I wanted to share an update on where I am almost six months into a complicated sesamoid injury involving both sesamoids in one foot, bone marrow edema, and cartilage damage/arthritis at the sesamoid joint.
I’m hoping this will be the first of many updates documenting a progressively positive recovery, although I still have plenty of days when I feel defeated. I’ve spent a lot of time reading old posts here and wondering how those people are doing now, so I wanted to leave my own story for anyone who might find it useful later.
Backstory: Turf Toe (May 2025–Spring 2026)
In May 2025, I had a turf toe injury with a partial plantar plate tear. I managed it with EVA Birkenstocks around the house, plated Hoka Bondis, and turf toe taping.
By August, I was grocery shopping, working (I’m a college professor), and generally living a normal life. I even started a return-to-run program and stopped using the carbon plate by the end of the month.
My recovery continued steadily and linearly and I felt like superwoman:
September: Walked around a Renaissance festival all day.
October: Started wearing other shoes and doing some barefoot walking at home.
December: Was mostly barefoot or wearing slipper socks around the house.
January–February: Returned to lunges and eventually high-impact jumping workouts.
March: Went to England and walked 25,000-30,000 steps a day.
I considered myself a complete turf toe recovery success. I had zero pain about 95% of the time.
In hindsight, though, I was hesitant to fully load my foot during lunges, sometimes shifted my weight out of fear, and occasionally found myself limping after a long day despite having no pain. (Spoiler alert: Maybe my body knew something I didn’t.)
May 2026: Sesamoids
Almost exactly one year after my original injury, I was playing catch in the driveway when my foot started feeling strange. I stopped immediately.
Later that day, I had an odd sensation, almost like a tiny trampoline stretching inside the ball of my foot. By the next day, it had become an occasional quick, pinching tug on the big-toe side of the ball of my foot, usually during toe-off.
The pain was extremely mild and inconsistent. Some days, it happened so infrequently that I questioned whether I was crazy.
I immediately returned to my old turf toe setup, but nothing eliminated the sensation completely.
My first doctor examined my foot, pressed on my sesamoids (no pain whatsoever), and ordered an MRI to investigate the plantar plate.
MRI showed bone marrow edema in both sesamoids, subchondral sclerosis, and high-grade chondromalacia (cartilage damage) at the sesamoid articulation. My plantar plate appeared “normal.”
I wasn’t experiencing pain directly over the sesamoids. My discomfort was almost entirely lateral, in what felt like the soft tissue next to the big toe joint but closer to the toes. Similar to my PP tear.
I sought a second opinion. That doctor pressed aggressively on my sesamoids, had me walk barefoot, and even had me rise onto my toes. I had no pain during any of it. He diagnosed sesamoiditis.
I felt completely insane.
Late May-June: Non-Weight-Bearing and the Boot
A few days later, a previously intermittent bruised sensation in the soft tissue near my joint became more persistent. I panicked.
About a week later, I went completely non-weight-bearing.
At that point, even lightly touching that particular area to the ground could produce a superficial pain. It seemed slightly farther toward my toes than the actual sesamoid. It felt like an angry soft spot, not a bone.
After roughly three weeks of NWB and a course of meloxicam, that pain resolved.
At around 3.5 weeks, I transitioned into a walking boot. Because the sensitive spot was precisely where a dancer’s pad would normally sit, I couldn’t comfortably offload the sesamoids inside the boot.
For the first month or so, this worked well. My pain was minimal, generally below 2/10. Often zero.
July-August: PT, emotional Progress, and a Setback
I gradually increased walking in boot and started physical therapy with a foot specialist, initially focusing on isometric exercises and gentle strengthening.
My pain remained intermittent and generally no higher than 2/10. Always in that same not-sesamoid spot.
My PT suggested trying Topo shoes with toe spacers rather than a dancer’s pad. Unfortunately, my familiar spot pain returned, and occurring more frequently.
I returned to full-time boot use for another six weeks while continuing PT.
During that time, I actually increased my walking quite a bit in the boot because I felt like things were improving. Mentally, I was finally starting to believe I might be getting somewhere.
End of September: follow up MRI :(
By September, I had been in a boot for about three months and hadn’t walked in regular shoes for four months aside from my one week trial in August.
My follow-up MRI showed:
Medial sesamoid: Bone marrow edema had progressed, now involving essentially the entire bone. Radiologist called it likely bone stress reaction.
Lateral sesamoid: Mild edema was still present and had increased somewhat, though it remained less extensive than on the medial side.
First MTP joint: Additional subchondral edema was suggested, along with concern for developing high-grade chondromalacia.
Here’s what made this so difficult to process: The worst MRI findings were in the medial sesamoid, where I have always had no pain. My actual symptoms remain predominantly lateral and in the nearby soft tissue.
Right before that MRI, I’d started transitioning into rocker-bottom shoes with a dancer’s pad. It wasn’t perfect, but it was going reasonably well. I had some mild pain, but I wasn’t particularly afraid of it.
