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Wednesday, June 5, 2013

Sesamoid Injury: Flip Flop Modification and Email Advice

This patient has had a sesamoid injury under the ball of the foot on his left side. We have had a few correspondences.

Hi Richard,

how are you? As agreed, here's some update:

doctor told me it was too early to start to run a bit so am still not running.

I now wear flip-flop with a hole in the sole. Much less pressure than in a shoe (see pic attached).

I did an MRI last week that showed less inflammation but still too much.

I had a PRP injection.

In 3 months time I will have another MRI. If it's still not sorted out, bone will be removed.

Would you have any thoughts/advice?

Tks and rgds, Paul (name changed due to witness protection).

Dr Blake's comment:

   Paul, brilliant idea about the flip flop!!! Over the next 3 months, gradually increase your activity each week slowly but progressively. Ice 3 times daily to control the inflammation. Start the Walk Run when your doc feels okay. Continue to stay in the Good Pain side of the problem. Give me monthly feedback. Stay good with your Vit D3 and Calcium. Rich 

Good luck!!!


  1. is it possible to ice too much? I have a sesamoid injury and I am currently icing 4 times a day for 10 minutes and then a contrast bath. But if I ice, say 7 times a day, would this be more effective?

    1. Thanks for the comment. Ice typically cools the area 4 times longer than you use it for. Therefore, 10 minutes of icing means another 40 minutes of anti-inflammatory action. I love the idea of patients controlling the inflammation with icing every two to three hours. You will keep the area cooled off round the clock. The skin and nerves in the area have to be watched for lasting redness or tingling/numbness. If so, start to back off the icing 50% or give yourself 1 day off to regain status quo. Sure 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.