@@ninasky7 Wow! The Goal of Rehabilitation is achieving 0-2 pain and maintaining it throughout the process. The phases of Rehab are Immobilization, Re-Strengthening, and Return to Activity. What phase are you in now is a big question? Probably have to do other Immobilization techniques, but I just do not know enough. Rich Blake
My entire heel hurts. The doctor told me I have plantar fasciitis and I need to just stretch it as much as possible. So that's what I've been doing and it's not getting any better.
It may have started as plantar fasciitis, but you must have incredible inflammation or nerve pain. Does it look swollen? Does it hurt to walk on your heels alone? If you can get an MRI, calcaneal stress fracture is my number one bet. How did it happen? Was the initial symptoms gradual or very sudden? All good questions to answer? If it is plantar fasciitis, the answers would be not swollen, not hurt to walk on heels alone, gradual onset. Rich
@@drblakeshealingsole thank you so much for your response! It does look swollen, it feels swollen, mainly on the inside edge of the heel. I couldn't even begin to walk on my heel alone. It was a sudden onset when I started taking a new dance class. I started the class in January and the pain started in May. I thought plantar fasciitis because the floors were hard and I was barefoot. That's the only thing that I've done differently. Based off of what you have said, I'll be going back to the doctor ASAP! I knew it was more than plantar fasciitis! It's probably the most painful thing I have ever experienced. I did get an x-ray and I do have a bone spur. But the part of my foot that hurts the most is not where the bone spur is. The bone spur is more towards the middle of my heel, whereas the most painful part is the medial edge. Thank you so much for your time! Edit: something else I forgot to mention that I think is very relevant is the fact that I put on a lot of weight very quickly. I think it was just a perfect storm of all of these different factors colliding to make my life miserable lol. I have begun losing weight, and I have implemented a regular workout/stretch routine.
You must find an activity that may force the toe to move more than the limited Range of Motion and use it then. Patients with hallux limitis or rigidus do not have the range of motion to run normally in general, so the tape prevents the bending while allowing you to run for example. Each patient is different. Rich
This video explained to me the issue. I am diagnosed with l5-s1 disc desiccation. (small left central annular fissure). No pain at all in my back but I feel electric shocks from time to time in my right foot (L5 Heel and S1). Did a nerve test on my right leg and all good. I am looking for treatment to stop the electric shocks.
Typically daily with the simpler exercises as you are really finding your level. And the beginning exercises, with no band work, can be done 2-3 times a day. However, once you hit your level where the 2 sets are challenging, switch to every other day so you can have a recovery day. Rich
@@drblakeshealingsoleHi Dr Blake This video is fantastic. My physical therapist threw me in the deep end right away with red band inversion exercises and it really set me back. I started with active ROM. Before this I started having hip pain. Any advice you can give me on that I assume it’s because my gait has changed
@@charlesboyer8811 Walking weird with any lower extremity injury can put stress on another joint. It is best to walk slower and maintain your normal gait. If you still limp, you really should be on crutches, or in a boot to rest the area more. Rich
So, many ways. I will refer you to my blog at www.drblakeshealingsole.com. But, the list starts with toe separators between the first and second toes to keep the big toe joint separated. This is probably all you need now, with 30 minute 3 times weekly yoga toes in the evening. Rich
HOW HAVE I ONLY JUST FOUND THIS VIDEO AFTER YEARS OF RESEARCH & FOOT SPECIALIST APPOINTMENTS?! I HAVE THE EXACT PAIN IN THE AREA IN THE LAST SECTION, LIMPING ALL DAY EVERY DAY& I RECENTLY HAD AN MRI ON MY SPINE WHICH SHOWED GENERAL DETERIORATION FOR MY AGE BUT THIS COULD BE WHY?! FINALLY SOMEONE SAID IT, I KNEW I WASN'T THE ONLY ONE! THANK YOU DR! - FROM THE UK!
I can't believe how much research it took for me to get here. 4 years of doctors and PT's telling me it's impossible to find the cause of my foot pain because of clean imaging and difficulty recreating the pain during the exam. They would act so irritated when I told them the pain was complex and unpredictable and generalized around a certain area. They'd brush off my questions about the pain possibly originating from a different area. They were in disbelief that it kept getting worse with treatment and rest. Whenever I googled "pain after injury heals" all I could find was info on neuroplastic pain (controversial). Whenever I tried to research referred pain, all I could find was facia info (also controversial). The only people who ever agreed with me on everything being connected were alternative medicine doctors. I can't believe none of these traditional doctors ever referred me to a neurologist. They just told me there's nothing else traditional medicine can do for me. Thank god my GP referred me to a neurologist for carpal tunnel, maybe there actually is hope for me after all...
