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Wednesday, January 10, 2018

Taking Pressure off the Sesamoids with Hapads

Hi Dr. Blake,

I’m a dancer (mainly jazz/tap but also ballet) and I have been having pain in the ball of my foot. I first experienced it this fall (October-ish) when I was dancing a lot in my character shoes. 

Then, it felt like stretching on the ball of my foot. After no longer using the character shoes, it got better. About two months later, it came back much worse and turned into more of an intense soreness underneath the big toe and second and third toe. This got worse on releve.

Ballet Releve on the weight bearing foot

 I rested it for three weeks. This week, I have returned to dance while being mindful of it, and as I have gotten back into dance it has gotten bad again. BUT I have VERY important college auditions this week and next week!!! 😱😰

I initially had thought it was Metatarsalgia from my own research, but my dance teacher thinks it may be Sesamoiditis, and now I think it may be that? I’m not even sure if I can even see a doctor before my auditions, and would need to power through anyway unless there is a fracture. The only thing I’ve seen online to do with these injuries is rest and ice. If I had to dance on it, what are things I could do to help with pain and limit the risk of further injury? I definitely struggle on releve and it feels like a big bruise on the ball of the foot, but at least right now, I could mostly get through a dance call. Any advice would be very helpful!
Dr Blake's comment: Get hapads, both small longitudinal medial arch and small met pads and try to protect the best you can!!

Image that is the sesamoid being floated and that should take 80% of the pressure off. Ice also. 
Many patients also will go into a removable boot for all non-dancing activities to rest it as much as possible. I linked to the Anklizer which is great unless you have a really thin ankle, and then you need a taller one to grab your ankle.

Boot with homemade float for the sesamoid (the area cut out of any insert).


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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.