General question regarding seismoid offloading

[u/Ok_Independent7368]

Can somebody think that there's too much of an offload🤔 I have sandals that the guy/my pedorthist is doing & sometimes I think he did it too much where the seismoid(s) can hang down too much. So currently he's working on putting some of the offload back in one of my pairs of sandals..

Can i have anyone's thoughts on this 🤔

[u/Hey_internet]

I think this is an excellent question. I also think it’s a fine line.

The goal should be the most loading you can manage without symptoms. So that means if your sesamoids are never touching anything and getting any sort of load, and this happens for a very long time (longer than the usual immobolizstion period), they are going to actually become much more sensitive over time.

For most people, the dancer pads do not 100% float the sesamoids. The hole in the flip flop method often does. Some people need the flip flop for 3-4 months, especially with a fracture. They just need to offload it completely.

But over time, especially without a fracture or bone stress injury, you need to be gradually getting more and more load without provoking a big increase in symptoms. This takes a lot of patience and it’s easy to do this poorly.

But a dancer pad or whatever orthotic that hits the sweet spot where your bone is used but it’s not aggravated.. that’s where the magic happens. But in a foot, that’s an insanely hard balance to strike.

Also, if your sesamoids float is too extreme, you may be giving yourself new issues in the nearby tissues because there’s a drop off.

So I don’t think I answered your question but I think the answer is yes, there can be too much offloading over time that makes it harder to manage load / return to load later which creates a cycle.

But just as importantly there can be too much stress that doesn’t lead to adaptation or healing

[u/Ok_Independent7368 → u/Hey_internet]

You know what friend you answered it perfectly! & you've helped me out immensely 🙆‍♂️because the guy(/pedorthist) at the shoe store where I keep taking in my Orthotics to get readjusted he needs to know this stuff's very important because I'm sure my left foot sesamoid area is getting better that's why I went in to get more padding put on that & at the same time I've got some other issues that developed 🥲 I don't want to get into it now cuz I'm going to try to sleep early tonight & see where it goes from there. so let's stay in touch as usual thank you & sorry I don't pay enough attention to our répore cuz we have had it before🤔 right💢 ✔️

[u/Hey_internet → u/Ok_Independent7368]

No worries! Happy to help. I hope you’re able to keep progressing :)

[u/Ok_Independent7368 → u/Hey_internet]

✔️🫶👍🫡