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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.
✅ Top 10 Initial Treatments
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Bone Stimulator (Exogen) – Use daily for 6–9 months to enhance healing.
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Boot or Stiff-Soled Shoe – Wear consistently for 3 months to keep pain at or below 0–2.
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Ice and Contrast Baths – Ice twice daily + nightly contrast baths (twice on days off) to reduce inflammation and swelling.
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Custom Orthotics – Designed during the first 3 months to offload pressure from the sesamoids.
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Dancer’s Pads – Learn to make and use these felt pads to relieve pressure (adhesive felt from Moore Medical works well).
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Spica Taping – Learn taping techniques for use after the boot phase.
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No Barefoot Walking – Always wear protective footwear, even at home.
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Stay Fit – Begin safe cardio, core, foot, and ankle exercises as early as possible.
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Nutrition Check – Ensure good intake of Vitamin D, Calcium, Magnesium, Zinc, and screen for bone density issues.
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Activity Modification – Gradually return to normal activities over 2–6 weeks after the boot; avoid increasing pain.
💡 Key Insights from Dr. Blake
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Most sesamoid fractures heal, though slowly—be patient.
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Imaging is crucial: MRIs or CT scans provide clarity, especially 5–6 months after baseline.
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Sometimes the problem isn’t a fracture—diagnostic accuracy matters.
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Bone health is key: Evaluate nutrition, vitamin D3, and bone density.
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Recovery follows 3 overlapping phases:
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Immobilization
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Re-Strengthening
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Return to Activity
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Avoid phase mismatches: don’t resume activity too soon.
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Your treatment team should plan for the return-to-activity phase from the start.
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Protected weightbearing (not non-weightbearing) is usually best—walking helps flush out swelling.
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Contrast baths are the gold standard for swelling reduction.
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X-rays alone are not reliable—advanced imaging is often needed.
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Joint mobility must be preserved: Start pain-free range of motion exercises early.
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Strengthen early: Even modified strengthening helps prevent long-term weakness.
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Setbacks are normal—don’t lose hope.
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If you’re dealing with a fracture, get a bone stimulator early (self-pay if necessary).
📺 Bonus Tools
Visit YouTube and search:
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“drblakeshealingsole Self Mobilization”
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“drblakeshealingsole foot and ankle strengthening playlist”
📌 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.