@@drblakeshealingsole thanks so much. Your blog has been teaching me so much for a couple years, I just didn’t think to look into the nerve pain resources until now since I was focusing on my sesamoiditis diagnosis
Hello, I have a stress fracture of the I lateral sesamoid, did MRI, doing streches for calf muscl, but I don't know which insoles to buy, maybe you can recommend me, which ones better to buy, I'm thinking about ortho shoes too. Thank you for the answer :)
Thanks for the comment. If I was to pick one shoe, it would be the Hoka Bondi. It is a low heel, rocker type shoe with great stability. However, Hoka shoes have 3 different rocker types (early, balanced, late) and one may be just better for you individually. Check out stores that sell Hoka when you have alittle soreness, and see if one of the Hoka rockers feels better for you. When you are in alot of pain, getting bike shoes with embedded cleats to walk around in can immobilize the area. For insoles, you want a full length Sole or Powerstep that you can place off weighting pads. Please see my blog at www.drblakeshealingsole for more info. Hope this helps. Rich
@@drblakeshealingsoleOkay thank you very much. If I would buy Hoka Bondi shoes, do I need to change insoles for them into orthotic insoles or maybe I can wear without changing the insoles, which way is better?
Wow. I have dex. scoliosis of lumbar spine and hyperlordosis of L/S part. Also bulging disk L4/L5, cyst on L5/S1, bursitis on L4/L5, Tarlov cyst S3-right. I have lumbar back pain, hip pain, muscle cramps, tingling, and last few weeks stabbing/burning pain in feet, especially right foot outside, around heel, both big toes pain (not all the time), and sometimes pain in my thigh bellow my right buttock. I work as a waiter and walk around 10-15 km and this pain in my legs and feet are killing me. I'm 40 y.o. but feel like I'm old lady.
Thank you so much first of all for marking the toes 1-5. Mine is 4. I couldn't remember which one to tape it to until I watched your video. I can't thank you enough this is the way my podiatrist did it while living in Miami he was the best podiatrist I've ever had. For many reasons beyond that. He also so educated with my Rheumatic disease A.S. haven't found one yet that knows beans about that and certainly not here in TX anyhow thanks again❤
@angelica225 I did, it took me about 3 years but i did. I am going to list my best advice/ recommendations/ mistakes, but keep in mind that i dont know what point of your sesamoid fracture journey youre at, your lifestyle/ work and body composition (which play a role in your recovery journey). You will be okay, it will take some time but eventually you will be fine! The Game Changers: First, you need to keep the weight off 24/7 for a long time. Google 'post op shoe for broken toe', and get you one. If you wake up at night because of the pain, buy 2, so you use one while you sleep. I lived with this shoe for about a year, but i was lucky because that year was the first pandemic year, so we were locked in so i wasnt being mobile that much. After a few weeks i could take it off while laying down. Then I used it on and off for about another year (there was a lot of trial and error, I will elaborate on this later on). After that, I searched for a long time shoes that I could walk in and then be okay (the pain will come and go for a long time before it disappears forever). I live in Greece so the weather permits it, and for the first time in my life I bought berkinstocks - they were they only ones that gave me freedom of movement. (Again, this was for my foot, I have severe flat footness, so im sure that played a role. So search around for your foot and see - forget heels for about 2 years. Second, you need to take care of your nutrition. This is the fuel your body uses to heal itself (build it too). Any inflammatory foods (especially sugar, breads, alcohol, processed foods) is your enemy. Stay away, your body will thank you for it. Inflammatory foods affect your body's immune system, cardiovascular system, brain chemistry - everything you do not want to be doing right now. Third, no smoking or at worst minimize to the max. You need to understand your sesamoid bones are floating bones, this means they are not a part of your skeletal system. Such bones get their nutrition through micro vessels, which smoking kills. Inflammatory foods also affect if those micro vessels will deliver nutrients to your sesamoid bones. Fourth, exercise. This comes in 2 stages. Stage 1 is when youre in excruciating pain, can't walk, hating life while being in the immobile stage. Exercise will become your daily motivation and source of endorphins - your happy chemicals. You need those now. At this stage all your exercises are on the floor, on a mat. You need to keep your legs strong, both of them, and your core too. Here I will introduce to you Caroline Jordan. Without exaggeration I owe her my whole recovery. Check this link out: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-b6ZZ1Vb6dOY.html Her videos made me stronger. I practiced yoga for 10 years before my injury, run every day, I was super fit - working out with Caroline Jordan's videos, I swear I was so much stronger after the injury when i got back on my mat. I couldnt believe it. Also, swimming if you can, sign up at a gym with a pool (swimming became my new running). Stage 2 comes when you can bear weight, and can walk on it a bit, without it afterwards getting swollen. Here you do serious strength training. Find an excellent personal trainer with specialised expertise in body rehabilitation - you dont play around here. This person is going to help you jump