Thank you for this video! Been struggling with this condition for 7 months, I’ve watched many videos and seen doctors and tried all sorts of things with minimal relief. I’m excited to try these exercises as I haven’t seen anyone else recommend these. Thank you.
@@Andy_Russell Hi Andy and @merristaylor1594 Try the suggestions that I made for @marianlipari7372 If the comments are sorted by "newest first", it will be slightly above this reply.
I have been experiencing sesamoiditis the past 2 months. I am 11 months post Hallux Rigidus surgery, with 2 screws at that joint. Can you recommend additional exercises that can accommodate that fused joint?
Thanks Bruce for the video, just a question about the exercises - when is it best to do these? I got sesamoiditis from running and am really struggling to heal. It has swollen again and I wondered if I should be doing the exercises yet or if I should wait until the swelling has gone down first?
Sorry for the slow reply. It's an empowering principle of the Joseph Pilates method that you can always experiment with **doing an exercise in a de-loaded way, with minimal pain**. If you sit in a chair, you can do the exercises more gently than if you are standing. You can work at moving a joint very gently with no load (I call this mobilisation). You can put a modest load on the sore part with no movement (isometric loading: this prevents the bony components of a joint from rubbing against each other while at the same time stimulating tendons to heal and muscles to stay strong). Or you can load a tendon without the tendon going around a sharp corner. These are all strategies that you can play with, provide you go slowly and thoughtfully. You can at least walk or run slowly if you don't vigorously toe off (this loads the sesamoid tendons while they go around their sharp corner). Ideally you would wear a stiff-soled (non-flexible) shoe and jog or walk with gentle steps and a short stride (without lifting your heel high at the toe off). Bicycling and aqua jogging would be good toe-resting exercises. Are our hip flexors tight? - Tight hip flexors would force you to lift your heels higher at toe off.
Thanks for your feedback. For what it's worth, I'm finding that the extra strength and agility this gives to my forefoot, is taking away the pain from an old ankle injury. Something that I wasn't expecting. Please visit & subscribe to my Pilates blog because this is a great way to keep in touch, and you can always ask more questions!- brucethomson.substack.com/ -:)
If you mean something like standing on a doorstep with toe pads only in contact with the doorstep, I should think that would be a terrible idea because (1) the high load and lack of control risks rupturing the damaged part (or healed scar part thereof). (2) It ingrains the overuse habit that overloaded the toe flexor tendon in the first place. I tried a low load version (perhaps this is what you meant?). Sit in a chair. Press the big toe of one foot into the ground and permit the mid foot and ankle to lift (the hip and thigh muscles, and the foot arch muscles will want to aid the movement, let them do so) Now with the heel lifted, curl the toe and foot into the ground (don’t let the big toe deviate into a bunion toe alignment). Finally, while keeping the toe curled down and the foot arch muscle activated, lower the heel back down to the ground and relax the foot. Repeat. This will look like a caterpillar crawling on a cabbage leaf. Notes: You can add load by using a hand to push down on your knee. The toe is strongly loaded from joint neutral to flexion, which means that the sesamoids/tendons are never asked to transmit a force around a sharp corner (this strengthens them without harming them). By doing “caterpillar foot” you also strengthen the foot arch muscles. Strong muscles around a damaged part are always a good idea. If you make a point of “toes up” just after the heel lands, you also strengthen the toe extensors and ankle dorsiflexors (and the sesmoids and sesamoid tendon get to experience going around the sharp corner while under a low load and also not being damaged or bruised by ground pressure. I think this would be a good exercise. Thank you for your excellent question.
