Sounds like you have a lot of sesamoid questions around here! I have one to add to the mix :-). I'm female, age 24, 5'3" and 127lbs.

I am a ballroom dancer (it's not my profession, but a serious hobby) and last spring started having sesamoid pain in one foot. I danced on it for several months before getting an Xray, which determined that I don't have a fracture. I tried many things to help it, including not dancing on it for a few months, wearing a dancer pad, and acupuncture (this included needles, painful massage, heat application, you name it). After a while the pain subsided and I started dancing again because I thought it was over.

More recently I've started dancing more intensively, and because I am preparing for competition, I started dancing in high heeled shoes (this is necessary for competing; otherwise, I try to wear lower heeled practice shoes just for everyday training). The high heel, perhaps with the more intensive schedule, has resulted in renewed pain and I am so disappointed! I saw another podiatrist and was told that the xray does not seem to show a fracture, but does look different from a previous xray I had when the condition first started. Apparently, it seems like the bone may have eroded, I was told, and was recommended an MRI. The procedure is expensive, though, so I have not gotten it yet.

I wonder if there is ANY way I can continue dancing without surgery, which, as I understand, may not necessarily have a positive outcome and also will require me to stop dancing completely for a long period! I'm quite worried about this and willing to do anything at this point. It seems like dancing in the lower heeled practice shoes is not bad, but with the high heels I just feel like I might be causing more injury. Many thanks for any advice!

Hi and welcome.

You're right that the higher heeled shoes are going to add load to the sesamoid and make things a bit worse. If you can avoid them, all the better.

The dancer's pad is going to help. But in many cases, the dancer's pad will only go so far in terms of helping with the pain.

The change in appearance of the bone and the request for the MRI might signal a change in the bone called AVN or avascular necrosis. Does that sound familiar from your conversations with doc #2?

Have you taken a peek at our pages on sesamoiditis and sesamoid fractures?

What to do? Unfortunately, often that choice comes down to either decreasing your activities or having the sesamoid taken out. I reckon that's the lessor of two evils, eh? What's the plan with your doc?

Jeff

Hey! Ok so here's my problem.

I am a senior in High School, and I am a VERY competitive runner. I have been running since middle school (6 years) and I had never had any serious injuries untill this summer. All summer I felt that "dull pain under the big toe". I know I shouldn't have, but I waited to see if the pain would go away. It didn't. I went to a podiatrist, and he told me to take two weeks off, anti-inflammatory medicines, and get special orthorodics.He said they weren't fractured. I took the two weeks off. Because we don't habe a lot of money, I had to wait untill janurary to get the orthodics (been wearing them since)

Here I am, in Feb. and the pain has worsened. It's not unbearable, but it has gotten worse, and I'm afraid that it will only get worse. I've heard the condition can be cured by taking weeks and weeks off, but heres my other problem: I have a full ride to a division 1 school for running and I would like to see if I can keep training. I don't know if this is possible. Should I ice more than just after I run? Take more anti-inflammatory medicines? I'm afraid since the pain has worsened they may have fractured?

I've heard they can cut out certain parts of the orthodics to take pressure off the sesamoid bones? I don't know how to tape the toe, otherwise I would do it.

I'll ice several times through out the day, take anti-inflammatory medications, do special exercises to strengthen, tape the foot.

My question is, this should be helping, but it doesn't seem to. Do I need to take some time off? Or go back to the podiatrist, and get another x-ray or bone scan?

Hi XCrunner and welcome.

I need to ask a favor of you...let's preserve G809's thread and get you into a new thread. Just copy the post above and pop it into a new thread. We'll talk there.

Thanks.

Jeff

Thanks for your response, Jeff!

I'm not sure my podiatrist knew why the bone changed (or if she had an idea, I wasn't told about it :-)). She suggested the MRI to try to assess the situation, but suggested that if my pain goes away/doesn't bother me, I can probably just ignore the problem. I've been trying to take the latter approach, and have been wearing my dancer pads religiously and bought dance shoes with a slightly lower heel (2" instead of 2.5").

I have looked at those sites but my understanding is that what I have is not a fracture -- is that incorrect? If the problem is lack of blood flow to the area, wouldn't it be possible to stimulate it using heat or other approaches? I'm still trying to hang on to the hope that this can heal without surgery, because my understanding is that surgery can make things even worse in some cases... do cases like mine ever heal on their own over time?

Thanks again!

I'd agree with your doc in that if it doesn't hurt, leave well enough alone.

So are you saying that it seems to be a problem secondary to blood loss to the sesamoid? (AVN) I don't think that was clear in your previous posts. But is that true?

Jeff

Hi Dr. Oster,
Just wanted to send a quick update that my injury seems to be improving (albeit very, very slowly) and seems to get better when I let it rest. I wonder if you have any suggestions for exercises that would help a sesamoid injury heal? For example, toe/calf raises or towel-scrunching with the toes? Would developing muscles in the foot in this way contribute to the injury or help to prevent it in the future?

Thanks!
Polina

Hi Polina,

Well that's good news. Rather than exercise, I've found that the best thing to do is to splint the foot to decrease the normal range of motion of the great toe. I use a lot of turf toe plates to do that. It may be a funny looking little insert, but it's effective in limiting the normal range of motion of the great toe joint.

Jeff

My daughter is 13 years old and she has a medial Sesamoid fracture. Our docter wants to perform surgery tommorow to remove the bone. They also wanted to carve into the other sesamoid bone to prevent a bunion. We visited other docters to get thier approval and they all said they have never heard of a 13 yr. old ever having this surgery. So now were stuck. What do you think we should do?

Hi Lauren,

First, let's get you into a new thread. It's tough for me to keep each case history separate unless you have your own thread. So just copy your post above and click on new topic and paste into a fresh thread.

Jeff