Sesamoid Injury: Email Advice

Hi Dr Blake,

     I have been to the doctors and they said I have a fracture in my sesamoid bone and sesamoiditis (yes I had an x-ray). I woke up on the 7/03/16 with this horrible pain which has subsided but I do still get some pain. I can't put any weight on my foot or move my foot up or down or my big toe. Its very debilitating. Yes I had a x-ray. I think it was caused by starting a new gym class in January which is high intensity cardio. I don't normally do alot of cardio, but thats when I really started to notice that the ball of my foot was uncomfortable but it didn't hurt until I woke up last Monday morning and couldn't walk on it.

 Do you know much about the condition? It is probably one of the top injuries on this blog. See the link to the original posting below. 

http://www.drblakeshealingsole.com/2010/09/sesamoid-fractures-advice-when-not.html

 and or recovery times? This is very variable, up to several years, but 3 monthes in an environment maintaining 0-2 pain seems crucial to obtain quickly. Try to get my patients to understand Good vs Bad Pain and the Magical 80% Rule.

http://www.drblakeshealingsole.com/2013/12/foot-pain-dilemma-of-good-vs-bad-pain.html

http://www.drblakeshealingsole.com/2010/08/injury-rehabilitation-magical-80-rule.html

And anything extra I should be doing? I have been doing the RICE method and using crutches. 

Would u know how long it will usually take for me to be able to put weight on my foot so I can hobble around without crutches?. This is based on maintaining 0-2 pain levels. You need to weight bear also for bone mineralization and healing/strength. So, figuring out how to weight bear with the minimal amount of irritation is crucial, and then to gradually increase the stress to the tissue. 

Or if doing exercises to increase blood flow will help? Motion of moving the joint, boot in general, and ankle is very important to circulation. No movement equals increased swelling and pain. No weight bearing equals increased swelling and pain. 

If so what kind of exercises?.  I have been asking around about this condition and not alot of people know much information on it, including the doctors. I just have my foot bandaged at the moment and using crutches to get around which is very difficult.  Typically the first exercises are active range of motion while you do your evening contrast bathing. You pretend your big toe is a paintbrush. Also, as soon as you can start metatarsal doming and Single leg balancing the better. With the balancing, you place the sesamoid area in the middle of 4 one inch high books with a center hole created to place the sesamoid. 

https://youtu.be/GY-mJjXmeIc