again. You need someone to push you through, while making sure it wont break/ hurt again. I can't stress this enough, you need a person who knows the correct steps to eventually get you back to jumping. And you will work with them for at least 2 years (I still go once a week). I had a collection of videos on 'Sesamoid strengthening', the folder i have kept public so you can access it. These were videos that I saved back then because I learnt/ gained something for my healing journey, but its been a long time, so I dont remember which ones were top, apart of course of this video by Dr. Richard Blake (which is on the list), and the the link above of a video by Caroline Jordan. Anyways, here is the link where you can check the other informative videos I had found back then on sesamoid strengthening: ru-vid.com/group/PLGk-epq1csvSrnM_K5vPYgy5ETACjyCtv Here is a link to another folder I made 'broken foot exercises', youll find 100 videos i had saved to keep me in shape during the different stages of my rehabilitation journey. These were of 'short' duration: ru-vid.com/group/PLGk-epq1csvQegrLyTXxD8PgIGM4q7Z_0 I had compiled another folder 'broken foot long exercises', 35 videos of longer workout routines, here is the link: ru-vid.com/group/PLGk-epq1csvSKZdn11kf6pWuYepyThwyw. Fourth, sleep. You need to have a good nights sleep. It is during the night when you sleep, your brain releases the chemicals that then, in 2 words, go around the body to heal/ repear damaged cells. You miss that window, you might sleep but you dont get the real benefits of sleep. Make sure youre asleep max by midnight. This is a period in your life where you focus on your body and put it first. Last your psychology. This is a long marathon, it will take time, discipline, but you will be able to jump again. I keep on saying jump because for me that was the ultimate goal. I dont know how you got your fracture, but mine was a stress fracture (overuse). If you also got it like this use this rest time to ponder why and learn something from this. For me, that fracture ended up being a blessing a disguise - i changed gears after that, respecting my body, you'll see you'll come out of this respecting your body and its ability so much after this. You'll never take walking for granted ever again. Keep your spirits high, this is only a phase, it gets better, and in due time the pain will disappear. But it is a long journey. And there will be a lot of trial and error as i mentioned earlier. What i mean is, what I experienced was, when i was able to walk again, even start doing very timidly and very humbly basic yoga, on the one hand i was scared to push through that fear of risking to break it again and relive all that pain, and on the other hand, to keep my ego in check. For example I would think 'oh yeah I can walk now 3 blocks with my berkinstocks' and then end up having to stay immobile again for 3-4 days because it ended up getting super swollen. Also I foolishly hurt it again twice, seriously hurt it once I had to go back to the shoe for a whole month. Be careful when you're starting to use your foot again, but make sure you dont get stuck in your mind about it. Dont worry if you do something and the pain is back, just keep the weight off for a couple of days, use the special shoe again, and youll be back to normal again. So there will be some back and forth going on in your healing journey. Be patient and respect and listen to your body. If you want to ask me anything, feel free. I remember how i felt when i got it, but this summer i danced on heels at a wedding for 10 hours, so eventually youll be fine trust me!
Hallo Dr. Blake, Ich leide seit 3 Monaten an einer Sesambeinfractur. Da kein Röntgenbild gemacht wurde wurde der Bruch des Sesambeins anfangs nicht erkannt. Nach 7 Wochen habe ich dann auf ein MRT gedrängt. Der Befund vom MRT ergab dann die Fractur mediales Sesambein. Auf den Bildern ist ein deutlicher Riss zu erkennen. Dieser klafft an der äußeren Seite auf und beträgt an der äußeren Stelle ca. 3 mm. Der Orthopäde hat mir einen Vorderfussentlastungsschuh verschrieben. Ich mache mir sorgen nie mehr normal laufen zu können. Ich bin jetzt seit 4 Wochen zu hause. Ich soll drn Fuß ruhig stellen. Ich habe dass Gefühl, dass eine absolute Ruhigstellung so nicht gewährleistet wird. Muss die Ruhigstellung nicht mit einem Air cast Walker durchgeführt werden? Sehen Sie Möglichkeit, dass ein 3 mm klaffender Bruch wieder zusammnenwachsen kann? Für eine Antwort bin ich Ihnen sehr dankbar. Vielen Dank. Grüße dirk
A 3 mm gap can heal, but typically is treated with immobilization in bike shoe with embedded cleat for 3 months, a electrical bone stimulator, and contrast bathes 1-2 times daily. The shoes need off weight padding for the sesamoid! Rich
Hallo Rich, Vielen Dank für deine Antwort. Es gibt mir Hoffnung:) Was ist das für eine elektronische Behandlung? Ist dass das Exegon Gerät? Ich überlege ein Magnetfeldtherapie-System zu besorgen. Ich habe in vielen Büchern und Berichten gelesen, dass damit der selbstheilungsprozess vom Körper angestoßen wird. Wie ist deine Meinung und Erfahrung? Dann habe ich eine Frage zum Schuh. Ich trage jetzt seit 5 Wochen einen Vorderfuß entlastungsschuh. Nachts trage ich den aber nicht. Ich merke keine Verbesserung. Ist das noch zu früh? Gestern Abend war mein Zehgelenk dick und im hinteren Bereich des medialen Sesambein verspürte ich schmerzen. Durch Abtasten konnte ich die Stelle lokalisieren. Vielen Dank vorab. Gruß dirk
This is a great post about the nuances of gait analysis. For many patients, doing a gait analysis can help so much in getting the right orthotic prescription! Thanks Dr. Blake!