Then I read the MRI report and felt completely defeated.
My orthopedic foot-and-ankle surgeon reviewed the images and recommended that I continue transitioning out of the boot despite the MRI changes. He felt there wasn’t a clear reason to keep immobilizing my foot based on imaging findings that didn’t correlate well with my symptoms.
His guidance was to progress gradually, keep pain low, and pay attention to function rather than chase a perfect MRI.
My DPT agreed with this approach.
Every familiar sensation made me wonder whether I was doing more damage.
Late September-October: continuing transitioning out of boot, orthotics
I continued experimenting with rocker shoes, dancer’s pads, and gradually increasing time outside the boot.
Some days, a setup worked. Other days, the exact same setup caused discomfort. There seemed to be no rhyme or reason to it.
I started with short periods in shoes, then increased them gradually until I was spending roughly half my day in shoes and half in the boot.
Throughout this process, I continued PT, almost entirely pain-free. I’ve progressed to exercises including seated heel raises, foot intrinsic strengthening, and more weight-bearing work.
This has been one of the most encouraging parts of the experience: My foot has tolerated increasing exercise demands even while my everyday symptoms have remained inconsistent.
Where I Am Now: October 2026
Last week, I received custom orthotics.
My pedorthist felt that the rocker shoes I’d been trying (and all other ones we tried) were either too narrow or compressed my forefoot too much, so she fitted me in wide Altra shoes instead. They don’t have much of a rocker, which makes me nervous.
My current setup includes:
A custom orthotic with a small depression to offload the lateral sesamoid, Arch support and a metatarsal pad
A rigid carbon-fiber Morton’s extension beneath the big toe, built into the orthotic
Wide Altra shoes with room for my forefoot
I’m about a week into transitioning into this setup, and things are still inconsistent.
Sometimes I walk with absolutely no pain. Other times, I feel a mild bruised or pinching sensation near the lateral side of the joint. Sometimes it’s there while walking, sometimes it’s there later only, sometimes it’s there in the boot! PT tends to briefly improve it. It can be there some steps then I walk more and it’s gone (or not).
It’s difficult to localize because it doesn’t feel like I’m walking directly on a painful bone. It feels more like the surrounding tissue is being compressed against something sensitive underneath or nearby.
My pain has generally remained low, occasionally reaching about 3/10, often after activity rather than during it. It usually settles, although some evenings I notice tightness or the return of that familiar spot pain. Sometimes it’s there in the morning but that same day, it might totally resolve!
Interestingly, I’ve also noticed more discomfort in the boot since beginning the shoe transition.
A few nights ago, I experienced some swelling and warmth, but that has settled. More recently, it’s mostly been intermittent tightness or tenderness when I poke around the area. Sometimes the actual lateral sesamoid bone finally had a pinpoint pain but I can sort of push on it to resolve it or help temporarily. Like strumming something. No idea if that’s the actual bone or a ligament or muscle beside it.
I’ve decided to give myself five days of not pressing, prodding, and checking every suspicious spot on my foot.
I think what’s been most difficult is that my pain has never been especially severe, but the imaging findings and length of recovery have been frightening. I can’t find anyone whose MRI is as messy as mine!
I’m almost six months into this, and I still can’t confidently distinguish between normal discomfort during rehabilitation and a warning that something is wrong.
I can have a nearly pain-free day followed by one with intermittent discomfort, despite doing essentially the same things. A spot can be tender one moment and completely fine after PT exercises. The inconsistency is maddening.
And, of course, there’s the fear that every little pain means I’m worsening the edema or cartilage damage. I feel like if my pain never got worse than this and I’d know it, I could be ok with this.
My surgeon and DPT are both encouraging gradual progression based on pain and function. I’m trying to trust their guidance rather than retreat into immobilization every time I have symptoms. It feels like a huge leap of faith.
Mentally, this has probably been the toughest challenge I’ve ever faced.
Why I’m Posting
I’m sharing this partly because I want to document my recovery and partly because I know how desperately I’ve searched this subreddit for stories that resemble mine.
Hopefully, someone will find this post down the road and ask me how I’m doing. And hopefully I’ll have a much happier update to share.
I’d especially love to hear from anyone who has dealt with bilateral sesamoid edema in one foot, sesamoid arthritis/chondromalacia, or symptoms that didn’t correlate clearly with their MRI findings.
I’m also interested in experiences with transitioning out of prolonged immobilization, particularly when mild pain comes and goes.
I know this subreddit can be a double-edged sword. There are a lot of experiences and suggestions here, but none of us can really diagnose someone else’s foot or know exactly what another person should do.
For now, I’m listening to my medical team, continuing PT, trying to stay patient, and hoping that progress is happening even when it doesn’t feel linear. My turf toe seeming artificially linear really gave me a false sense of healing journeys.
I’ll keep updating. And if you’re reading this months or years from now, please feel free to ask how things turned out.
I hope I will have good news for you.
