• Plantar sesamoid pain is usually the result of excessive pressure exerted by bone on the soft tissues below it. This can be caused by abnormal pronation of the rearfoot, abnormal position of neighboring metatarsals and/or hammering of the toes. Excessive pressure causes injury to the soft tissue structures that hold the toe to the metatarsal bone and cause dislocation of the joint.
  • The influence of pathomechanics and foot gear on the deformity was explained. Pronation of the rearfoot during walking causes instability at the base of the first metatarsal allowing it to move up and out of position. The big toe joint then becomes progressively more and more subluxed.
  • Treatments include padding with aperture pads, well cushioned shoes like sneakers with thick cushioned innersoles, orthotics that are custom made to protect the site and control the mechanics of the foot. It was explained that orthotics address the biomechanical cause of problem, pronation of the rearfoot. Control of pronation reduces the deforming forces that make metatarsal pressure worse.
  • Following protection of the injured site, stimulation of healing can be performed with Cutting Edge Laser Therapy to improve blood circulation to the site, and Shockwave therapy to stimulate tissue to heal.

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