r/sesamoid

I saw a pedorthist to make my orthotics. She is also an athletic trainer/PT in the foot/ankle center I go to. She saw the shoes I brought and said, "absolutely not. You need zero or very low drop for this issue. The Bondi is too squishy and is pushing you out to the outside of your ankles and the Ghost Max is too high drop." And she fitted me for Altra Torins and they fit well. She also helped me adjust a gel dancer pad and said she has better success with those than the felt ones. She also makes her orthotics in house. They will be ready in a couple weeks.

I was so excited that a person seemed interested in helping me come up with practical solutions that I didn't think about the fact that the Altra Torin does NOT have a rocker sole.

Since my pain is in a unique spot (right off the lateral sesamoid bone, though it's unclear if it's just referred pain from the lateral sesamoid), I don't really have much pain WHILE walking. It tends to be a later thing, more of a pinpoint touch pain than a walking pain. I do have a carbon plate in the Torin.

So the TL;DR:

• Pedorthist/foot and ankle specialist PT recommended moving me from Hoka Bondi wide/Brooks Ghost Max 3 wide and into Altra Torin wide (she isn't just a Hoka hater - she was wearing Hokas)
• Suggested I wear one full size bigger than I was wearing (so wants at least one full thumbs width between my toes and the shoe front edge)
• Moved me from felt dancer pad to gel dancer pad
• Was worried I was in too acute a healing phase for the orthotics fitting to be really accurate, but I really want orthotics so I did walk a few steps on the floor barefoot and she said she can make it work and I just may need new ones sooner than usual because once I return to more normal walking may not find them entirely comfortable for that

Worried about continuing in the Torins if they don't have a rocker!! I don't want to try them for a few days and go weeks backward. Not sure what to do. Since my bone marrow edema got worse between MRIs, I'm just feeling like healing is really vulnerable and don't know what to do.

Been dealing with this for over a year and nothing works. Just walking through the pain at this point. Here is what I have tried so far

Shoes: Brooks Ghost, Sketchers Max Cushion, Altra FWD Via, Hoka Bondi 9

Custom orthotics: Were done to help with both my sesamoiditis and heel pad loss. Fixed heel pad pain but not sesamoiditis.

Dancer pads: tried all different sizes and moving around. Does not seem to improve things at all

I have a plantar flexed first Ray. I think this is why I’m struggling so much as my big toes bottom rests lower than rest of me feet.

MRI in April of this year: no broken bones but fluid all around in areas near sesamoid.

Other: have tried icing and may try contrast bath instead soon

Any tips welcomed. Thanks!

I walk barefoot in my home a lot and my pain started suddenly and intensely from no apparent injury. I went to an orthopedic walk in because it hurt so bad to walk and they did an xray which revealed I had a bipartite tibial sesamoid. The doctor gave me a walking boot and prescribed me a ridiculous amount of prednisone over a week (70mgs on day 1 and tapered)

It’s still early, but I don’t really feel like the pain is going away and it still hurts to walk even when I have the boot on. Is this normal?

I have a follow up appointment in 2 weeks and I’m hoping this is just a flare up and not actually a fracture. I’m torn between whether I should be icing or heating. I didn’t really receive much guidance from the doctor. How often am I supposed to wear the boot? Can I drive with the boot on? Do I generally want to avoid walking even if I have the boot? I can’t really ever find a comfortable way to hold my foot where I don’t feel any pain.

Any advice is appreciated.

I’m wondering if anyone has had what was diagnosed as sesamoiditis that ultimately turned out to be an issue with the flexor hallucis longus (FHL) tendon.

I’ve been dealing with intermittent mild-to-moderate pain (rarely more than a 3) underneath/around the ball of my foot near the sesamoids. An MRI in June showed an intersesamoidal ligament tear, minimal edema around the sesamoids and a small 1st MTP joint effusion. There was no fracture.

My orthopedic doctor thinks the main issue is irritation around the lateral sesamoid. He didn’t think the intersesamoidal ligament finding was clinically significant and didn’t think I had a turf toe/plantar plate-type injury. The current treatment has been a dancer’s pad/custom orthotic and PT.

Since early June, I’ve gone through several cycles of irritation/pain to weeks of pain-free activity — going for so long that I thought the issue had resolved itself. Sometimes the pain can come and go in the course of the day with no rhyme or reason.

What makes me question the diagnosis is how oddly the symptoms behave:

I cannot replicate the pain by pressing on the sesamoid area.

Walking seems to aggravate it more than anything, but sometimes I’ll get twinges of pain at rest.

I’ve taken up swimming since I’ve dialed back running. Sometimes kicking results in mild pain.

Running doesn’t really hurt it, even though I would expect running to aggravate sesamoiditis.

The pain can be intermittent and sometimes feels more nerve-like than like a straightforward structural injury.

I don’t have the typical constant pain I associate with a significant sesamoid injury.

I’m curious if anyone else has experienced something similar.

I've been dealing with sesamoid pain for about 2 years in my right foot. I wear a carbon foot plate or stiff shoes to limit toe movement and occasionally wear orthotics instead (but typically have pain the day after I wear them). I've stopped all running/excessive walking/elliptical/etc. and just work the rest of my body at the gym. It's gotten a great deal better since I first injured it, I can now walk on vacation and do day trips in the car with only mild pain for the most part where I used to be in excruciating pain after only walking a block or two and after driving to work. Doctors all said just wait and heal, which is what I have been doing, I'm planning on going back for another opinion soon.

I sometimes use the leg curl/abductor machines that work my thighs and put no pressure on my feet. I have tiny chicken calves now and would like to start building some leg muscle again. My problem is all exercises that involve the calves also involve the feet and cause me pain (squats, walking, running, calf raises-the exercise which injured it in the first place). Any good exercises that can at least somewhat work my calves but not cause me more foot pain aside from swimming (don't have frequent access to a pool)?

Hi fellow sesamoiders

I had a lateral sesamoidectomy (tibial) in March of 25. I chose a very well reputed doctor who was the head of foot and ankle ortho at USC. He’s been recognized as one of the best in the world.

My recovery was smooth and I did a ton of PT to regain strength in my left foot/leg/ankle. All this is to say, I did this by the book and under the supervision of a really good doctor. Since then I’ve had trouble in my right foot (forefoot pain) which I have since healed with dancer pads and comfortable shoes.

My left foot, the one that I had the surgery on, was doing really well. It was pain free and I could do almost any activity. There were 23,000 step days where it held up great and there was very very little pain and no swelling. For all intents and purposes it was pretty much back to normal.

3 days ago I was walking barefoot in my apartment (I like to walk barefoot because it helps with burning pain I experience sometimes) and I felt a twinge of pain in my left foot. I took another couple steps and I felt it again. It was not severe, but a dull ache in the area followed these twinges. First I thought it was my fibular sesamoid as the ache seemed localized in that area, but yesterday and today it’s been more around the surgery site.

I know the mtp complex is interarticular and inflammation in one part of it can lead to inflammation in another which would explain why I have a diffuse ache all around the joint now. There’s no swelling and it really isn’t a severe pain. Today I walked about a mile and a half and it was ok. But it did start to ache a little towards the end of the walk. I’m pretty scared this starts to devolve again but hoping it goes away. Has anyone else had this happen a year and a half after a sesamoidectomy?