u/snaboopy

I started with mild symptoms in my right foot, atypical pain location, but busy MRI results (chondromalacia between the sesamoids and joint, sclerosis of the sesamoids, some BME in both sesamoids, bursitis between every toe, possible emerging MN between first and second toe, etc). I desperately tried to avoid boot with various other offloading strategies, even making my own dancer pad to accommodate the interspace pain, but nothing worked and the pain was so immediate when anything even lightly touched the painful spot on my foot that I went NWB for 3.5 weeks and then transitioned to a boot, which I’ve been using for 1.5 weeks. I just stopped meloxicam.

The original foot is doing OK in boot. I had a couple days of real mental relief from this. I even stopped meloxicam two days ago.

However, the other foot and leg are failing me.

I started having sciatica pain when NWB. That comes and goes. It’s maybe improved a little.

I’ve developed actual pain on the medial sesamoid/where the joint meets the arch in the compensating foot. I started feeling this weeks ago but it would improve for days. Now leaning forward even a little or at the end of the day it’s painful. Even with limited walking. This is the first time I’ve felt sesamoid pain, and it’s totally different from what I felt on my other foot. Sigh.

And now I seem to have developed peroneal tendonitis. The outer lower calf has been on/off zingy, tight, or burning since I started limping before going NWB. Since that foot has started having sesamoidITIS pain, I must have changed my gait and now the pain extends to the outer edge of the bottom of my foot, from a couple inches below the pinky toe to mid foot toward the heel. It’s worse when I lift my foot toward my heel while the ankle pain is worsened when my foot is away from the heel. The calf/ankle pain has worsened. At night, my compensating foot and the calf pain keeps me from getting comfortable.

I’m just feeling like every time I have any minor improvements or stability with the original side, something new and somehow more disabling happens with my body.

I did not have aches and pains before this. I recovered from turf toe last year and was able to return to my usual, pain free self and never had any of these extra issues. It’s so concerning, debilitating, and making it really hard to feel hope that I’ll ever improve. Every issue I have now seemingly requires contradictory treatment.

I don’t even care that I can’t run and jump. I just want to know I’m not going to be so disabled, or increasingly disabled, over time.

I’m just so tired. Please, tell me this can all get better, even if it doesnt fully go away.

I don’t need to commensurate or add to the doom and gloom, I just need to know I can do this. I need to know I’ll be Ok. It’s been a hard few years for me otherwise and I’m not feeling up to the challenge right now.

Hi everyone.

Booted up. Getting bilateral pain now (but very mild on the new foot). Some body pains have me thinking ahead to PT for when I’m out of the boot or maybe even for the last weeks in the boot (which I desperately wanted to avoid, because I am a firm believer that if you can find a way to be pain-free without the boot, that’s the best option).

For those who found PT helpful, can you tell me:

- How you found the PT who was helpful
- When you started PT (and, alternatively, when you think you SHOULD have started PT)
- What your diagnosis was (ligaments, bone marrow edema stress reaction, bilateral, fracture, etc)
- How you think PT helped

Bonus if anyone has specifically reached out to or worked with the Gait Happens team or people certified by Gait Happens.

Thanks!!!!

I apologize for two posts in two days! I'm just trying to make some decisions.

I posted my MRI results yesterday. Here are my symptoms:

• It started two-ish weeks ago with sharpish but quick (zappy) ball of foot pains on toe-off (2/10 pain - initially only pain on toe off and no pain underfoot) one day after a weird feeling in my foot during an activity. Upon first zap, I went into offload mode (this ain't my first rodeo with big toe crap)
• After 4 days, the pinching resolved, no pain on toe off in Birks, but it started to become more of a squishy bruise feeling slightly above (above = toward the toes) the lateral sesamoid. When I feel it underfoot (not always), it feels closer to the second toe than it is, and it doesn't seem worse on toe off - it's just kind of there, hanging out on the far lateral side. Maybe 1-2/10 pain on walking when I feel it, 2-3/10 pain if I press into it with my thumb. I can also make it go away by touching it. It doesn't make me need to stop walking or make me limp.