@@btpilates-solutions sorry im slightly confuseed by your response, i dont understand the exercise you described, could you elaborate? Also, to clarify my question -the exercise at 6.37 in this video - i was asking if a progrssion to this exercise was a full calf raise just using the toes
@@Maizeak Confused by my response. Understood - it was a bit of a waffle on my part. If you (1) sit in a chair and tap the ground with your toes (just the toes move - not the foot) and, (2) if you place a tennis ball under the ball of your foot and attempt to wrap your toes and foot around the ball "as though attempting to pick the ball up" - that would strengthen the whole of the toes and foot without risk of hurting the sesamoids. (You could do number two either sitting or standing). The (1) and (2) above are NOT a strength progression of the 6:37 exercise. They will, however, provide a gentle mobilisation (the toes lifting and the blood flowing) and an exercise that makes other muscles work MORE than the big toe muscles (so that the big toe muscles can relax while other muscles do the work). Do you see how I am trying to divert you away from a pure strength strategy just for your damaged part? - You CAN'T make a sesamoid bone do more than it is designed to do. But you CAN offload the work to other body parts, and you CAN exercise it in a gentle way that promotes healing. As to your progression? - No! - you would be doing the very thing that extreme athletes and especially dancers do, that overloads and damages the sesamoids. Ref:- my.clevelandclinic.org/health/diseases/21671-sesamoiditis Thank you for your feedback. It's a crucial part of our conversation and I'm glad you asked. Am I making more sense now? Can you see a little better, as to what might help, to fix your problem?
With the 4.27 exercise are you pushing your big toe into the ground? that would be the only way that exercise makes sense to me as your not. loading muscles much at all if you just stand there without pushing the big toe down
Yes, push the big toe into the ground. At a moderate load - you don't have to punish yourself with hard labour, but you should be patient and consistent - a few minutes each day. Isometric contraction means no movement, which means there is no risk of departing from the intention of loading the sesamoids in a straight line; loading the sesamoids around a sharp bend is a significant cause of damage to sesamoids.
A good description of the anatomy of the FHL and the sesamoids is found here:- radiopaedia.org/articles/hallux-sesamoid There is likely some squeeze on the flexor hallucis longus as it glides in its joint-fluid-lubricated groove that runs between the sesamoids. But I do not think it would be greatly involved. More usually the problem with the FHL is pain at a spot halfway between the Achilles and the back of the medial (inner ankle) bone. This pain is easily confused with Achilles pain. Ways to tell if FHL strain is contributing to pain at the ball of the big toe include (all of these answer the question, "are you overusing your FHL? - A painful ball of big toe in the sesamoid region may be at least partly caused by FHL overuse if:- (1) your wear out the part of your shoe immediately under the pad of the big toe (2) you feel pain behind the medial ankle bone (describe above) (3) you find the Flexor hallucis longus muscles painful upon massage
On one foot mysesmoid bones never merged so instead of the 2 bones you should have I have 3. On the other foot the 4 bones that you start with as a child never merged into the 2 you should have as you are older. So on my other foot the sesmoid is in 4 pieces. Had great pain growing up playing sports it caused me to stop playing. Im 20 now and my warehouse job + work boots have caused the pain to come back. Going to give these a try!
I understand your frustration but am unable to help... possible solutions:- translate.google.com/?sl=es&tl=en&op=translate editor.flixier.com/ A friend who is bilingual? Or is there a viewer with any ideas?
@@BruceThomsonDoesPilates You could turn on auto subtitles, the default is english (like closed caption). Then you are able to choose another language, Español is in the list.
Hola! podes activar la opción de subtitulos automáticos, te van a aparecer en inglés. Lo que podes hacer después es elegir cualquier otro idioma, para hacer esto tenes que ir a los ajustes del video (el engranaje, donde también se cambia la definición del video y otras cosas), ir a subtitulos > opciones y ahi elegir Español.
