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Sunday, February 14, 2016

Post Op Sesamoid Removal: Email Advice

Hi Dr. Blake,

I'm not sure if this is the best thread to ask my question on, but I couldn't find exactly what I was looking for.
I just had my stitches taken out yesterday from having my sesamoid (tibial?) removed. I had the same procedure on my other foot 4 years ago by an awesome doctor in Monterey. Unfortunately, this time it was done by a Navy doctor and I had no choice. They don't seem to care all that much about recovery and follow up and the only instruction I was given yesterday was to grab my big toe at the base and push it as far forward and backward as I could for an hour a day. She said if after a month it's stiff, then I could do PT. Does that seem normal to you? Last time I did PT right away for a couple of weeks. 

It just seems really stiff and there is a lot of numbness. Nothing like last time. I just want to make sure that there isn't anything else that I can be doing since I've been left to my own devices for healing it.

Thank you so much for any info you can send my way for stretches or ice/heat therapy suggestions for 2 weeks post op!


Dr Blake's response:

Hey Amber, sorry for my delay in responding. I hope you are healing well. You should definitely get a referral for PT which is typically started between 2 and 6 weeks post op. Three times daily you should either just lay your foot on an ice pack for 15 minutes or do contrast bathing (as long as you are doing something three times daily to influence the joint swelling). I do not think you should just move the joint up and down (see my post on Hallux Self Mobilization). Do you have protective orthotic devices and/or can you make dancer's pads, but it is important to off weight the surgical area for the next year at least to some degree? You can definitely start doing metatarsal doming three times a day, and even flat footed balancing with the ball of the foot off the ground. Hope this helps you some. Rich

Photo of the Dancer's Pad Placement 



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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.