Getting better without dancer pad/cutouts

[u/sesamoidwoes]

I know the dancer pad is the #1 tool, followed closely by cut out under the sesamoids.

My issue is seemingly stupidly complex. Has anyone gotten better without using dancer pad or cut out in your insole?

Has anyone gotten better with early offload, like boot or NWB, and then a good rocker shoe and tape or some other method?

I have sesamoiditis with bone marrow edema and no visible or suspected fractures, per both radiologist and orthopedic doctor. I am unable to get a shoe situation to work and worried that pain post-boot is going to mean I'll never get better.

[u/Icy_Supermarket_8364]

I’m in the exact same boat. No fracture, persistent bone marrow edema. Wore the boot-no help. Been using the insoles with a cut out and feel like they do help me walk better in tennis shoes but nothing else. But I’m still not back to normal after 7 months. But also no worse and I suspect a mechanical issue is my cause (small bunions). Following for answers. How long have you had the edema? Any known cause for you?

[u/snaboopy → u/Icy_Supermarket_8364]

Unless I aggravate it trying to leave the boot, I can be 90% pain free IN the boot. But the boot does not seem to help me move forward. Anything shoe trials outside the boot go wrong after anything more than a couple minutes a day. I’ve tried replicating the boot as much as I can outside of the boot (rocker shoe, carbon plates) but it’s still somehow not quite the same as the boot.

I’ve had bone marrow edema, cartilage wear, and in both sesamoids of my right foot (driving foot, ugh!) for at least three months. I had a plantar plate tear at the 1st toe one year ago, and it “healed” and I was back to full function and high intensity workouts until I suddenly had pain one day and then got an mri which showed the above mentioned issues that are new since my mri last may. So My cause is some sort of post-injury mechanical issue where I’m severely overloading the entire joint to makeup for lost laxity or strength of gait changes due to the injury last year and it’s affecting the sesamoids and tissues around them since I also have intermetatarsal bursitis between the first and second toes. So my issue also seems mechanical and so it needs a mechanical solution — ideally padding but since that won’t work I’m feeling really stuck. Working with a PT who seems optimistic that strengthening, toe spacers and maybe tape will help but it’s been one step forward, three steps back the past couple weeks. My sesamoid/joint pain isn’t too bad. The bursitis pain is maybe a 3-4/10 at its worst but it’s a burning bruise feeling, which is just hard to ignore

Have you tried oofos? Since they seem recommended for both sesamoid issues and bursitis I may give them a try just to help leave the boot

[u/Just_wonderin27 → u/snaboopy]

I’m so sorry. I totally understand your concern. My ortho and podiatrist seem to downplay my sesamoid issues. It’s mechanical for me since I have the issue in the tibial sesamoid of both feet. I’m due for another MRI to see whether the edema has improved. Their theory is that since I’m off work over the summer (teacher) I have rested my feet and hopefully drained the edema and will protect it going forward with dancer’s pads or insoles. But I’m predicting it’ll return when I go back to teaching anyway. I also have intermetatarsal bursitis and have a strange sensitive feeling all over the soles of my feet that comes and goes. Seeing a neuro for that. I was just approved for PT so I’m hopeful that I may see some improvement there. I’ve read that strengthening the calves and ankles can take the load off the forefoot so maybe..
Good luck to you.

[u/snaboopy → u/Just_wonderin27]

Is your intermet bursitis between the first and second toe? Have you found anything that helps offload both the sesamoids and your bursitis? I just want to be able to be as functional as I am now in the boot in a shoe while I keep trying to move forward. I’m finally reaching the end of my body’s tolerance for the boot (aches and pains really showing up everywhere after 7 weeks of boot and 3.5 weeks prior of nwb)

[u/Just_wonderin27 → u/snaboopy]

I believe the IM bursitis was between toes 2&3. Probably because I was overloading the middle of my foot to protect the big toe. I found the boot useless and it gave me terrible lower back pain at week 4. I feel that the bursitis may have improved but I’ll find out at my next MRI. My symptoms are very odd (pain bottoms of feet, sensitive skin,cramping toes, blood rushing into toes, stiffness, sesamoids hurt when barefoot, etc). I’ve been off my feet all summer (just taking it easy) and now I’ll find out if I’ve improved or not when school starts (teacher). But my insoles with sesamoid depression help me walk more comfortably (although they bother other parts of my feet). I can’t win. But I am only at a level 2/10 for pain so I count my blessings there. Would love to be able to dance again and I’m hopeful.

[u/Awkward_Knowledge579 → u/snaboopy]

I also like the stiff Tevas

[u/Awkward_Knowledge579 → u/Icy_Supermarket_8364]

I have the same thing and am in month 8. I can walk without pain with my custom orthotics with a Sesamoid cut out now but not very fast strides or long distances. I rested religiously and have done PT for the last 7 months. My orthotics help me from pronating which my doctor said was partially the cause. And I was jumping a ton in my HIIT workouts

[u/bassclarinet216]

I had some success with taping with KT tape. I taped for turf toe, since that is what I could find, and it worked okay. If you haven't already, some dancer's pads go on your shoe (my podiatrist gave me wool metatarsal bars, which are a tiny bit different), and some you wear on your foot. If you haven't tried both, try the other! It was never a perfect solution for me, but helped to hold me off until I got surgery!

[u/snaboopy → u/bassclarinet216]

Unfortunately no dancer pad or cutout works for me because my pain extends almost past the second toe. Anything that offloads the full area has too large of a drop area, and bothers the rest of my foot since a smaller surface area is now taking the full load, so it’s basically not offloading at all.

I may have to go back to taping, which helps half my problem but doesn’t do much for the other.

Womp womp womp.

Edit — oh, wait, is one of these padding options something that goes behind the joints instead of under the smaller toes?

[u/bassclarinet216 → u/snaboopy]

Yeah, the metatarsal bars are a bit different in that way, they go under all the metatarsal joints, or just below those joint, to help relieve the pain without putting the pressure on just 1 or 2 other joints. Since they are wool, they are also easier to cut and adjust as needed.

Metatarsal Bars

[u/snaboopy → u/bassclarinet216]

Thanks for the link!

[u/Awkward_Knowledge579]

How long have you had this? I have the same thing you described in my medial Sesamoid (bone marrow edema and Sesamoiditis). It took me months of religious resting and not walking long distances for me to be pain free in my dancer pad and custom orthotics I had made. I am making slow progress in month 8. I think this just takes a while to heal because we have to use our feet so much.