I feel the exercise at 6.35 mostly in my claves - is that ok? Is it still effective for Sesamoiditus ? Although I still do feel my toes working to grip
You asked a one-dimensional question (progressing or not progressing?). But I chose to give you a multi-dimensional answer (progresses in one way and regresses in another). I hope the following makes sense. (Note: isometric means "no movement") 4:27 loads the sesamoids and surrounding tendon ***in a more or less straight line with no movement***. Isometric strengthening with the tendon more or less in a straight line is the number one strength exercise for tendon and sesamoid damage. If done every day for a month or two, it will heel the tissues of the tendon. The load is on one foot, so there is ***more than if we were standing on two feet***. 6:37 loads the sesamoids and surrounding tendons in a small range of controlled movement, from straight line tendon to slightly bent tendon. Since this is on two feet, the load is half or possibly less than half than that of the 4:27 exercise. So in reply to your question: *Since 6:37 halves the load it is a regression (an easier exercise) *Since 6:37, it takes the loaded tendon and sesamoids into a gentle bend, and it is a progression. The first is a high-load exercise, which provides a tissue-healing stimulus The second is a low-load exercise that gently mobilises the area. As such, it introduces the possibility of loading the tendon with a progressive amount of bend (by lifting higher), and so gently re-introduces the sesamoids to the challenges of typical everyday movement. If you want to progress the first, then do it for longer (but it's high load, so don't risk lifting the heel too high; you'll only get the healing stimulus if you don't lift high). If you want to progress the second, then explore lifting the heels higher and gripping more with the big toes (but not so hard and high that you are pushing into severe pain). Both exercises are important, but for slightly different reasons.
![BEST Sesamoiditis Treatment [Big Toe Joint Pain & Big Toe Treatment]](http://i.ytimg.com/vi/ItwfjjX2_Uc/mqdefault.jpg)
![BEST Sesamoiditis Treatment [Big Toe Joint Pain & Big Toe Treatment]](/img/tr.png)
![BEST Metatarsalgia Exercises, Massage & Stretches[HOME Treatment]](http://i.ytimg.com/vi/tqOzHZ8rUqs/mqdefault.jpg)
Excellente! Superior demonstrations of effective techniques. Gracias.
Thank you, de nada.
Let me know how it goes.
Thank you for this video! Been struggling with this condition for 7 months, I’ve watched many videos and seen doctors and tried all sorts of things with minimal relief. I’m excited to try these exercises as I haven’t seen anyone else recommend these. Thank you.
Did they work?
No. I was completely misdiagnosed and didn’t have sesamoiditis. I have big toe joint osteoarthritis and nothing helps 😥
@@merristaylor1594 I’m sorry to hear that. Thanks for your reply.
@@Andy_Russell
Hi Andy and @merristaylor1594
Try the suggestions that I made for @marianlipari7372
If the comments are sorted by "newest first", it will be slightly above this reply.
How was the onset?
I have been experiencing sesamoiditis the past 2 months. I am 11 months post Hallux Rigidus surgery, with 2 screws at that joint.
Can you recommend additional exercises that can accommodate that fused joint?
Thank you!
You are welcome!
Thanks Bruce for the video, just a question about the exercises - when is it best to do these? I got sesamoiditis from running and am really struggling to heal. It has swollen again and I wondered if I should be doing the exercises yet or if I should wait until the swelling has gone down first?
Sorry for the slow reply.
It's an empowering principle of the Joseph Pilates method that you can always experiment with **doing an exercise in a de-loaded way, with minimal pain**. If you sit in a chair, you can do the exercises more gently than if you are standing. You can work at moving a joint very gently with no load (I call this mobilisation). You can put a modest load on the sore part with no movement (isometric loading: this prevents the bony components of a joint from rubbing against each other while at the same time stimulating tendons to heal and muscles to stay strong). Or you can load a tendon without the tendon going around a sharp corner. These are all strategies that you can play with, provide you go slowly and thoughtfully.
You can at least walk or run slowly if you don't vigorously toe off (this loads the sesamoid tendons while they go around their sharp corner). Ideally you would wear a stiff-soled (non-flexible) shoe and jog or walk with gentle steps and a short stride (without lifting your heel high at the toe off). Bicycling and aqua jogging would be good toe-resting exercises. Are our hip flexors tight? - Tight hip flexors would force you to lift your heels higher at toe off.
@@BruceThomsonDoesPilates really interesting, thanks very much for taking the time to reply!
@@lfoster2091 how it goes bro ? me too with trail running :(
thank you so much! a great help to find relieve !! too much appreciated
You’re welcome.
Go well.
Thank you for this do the toe shoes help at all ?
