told that the pain in the ball of the foot is sesamoiditis(irritation of the sesamoid bones)and the numbness is pressure on the the plantar nerve.The podiatrist swears by Active Release Technique {If you have high arches}Check out the ART info on this website.There are only 500 practioners in North America.I start treatment Monday and will keep you posted.Don;'t give up hope.

Result number: 140

Message Number 3918

Re: pf PAIN on balls of feet & NOT heel?
Posted by Cathy on 1/26/99 at 00:00

I have the same symptoms and was told that the pain in the ball of the foot is sesamoiditis(irritation of the sesamoid bones)and the numbness is pressure on the the plantar nerve.The podiatrist swears by Active Release Technique {If you have high arches}Check out the ART info on this website.There are only 500 practioners in North America.I start treatment Monday and will keep you posted.Don;'t give up hope.

Result number: 141

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