Sesamoid Injuries: Consider Dr Jill's Dancer's Pads to Off Weight

Comment off of my YouTube Channel on Sesamoids:

Jill's Dancer's Pads were a life saver for me! They greatly reduced my pain and allowed me to continue to get around. They stick to your feet so they will stay in place and fit into shoes, and they're washable. Don't get the extra thickness. The regular thickness works best.

https://www.drjillsfootpads.com/

5 Common Orthotic Adjustments (Answers on Wednesday 6/10/22)

Match Orthotic Adjustment with Image

1. Morton's Extension vs Dancer's Padding
2. Denton Modification for Lateral Stability
3. Metatarsal Accommodation with Met Support
4. Temporary Kirbys
5. Arch Pain Adjustments

Image 1

Image 2

Image 3

Image 4

Image 5

Answers: Image 1: Metatarsal Support with Accommodations

                Image 2: Temporary Medial Kirby Skive

                Image 3: Arch Pain Adjustments with Increased support

                Image 4: Denton Modification for Lateral Support

                Image 5: Dancer's Padding to Off Weight Big Toe Joint

14 Point Patient Assessment for Treatment Summary

1. History of the injury and the patient’s reason why they were injured.

2. Gait evaluation of walking (running is crucial if their activity requires running) to decide on gait patterns and if the patient’s complaint matches)

3. Physical examination of the injured part (begin to separate the 3 sources of pain: mechanical, inflammatory, and neuropathic)

4. Physical examination of possible biomechanics involved

5. Is there biomechanical asymmetry? 

6. Tentative working diagnosis made

7. Common Differential Diagnosis: common not rare

8. Occam’s Razor and the Rule of 3 for initial treatment help

9. What Phase of Rehabilitation is the patient in at this visit?

10. Should we do Imaging at this point?

11. First Decision: What do I have to do to get the pain consistently between 0-2? This is the real reason that the patient has to be put into Phase 1 of Rehabilitation where PRICE rules. The 0-2 pain level realm is where injuries can heal.

12. Second Decision: How Much Inflammation needs to be Addressed?

13. Third Decision: Is there any neurological component that should be treated?

14. Fourth Decision: What mechanical changes can I make in the first few visits that may help the pain relief, better biomechanics, and cause reversal?