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Sunday, December 19, 2021

Big Toe Pain: Email Advice

Hi Dr. Blake,

     I found your blog after dealing with chronic toe pain for the past 4 years. It started in 2017 when I was trying to stay healthy and did a bunch of yoga. I ended up doing a lot of hand stands and every time I would end I would plant my right great toe to the ground. Didn't start bothering me until I did some minimalist incline hiking. 
     Limped for a few weeks and had some serious pain below my great toe, gradual felt better, never 100%. I wound up on a beach a month or so later and have never been the same. I walked a little and then all of a sudden couldn't plant with my great toe due to the pain. limped for weeks and finally saw a specialist. 
     I was initially diagnosed with hallux rigidus, seemed kinda crazy. Luckily I found hokas and was able to walk normal and have been in them ever since. Saw multiple other doctors and had an MRI a year later. 
     I had a sesamoidectomy after the surgeon thought there was an unhealed fx that may have been causing the issue. The certainly didn't help. Have seen multiple surgeons since and just had a 3rd MRI, this time it showed a possible partial tear through the plantar plate. 
     I initially thought this was the injury but was told it wasn't because there was no instability and the MRI read didn't mention one. But now since it did, I have a feeling that was the issue all along. 
     Anyways I am reaching out for advice. Would a partial plantar plate tear heal after 4 years? Dr. Blake's comment: Probably not, but when you had the sesamoidectomy didn't they see a tear, or make any comment? Odd. You probably have to at least send me the MRI reports: all 3 to look at. 

What options are out there for me? Dr Blake's comment: The treatments are many to control pain and allow activity including: Hokas, spica taping, off weight bearing orthotics, avoiding activities that cause pain over 2, etc. However, the diagnosis is what is crucial and 3 MRIs should be fairly conclusive. 

 I have been wearing hokas for the past 4 years and have not participated in any physical activities that I like or even ran since 2017. Really hoping to change that. Any recommendations or advice would be greatly appreciated. Thanks - 

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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.