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Saturday, February 23, 2013

Sesamoiditis and Hallux Limitus: Email Advice

Hi Doctor,
I've been following your blog closely and I greatly appreciate your helpful optimism and passion to tackle people's ailing foot problems.  I was hoping that you could enlighten me with your opinion on the "Cluffy Wedge". I've pasted a link here http://www.cluffyinstitute.com/. I am struggling with sesamoiditis and hallux limitus, and so far I have found some relief with custom made orthotics from my podiatrist and a handmade, felt version of a dancer's pad which I wear with sturdy soled Dansko shoes. I tried the spica taping from your video with the kinesio tape, but I am unable to have it hold my feet in a sturdy and still position. It seems like despite bringing my toe down and taping it securely, it starts to come lose when I walk because of the necessary flexing motion of my feet that occurs. I stumbled on these cluffy wedges at the Good Feet store here in San Francisco and I thought I might as well try them. However I tried doing some research, and aside from their own site, I can't find many critical evaluations of the product. Are you familiar with them? And in your opinion, could it help with my sesamoiditis and hallux limitus? 

Thanks so much,
Sharon (name changed)

Dear Sharon:

     Thanks for sharing about the Cluffy wedge. Dr Jim Clough was one of my students, and I remember him well. How fun!! There are 3 or 4 very positive effects of his wedge that I put occasionally on my orthotics, but one big negative. The negative, based on how you use your big toe, the Cluffy Wedge may put too much back pressure on the sesamoids and increase the motion across the big toe joint when it should be lessened. These are normal aspects of working on the delicate biomechanics of the orthotic and shoe interface. I have routinely needed to have 3 different orthotic and padding combinations for the 3 main shoes a patient uses. Some made need the cluffy and dancer's, some Morton's extension, some greater arch support, etc. Now that you have written, since I have never actually called the padding I use a Cluffy Wedge, I will begin giving credit where credit is due. Also, try 3M Nexcare Waterproof tape, usually sold at Walgreens, for better stability when taping than Kinesiotape. Hope this helps. Rich

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.