Dr Blake's comment: If you have been in the removable boot for 4 months, you have done everything right up to now. But, it is time to move from the Immobilization Phase to the Restrengthening Phase of Injury Healing. The Restrengthening Phase should continue your 3 times per day icing/contrast bathing, your Calcium and Vit D intake considerations, your protected weight bearing with orthotics and/or dancer pads and/or stiff soled shoes, a gradual strengthening program from the core down, and a gradual return to full weight bearing with no barefoot.
In the past month I swear it's been getting worse and the boot itself is driving me nuts and starting to hurt the other parts of my leg. Any advice?
Dr Blake's comment: Typically after 3 months in a removable boot, the negative effects of immobilization start to take their toll and pain syndromes develop. How to begin protected weight bearing without the boot is the next goal and many of your new soreness will abate.
My next appointment is in the first week of May and I'd like to sound like I know my options.
Dr Blake's comment: Sorry, I just had some personal family problems that needed me so I am late with this response.
My podiatrist is a nice guy, but this is getting really frustrating, according to him I should have been healed by now.
Dr Blake's comment: You can ask any athlete if they continued to have pain when their injury was healed and the majority would say affirmative. You need to respect pain levels over 0-2 and increasing as you work out. You need to gradually stress the injured area to prevent flares. Working with a good physical therapist on lower extremity strength and flexibility at this time on a weekly basis will also get their regular feedback on activity levels permissable.
- Can an orthotic device be designed to off weight the sore sesamoid?
- Can you go to PT to learn joint mobilization, spica taping, dancer's pads, foot strengthening, and anti-inflammatory techniques?
- Can you get a baseline MRI to see where you are at, or CT Scan? There are many reasons to get a MRI other than healing of sesamoid for it can show if other structures are involved.
- If he thinks you are slow at healing, can you get a bone stimulator?
- What shoes, like hiking boots, can you wear to begin to wean off the cam boot?
- Has he had cases like this that heal without surgery? This is check if he has a bias.
- Does he feel you can heal without surgery? If not, who should you see for a second opinion?