A New Non Opiod Pain Med to Watch

https://www.medscape.com/viewarticle/prescriptions-rising-new-non-opioid-analgesic-clinicians-are-2025a10010e3?ecd=wnl_dne1_251230_MSCPEDIT_etid7998270&uac=399573HX&impID=7998270

     Ever since the Opioid crisis hit the medical profession hard, many patients have not been getting new pain coverage in acute injuries or post surgery. This non opioid choice called suzetrigine or Journavx may prove remarkable. 

Isometric Exercises Help Lower High Blood Pressure

Here is an excellent article highlighting the benefits of using isometric exercises to lower high blood pressure !

https://www.aarp.org/health/healthy-living/best-exercise-to-lower-blood-pressure/?cmp=EMC-DSM-NLC-OTH-WBLTR-2002400-2095010-9862504-NA-12262025-Webletter-MS5-NA-BTN-NA-Health&encparam=whSL9LXkRLAnqPiCm04mAeD4JatvP4Rvj23BXPQkKL4=

Do You have High Arches? These problems May Be Related.

     

     People with High Arches have the Pes Cavus Foot Type. This differs from Normal Arch or Flat Feet (called Pes Planus). Pes Cavus occurs in 10-15% of the population, and never get good arch support from shoes alone. Due to the abnormal excessive weight better in the heel and ball of the foot, these areas can develop more problems. Therefore, diagnoses of plantar fasciitis (primarily heel pain) and metatarsalgia are common in pes cavus feet. The article below discusses this problem. 

https://www.sciencedirect.com/science/article/abs/pii/S0268003305000720

     So, if you have high arches, the weight bearing across the bottom of your feet is not evenly spread. More weight or pressure is centered on the heels and ball, with no weight in the middle of your feet (mid foot). Arch Supports to put some weight in the middle of your feet can be very helpful. My next post will talk about the instability problems produced by pes cavus, the most unstable foot type. 

Keywords: Pes Cavus, High Arches

Pointy Medieval Shoes

https://historyfacts.com/world-history/article/why-did-medieval-people-wear-pointy-shoes/?email=sffootdoc%40aol.com&lctg=1c5f8784-7c0f-4c65-899b-901945273a2e&sub_level=L1&sub_source=email_daily&utm_campaign=3106504896&utm_content=email_daily&utm_medium=email&utm_source=19746354

LDN a great Help for Many with Fibromyalgia

https://www.medscape.com/viewarticle/label-treatment-helps-many-fibromyalgia-2025a1000tjm?ecd=wnl_dne1_251030_MSCPEDIT_etid7837059&uac=399573HX&impID=7837059

Sesamoid Fractures Handout Reviewed

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Sesamoid Fracture: What You Need to Know

Dr. Blake’s Patient Handout

Sesamoid fractures—small breaks in the tiny bones beneath the big toe joint—are stubborn injuries that often take months (or even up to 2 years) to fully heal. But with the right strategy, most patients recover well.

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✅ Top 10 Initial Treatments

1. Bone Stimulator (Exogen) – Use daily for 6–9 months to enhance healing.

2. Boot or Stiff-Soled Shoe – Wear consistently for 3 months to keep pain at or below 0–2.

3. Ice and Contrast Baths – Ice twice daily + nightly contrast baths (twice on days off) to reduce inflammation and swelling.

4. Custom Orthotics – Designed during the first 3 months to offload pressure from the sesamoids.

5. Dancer’s Pads – Learn to make and use these felt pads to relieve pressure (adhesive felt from Moore Medical works well).

6. Spica Taping – Learn taping techniques for use after the boot phase.

7. No Barefoot Walking – Always wear protective footwear, even at home.

8. Stay Fit – Begin safe cardio, core, foot, and ankle exercises as early as possible.

9. Nutrition Check – Ensure good intake of Vitamin D, Calcium, Magnesium, Zinc, and screen for bone density issues.

10. Activity Modification – Gradually return to normal activities over 2–6 weeks after the boot; avoid increasing pain.

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💡 Key Insights from Dr. Blake

• Most sesamoid fractures heal, though slowly—be patient.

• Imaging is crucial: MRIs or CT scans provide clarity, especially 5–6 months after baseline.

• Sometimes the problem isn’t a fracture—diagnostic accuracy matters.

• Bone health is key: Evaluate nutrition, vitamin D3, and bone density.

• Recovery follows 3 overlapping phases:

  • Immobilization

  • Re-Strengthening

  • Return to Activity

• Avoid phase mismatches: don’t resume activity too soon.

• Your treatment team should plan for the return-to-activity phase from the start.

• Protected weightbearing (not non-weightbearing) is usually best—walking helps flush out swelling.

• Contrast baths are the gold standard for swelling reduction.

• X-rays alone are not reliable—advanced imaging is often needed.

• Joint mobility must be preserved: Start pain-free range of motion exercises early.

• Strengthen early: Even modified strengthening helps prevent long-term weakness.

• Setbacks are normal—don’t lose hope.

• If you’re dealing with a fracture, get a bone stimulator early (self-pay if necessary).

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📺 Bonus Tools

Visit YouTube and search:

• “drblakeshealingsole Self Mobilization”

• “drblakeshealingsole foot and ankle strengthening playlist”

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📌 Final Thought

Healing a sesamoid fracture takes time, consistency, and smart treatment choices. Stick with your plan, monitor your symptoms, and don’t hesitate to seek expert care if progress stalls.

Video discussing Sesamoid Fractures and use of Xrays

https://www.youtube.com/watch?v=I-SQjmo-hIc

Book 4 is now on Sale of Practical Biomechanics for the Podiatrist

https://store.bookbaby.com/book/practical-biomechanics-for-the-podiatrist3

This book is the end of my series on Practical Biomechanics for the Podiatrist. The information in these books took me 40 years to understand, practice, and see patient responses. This book reviews the topics of:

• Custom Made Functional Foot Orthotic Devices
• Computer Assisted Gait Analysis
• Common Shoe Changes Made
• 23 Patient Cases showing how to thoroughly look at a patient at each visit and make recommendations

My overall goal is for the student, resident, or those beginning to treat patients from a biomechanical lens. 

Biomechanics: Mentoring the New Generation of Podiatrists

    I just received this by email today. I lecture, write, correspond, and mentor the young generation of new podiatrists. It is very rewarding as any of you know who is involved in mentoring. Today I will spend all morning with a 3rd year Podiatry student for more of the same. It is a small but powerful act. 

Article on Sesamoid Surgery and Return to Athletics

https://journals.sagepub.com/doi/10.1177/0363546520962518