Avascular Necrosis of the Sesamoid

I wanted to write about a condition I have been dealing with in order to help others who are facing the same thing. After a lot of searching, I realized there's not a whole lot of good information out there and I want to prevent others from being discouraged, and let you know that you're not alone! So if you've stumbled upon my site while searching for help, here is what I have learned.

Condition: Avascular Necrosis of the Sesamoid
(This means one of the little sesamoid bones in your foot is decaying).

Onset: After visiting an orthopedic specialist, I found out this is a very random and unpredictable injury. In my case, I landed on my foot the wrong way during a P90X Plyometrics workout.

After the initial injury, the onset of pain was gradual, until one day it became unbearable. I discontinued my workout program and stayed on the couch frequently with an ice pack. Ibuprofen alleviated the pain slightly, but not much.

I did not immediately go to the doctor. I didn't want to be a wimp and thought I could wait it out.

After a year of waiting and altering my workouts (swimming in the summer and short walking stints in the winter), the pain had gone from a 10 to a 6, and I was tired of waiting for it to go away completely.

Diagnosis: Required foot x-rays which helped the doctor know to do an MRI. The MRI showed that one of my sesamoid bones was in fact decaying. I did not want to pay for an MRI or any doctor's bills, but the diagnosis actually gave me peace of mind because I finally knew what was going on in my foot!

(If you happen to be in the DFW area, check out Texas Orthopedic Specialists. I had Dr. Modlinski, and he's GREAT! He also looks like Jon Hamm, which is a plus).

Treatment: Two options: 1 - Wait it out and let the bone die or 2 - Surgery.

As with many situations, surgery should only be a last resort. The doctor recommended that I give it 6 more months while wearing some specialized pads on my feet (shown below). He said my bone was in "hospice care" and our goal was to make it as comfortable as possible while it was dying. When it's dead, your body absorbs it (weird!) and makes do with it being gone. But until the eventual death, it's a painful road.

After he told me to wear these foot pads, I was a little skeptical and disheartened. I hadn't been able to run in a year and suffered emotionally from not being able to workout and have those good endorphins going through my body! How would foot pads make that much of a difference?

At first, they didn't. But I kept on, every day, and sure enough they are helping a lot right now. Here is my experience with the pads:

My doctor recommended "Dancer's Pads" which have a cutout that you place around the sesamoid area to alleviate pressure.

The first ones I tried were the ones the doctor gave me: HAPAD Dancer pads. (I only wear one on the hurting food and wear nothing on the other).

My experience with these was not so great. They are a really dense material and not very comfortable or plushy. But, what is great about them is that you can stick them directly to your shoe and it stays there until you decide to remove it. You can get one for every pair of shoes and never have to worry about remembering to wear them. My doctor did recommend them, so even though they didn't work for me, they might work for you. You can order them here for $7/pair.

Since I wasn't super happy with the HAPADs, I kept researching and found Dr. Jill's Gel Dancer's Pads.

These are available in two different thicknesses - regular or thick. I thought since my pain was so bad I would order the thick. It seemed to make sense to me. When I started wearing them, I loved the texture and comfort but the thickness was really hard to deal with. They rubbed on my foot in a harsh way and actually pulled some skin off (ouch!). But, I loved everything else about them so I ordered the regular thickness and they worked GREAT. 

They are reusable as long as you wash them with soap and water after each use (I didn't believe that they would remain sticky, but I've been using the same pad for 3 months and it still works just as well as it did on day one).

I also love that you can order only one foot instead of a pair. 

The only downside is that you have to remember to put it on your foot every day, unlike the HAPAD that stays in your shoe. 

Overall, this is the winning pad for me! I wear it every day and it has brought my pain from a 6 to a 3. You can buy it here for $11.99 for two. I can also work out easily in this pair with little extra pain. 

Here's one more helpful thing I found: 

It's a sesamoid relief sleeve. I ordered one so I could have something to wear when I was barefoot around the house. There are also two sizes available for this product (small and large). I bought a small first (I wear a women's 8.5). I love the design but the big toe sleeve is a little too small for my foot. When I do wear it, it works for a period of time until my big toe says "no more!"

I ordered the large which fit a little better but not perfectly. I still love this sleeve though, because it gives me options. You can buy it here for $16.95.

Final thoughts:

This condition HURTS really bad. No one else I know has gone through this or even heard of it, so I don't have anyone to sympathize with, but if you are going through this, message me! Ask me a million questions! I'll help you as best as I can. It has taken a while (about 15 months), but my foot is getting better every day.

Hang in there, be smart in your exercising, and find a pad that fits your foot! This will make all the difference in the world.

Hope this has been helpful. :)