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Saturday, July 15, 2017

Healing Sesamoids!!!

Hi Rich!

Just wanted to send you an update on my sesamoid injury. I'm doing great! I can walk barefoot when I'm staying indoors (been doing so for several weeks), and I can use regular footwear when walking short distances (although still good shoes, just without specific sesamoid protection). Without any significant pain, of course. I'm still using the Hoka shoes with orthotics when walking longer distances, for example an hour's walk. 

Still, I have to admit I haven't been as good as I should be at following up the contrast baths and foot exercises regularly. The reason for that is that I'm pregnant, and I've been feeling really tired and sick at the beginning of the pregnancy. Despite this, I've used Exogen every day and I've been doing the contrast baths and foot exercises regularly again for the last six weeks. Also, because of the pregnancy, I can't have any images taken of my foot, therefore I don't know what the fracture looks like at present. 

I feel like I can mostly do all sorts of activities again, but I still can't run without pain and I can't go for long walks without protective foot wear. Should I continue on with foot exercises, contrast baths, etc, any specific exercises I should pay attention to? Is there anything I should do differently now when I'm doing much better? Do you have any advice on footwear at this point? 
Dr Blake's comment: Thanks for the great news. For our reader, I placed your original posting 9 months ago below. And, congratulations on the pregnancy!! I wish you all the best for a healthy and happy little one. I just love my grandson, and we have 2 boys. Boys, boys, and boys. Lucky we have a wonderful daughter in law, and my other son just got engaged to a good soul!!
     As you feel better, and have other issues, it is easy to be lax at what you do. As long as you are doing the Exogen (and 9 months should be perfect) you want to do the contrast bathing 3 times a week as a deep flush. Ice also once a day now just to keep the inflammation under control. You should be able to do a walk run program with the Hokas by now, so if not, you may need a separate orthotic device with higher arch and more dancer's accommodation. And, some of my patients need to spica tape and use cluffy wedges to run also. But, gradually building up to 30 minutes running is the next step in your healing. You need to review the walk run program I have on the blog. As you return to full activity, you need to keep up a 10 minute daily routine of strengthening: single leg balancing, met doming, heel raises are normal. Make sure your achilles are stretched out because tight achilles lead to more forefoot pressures. Keep up the healthy diet, Vit D if you are not in the sun enough, and any other bone supplements you take. I have my patients alternate walking and alternate running with the Hokas and more normal but stable shoes that bend easily in the front at the ball. By alternating, you really get a feel of how important the Hokas are to limit the bend. You should slowly need that protection less and less. 
     As you walk with any shoe and orthotic, feel where the weight is going through the front. If it is entirely on the first, either ditch the shoe or modify the orthotic. Then weight should be even 1st and 2nd mets, or all the way across the front of your foot. I sure hope this helps some. Congrats again. Rich

Hope you're doing well and having a great summer!;postID=8800716870601474755;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=117;src=postname

1 comment:

  1. where is the original posting? the link doesn't work...thanks!


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.