UK here, let down by the NHS repeatedly, now onto my second private podiatrist at great expense but your website and videos have greatly helped a mid 20 year old who is struggling greatly with this! Thank you for everything you do
Went to the podiatrist today and this was the area that was sore and I had all the symptoms, it’s been 3 weeks. Have been in a boot for that time but they told me 2 more weeks and gave me a steroid injection into the joint where the sesamoids are. They didn’t exactly give me a specific name for the diagnosis other than saying it was a joint and soft tissue injury with fluid buildup/swelling but did an xray at least. They said I had a slight bunion which showed on the xray. This video was very helpful, just like what my podiatrist did to assess the issue. Thanks! I hope mine gets better and that it isn’t permanent, it would be great to avoid surgery but the pain from it is so sharp and tender and unbearable to walk on without my walking boot. I just want to walk normally again and use my toe.
@@drblakeshealingsolein week 11 since injury. Medial fracture after slipping off stair tread whilst dorsiflexed. Minimal rest post injury until week 10. On boot, bone stimulator and contrast baths. Week 10 MRI shows biparte consistent with contusion. Opposing foot is not anatomically biparte. Fingers grossed for healing and to avoid surgery; Thank you for your videos.
The instructions about the anterior not supposed to help are priceless!!! So I do not do exercises from each segment right from the get go , but start with range of motion only, then go through the variations and then move up to isometric and functional?
Your thumb is pressing on my Nerve enervation. That medial pain just under the maleosis is exquisitely bad and it’s so relieving to have it recognized.
Where your thumb is in the middle is where most of my pain is. It feels like it is bruised. The soreness is all around where you pushed but the main soreness for me is where you kept your thumb
Wow this is actually helpful! The two tips help in choosing which shoes are best for a certain sport, in my case, basketball. Might be a decade late gor this comment, but thank you!!
What should I do if I have multiple broken toes? My #3 toe, my #4 toe and I think my #5 (not 100% on that one) are broken and have been for something like a year now (my mom told me "they cant do anything for a broken toe", so I basically left it) and now the pain is so bad I can't wear shoes or boots (or even slippers!) for more than 30 min or so. Can I buddy tape all three toes to my remaining healthy ones or would this require a different approach? Is it possible they've "healed wrong" over the past year?
Thanks for your comment. Yes, It is hard to know how they have healed. Having pain for more than 3-4 months after a broken toe or toes is quite unusual. You need x-rays to see what is going on and design a plan. Hope this is possible? Rich
@@drblakeshealingsole Luckily I live in Canada, so the financial side is less a concern and it was more a general dislike of going to doctors unless it's absolutely necessary that was stopping me (especially since we have free socialized healthcare, I feel bad if I'm using our already over-burdened system for anything that isn't truly necessary) - I'll make sure to get x-rays done ASAP. thanks.
Great comment! Yes, patients have to be careful when doing the anchor strips that they are not too tight! If it tights during the day, you need to take off. There are plenty of other tape techniques that do not wrap completely around giving swelling an Avenue to escape, This particular tape is for a single game time frame in general! Thanks for your comment! Rich
Is there any circumstance where buddy taping 2 to 1 is acceptable? I only ask because my toes are already naturally curved, and when I stubbed my 2nd toe, it curved a little further into toe 3.
As a general rule you dont, however patients do come in with that configuration and say it feels the best to them. In those cases, I do not have them switch back. So, I would try it if you feel better with that arrangement. There are reasons that would be naturally true anyway, so good with which way feels the best. Rich
Would it be a mistake to put on a ski boot and ski when I’m five months out from A non-union tibial sesamoid fracture? Other words, if I decide to go skiing, could this possibly set me back in my recovery? Thank you.