I met with an orthopedic surgeon (as a second opinion from a doc who ordered the MRI last week) to go over the MRI today. The results sounded really bad on the radiologist's report, but the orthopedic surgeon said the radiologist added a bit more dramatic interpretation than he would. The doctor visit:

• Yes, I have a bit of bone marrow edema in both my sesamoids on the right foot, but only one is symptomatic, and it's the one that's not as bad on the MRI. He thinks my pain is actually from the cartilage issue at lateral sesamoid, not the bone itself. He said we treat what's symptomatic, not everything the MRI says. (He is also of the belief that BME does not equate to stress fracture, automatically.)
• He pulled my toe back really far and pushed all around and under my sesamoids and could not recreate any pain. Like not even a bit of pressure, which was actually embarrassing because I have definitely had some transient pain! just not directly over the sesamoid bones... but he even pressed hard into where I have transient pain, and nada.
• He had me walk across the floor barefoot - no pain. He had me go up onto my toes on only one foot - no pain.
• I left his office with somehow zero pain, despite having a slightly squishy bruise feeling under my foot before the appointment. My foot has not felt worse since the appointment than it did before, despite all that pokey-doking, the barefoot walking, and the one-legged heel raise.
• His recommendation - keep wearing the cork Birkenstocks I'm wearing or go back to the carbon fiber plate I used in my shoes one year ago (for turf toe) and aim for 6 weeks of not aggravating it, and go from there. He said the minor aggravation I feel now is OK, and he expects it would improve if I continue as I have been and take it really easy.
• He said I could start sesamoiditis-specific PT whenever because my symptoms are very mild, the sesamoids themselves aren't painful to the touch, and I could do a heel raise and walk barefoot and have no standing pain. He said I am where many are when they come out of a boot.
• I got a little teary eyed and asked him what we will do if it's worse or keeping me from living a full life in 2 years, and he said, "we will cut it out." I said, "the one that hurts, or the worse one on the MRI?" He said, "the one that hurts." I said he seems confident that surgery would be an option for me even though I'm scared it's not because the MRI doesn't match the pain and he said, "I am confident. Your lateral sesamoid is being aggravated by the cartilage issues, and I would cut it out if it can't heal."

I'm feeling a bit stuck because I intentionally chose a doctor who has real experience with sesamoiditis/sesamoids -- he was mentioned multiple times on a local forum when people asked about sesamoids and he regularly performs sesamoidectomies. I asked how often he treats sesamoiditis, and he said regularly, and with pro athletes (this is true -- he works with local DC teams and ballet).

However, he also didn't suggest any of the super conservative things this sub seems quite confident about, so I find myself in this awkward space of "do I listen to the doctor, or do I take things into my own hands and put myself in a boot for 6 weeks or go NWB? Bone marrow edema seems very bad!"

It may seem like a "why not, just to be safe," thing, but I've been so anxious for the past 2.5 weeks that I already have compensation pain in the other foot (I'd actually say the other foot is more symptomatic right now, especially at the top of the big toe and along the side) and my entire body already hurts from being so... stiff. So going into a boot or using crutches feels risky to me, too, in other ways.

(P.S. - why can't I pull a Jordan Peterson and get put into a medically induced coma for 8 weeks while someone comes and manually exercises all parts of my body for me?)

Anyway, this is a really long post about not wanting to have any regrets, be it throwing everything and the kitchen sink at this and going insane in the meantime, or causing a new issue in my other foot, or missing an opportunity to really get ahead of this.

I'm thinking these are my options. Keep in mind that I can stay home 95% of the time, if I want, because it's summer and I'm a teacher:

a. Continue to take it easy at home in the Birkenstocks for 3-4 weeks. If all stays calm, start PT. But keep steps pretty low and progress to more walking in Hokas or Altras after the 4 weeks.

b. Continue to take it easy at home in Birkenstocks and Hoka Bondi (I've already found my Altra, without a dancer pad, is too flexible to feel safe right now, despite much preferring its toe box width), for 3-4 weeks before starting PT.

c. Try my Hokas with carbon fiber plates again, reliving summer 2025. So awkward. So stiff. Back to walking like Frankenstein. (Hokas are a little narrow for my toe box)

d. Cut holes in my plastic Birkenstocks to offload the sesamoids and mostly use those. Start PT in 3-4 weeks if it goes well.

e. Go NWB or booted for 6-8 weeks and pray the other foot and my knees don't get any worse than they already are with just stiff, careful walking. Start PT after transitioning back into a shoe?

**Note 1: For all options, I'd do a little heel biking (if in Hokas, maybe with plates) and chair cardio and upper body weights for exercise. After the end of the period I discuss, I would not return to regular exercise etc! I'd add a few minutes a day of protected walking for a while, continue PT, etc like I did with my plantar plate tear, but even slower.

