Sesamoid Injury: Email Advice

Hi Dr. Blake,

I have been managing my sesamoiditis since August, from an injury sustained 
in April due to 10k training. Initially diagnosed as arthritis until I saw 
a podiatrist in August who diagnosed sesamoiditis after x ray. By October I 
was in a boot without orthotic and improving, but unfortunately my 
podiatrist encouraged me to get out of the boot and go back to normal shoes 
with tape without a wean out period, and pain returned by Thanksgiving to a 
5-7 pain scale. I discovered your blog at the end of November, and have 
been doing boot (used felt to offload sesamoid) constantly, contrast baths 
BID, icing BID, and had some custom orthotics made to offload the sesamoid.

I decided to get a second opinion from an orthopedist, who took some x rays 
and found no fractures in my sesamoid itself, but that I had a stress 
fracture in the middle part of my navicular bone of my foot. He assures me 
this is unrelated to my sesamoiditis. The navicular area itself doesn't 
hurt. I wanted to see if you have ever heard of a navicular stress fracture 
causing sesamoid problems. I'm currently maintaining a 2-4 pain at my 
sesamoids and am hoping to start transitioning into shoes with orthotics 
next week when my pain is at a 0-2.

Any perspective you can offer would be valued.

John (name changed)

Dr Blake's comment: John, thanks for reaching out. There is no obvious connection, and the navicular diagnosis is suspect due the lack of pain in that area. Sounds like you are doing well. Make sure you experiment with cluffy wedges and spica taping as you attempt to leave the boot behind. I also recommend Hoka shoes for their rocker platform at least as a part time shoe. Rich