Note 2: you do not see Hoka/Altra + dancer pad on this list. I have, much to my anxiety, tried and failed the dancer pad experiment. While I can walk in them, and they do seem to do something, it seems they also to press into the lateral sesamoid/lateral edge region after a while (or press some edema into that area - when I remove them, there's squishiness built up at the edge of them where they're offloading), but putting it any further off to the side doesn't seem to be offloading anymore. The bruisy squishy feeling only increased after a couple days I tried the dancer pad. Maybe I don't have it out far enough, but it just generally bothers my foot while maybe reducing the bruisy walking feeling briefly. I would love for that to be the solution, but alas! I need dancer pad-free or improved options.

This is officially the longest post I've made on Reddit. Thank you for reading it! I hope to figure something out that makes me feel confident enough to commit to it, stop frantically reading the entire internet, and move forward with some semblance of a plan.

Hello, everyone. Long time, no post! Apologies for the long post, but I'm a bit stuck.

Background: Exactly one year ago, I suffered a small plantar plate tear at the level of the medial sesamoid. However, all of my pain then was at the lateral sesamoid side of the joint. I let the plantar plate tear heal and did PT, and all was good for many months. I returned to running, jumping, and lifting, and unlimited walking. I had zero pain after around month 1.5-2 of my initial treatment, though I was very conservative with returning to shoes without carbon fiber plates and taping. Thing seemed back to good!

Three weeks ago - now: My foot suddenly felt odd during an activity, so I stopped the activity. The next day, I had a sharp pinch on toe-off. After a few days, I was able to stop the pinch with my old tricks: Birkenstock shoes, taping. The pinch became replaced with swelling and general soreness on the area. Sometimes it hurt to press, other times it did not. The soreness has increased over these days, especially after a doctor's visit where he poked very hard but did not produce any pain on either sesamoid bone. I can walk with only some transient pressure pain when offloading with a dancer pad and/or in Birkenstocks (although the Birkenstock seems to be helping less than the dancer pad at this moment). All of my pain is at the lateral side, a bit closer to the toes to where the lateral sesamoid bone is, but in that same area. This is the same area as my pain last year.

MRI results: a new, local doctor ordered a 3T MRI to check the plantar plate, and these are the findings:

• FINDINGS: Field-of-view is focused on the forefoot and midfoot where a marker was placed on the plantar aspect at the level of the first metatarsophalangeal joint and hallux sesamoid complex.
• The visualized bone marrow signal demonstrates no evidence of an acute fracture, discrete contusion or periosteal reaction.
• Subchondral bone marrow edema and sclerosis are now identified involving the medial sesamoid bone at the articulation with the first metatarsal bone, new when compared to the prior study. This is also present to a lesser degree involving the lateral sesamoid bone.
• No evidence of high-grade chondromalacia involving the metatarsophalangeal joints or the visualized tarsometatarsal articulations.
• No evidence of acute pathology involving the plantar plates with specific attention to the hallux sesamoid compact on the current examination.
• Ill-defined soft tissue edema is again identified within the plantar soft tissues at the second metatarsal head, similar in appearance to the prior study, best seen on images 19-22 of series 4 with very subtle enhancement suggested.
• There is mild intermetatarsal bursitis now identified in the first through third interspaces.
• IMPRESSION:
  1. Interval development of high-grade chondromalacia involving the hallux sesamoid articulation, greater involving the medial sesamoid bone without evidence of acute pathology involving the plantar plate on the current examination.
• 2. Findings against concerning for a Morton neuroma within the plantar soft tissues of the second metatarsal head, similar in appearance to the prior study with subtle enhancement suggested on this examination. (Note from OP: this was considered incidental last time; so it's still there)
• 3. Mild intermetatarsal bursitis now identified involving the first through third interspaces. (Note from OP: No pain here)

This doctor really shrugged off the radiologist's report, saying that he thinks she's over-reading the arthritis. I only went to this doc hoping to get a quick MRI (which I did), so I'll get a second opinion.

I have NO pain when palpating the medial sesamoid bone, though the MRI says that's where the issue is. I have no idea what this MRI is saying, how bad things look, etc. I know I want a second opinion, but in the meantime, anyone have any thoughts on this MRI?

Oh, and new doc gave me a prescription anti-inflammatory. Unsure whether to take it.