Many thanks, Bruce. Very clear video which provides helpful guidance. It’s very rare. Much appreciated
Thanks for your feedback.
For what it's worth, I'm finding that the extra strength and agility this gives to my forefoot, is taking away the pain from an old ankle injury. Something that I wasn't expecting.
Please visit & subscribe to my Pilates blog because this is a great way to keep in touch, and you can always ask more questions!-
brucethomson.substack.com/
-:)
Thanks Bruce Thomas, like Bruce Wayne and Thomas Wayne combined 😂😂😂😂😂😂😂😂😂😂😂😂😂😂❤
I like the comparison. You can’t go past a good Batman movie.
Would calf raises just using toes be a progrssion once youve built up strength?
If you mean something like standing on a doorstep with toe pads only in contact with the doorstep, I should think that would be a terrible idea because (1) the high load and lack of control risks rupturing the damaged part (or healed scar part thereof). (2) It ingrains the overuse habit that overloaded the toe flexor tendon in the first place.
I tried a low load version (perhaps this is what you meant?).
Sit in a chair. Press the big toe of one foot into the ground and permit the mid foot and ankle to lift (the hip and thigh muscles, and the foot arch muscles will want to aid the movement, let them do so)
Now with the heel lifted, curl the toe and foot into the ground (don’t let the big toe deviate into a bunion toe alignment).
Finally, while keeping the toe curled down and the foot arch muscle activated, lower the heel back down to the ground and relax the foot. Repeat. This will look like a caterpillar crawling on a cabbage leaf.
Notes:
You can add load by using a hand to push down on your knee.
The toe is strongly loaded from joint neutral to flexion, which means that the sesamoids/tendons are never asked to transmit a force around a sharp corner (this strengthens them without harming them).
By doing “caterpillar foot” you also strengthen the foot arch muscles. Strong muscles around a damaged part are always a good idea.
If you make a point of “toes up” just after the heel lands, you also strengthen the toe extensors and ankle dorsiflexors (and the sesmoids and sesamoid tendon get to experience going around the sharp corner while under a low load and also not being damaged or bruised by ground pressure.
I think this would be a good exercise. Thank you for your excellent question.
@@btpilates-solutions sorry im slightly confuseed by your response, i dont understand the exercise you described, could you elaborate? Also, to clarify my question -the exercise at 6.37 in this video - i was asking if a progrssion to this exercise was a full calf raise just using the toes
@@Maizeak Confused by my response. Understood - it was a bit of a waffle on my part.
If you (1) sit in a chair and tap the ground with your toes (just the toes move - not the foot) and, (2) if you place a tennis ball under the ball of your foot and attempt to wrap your toes and foot around the ball "as though attempting to pick the ball up" - that would strengthen the whole of the toes and foot without risk of hurting the sesamoids. (You could do number two either sitting or standing).
The (1) and (2) above are NOT a strength progression of the 6:37 exercise. They will, however, provide a gentle mobilisation (the toes lifting and the blood flowing) and an exercise that makes other muscles work MORE than the big toe muscles (so that the big toe muscles can relax while other muscles do the work). Do you see how I am trying to divert you away from a pure strength strategy just for your damaged part? - You CAN'T make a sesamoid bone do more than it is designed to do. But you CAN offload the work to other body parts, and you CAN exercise it in a gentle way that promotes healing.
As to your progression? - No! - you would be doing the very thing that extreme athletes and especially dancers do, that overloads and damages the sesamoids. Ref:-
my.clevelandclinic.org/health/diseases/21671-sesamoiditis
Thank you for your feedback. It's a crucial part of our conversation and I'm glad you asked.
Am I making more sense now? Can you see a little better, as to what might help, to fix your problem?
Thank you for this video ❤
With the 4.27 exercise are you pushing your big toe into the ground? that would be the only way that exercise makes sense to me as your not. loading muscles much at all if you just stand there without pushing the big toe down
Yes, push the big toe into the ground. At a moderate load - you don't have to punish yourself with hard labour, but you should be patient and consistent - a few minutes each day. Isometric contraction means no movement, which means there is no risk of departing from the intention of loading the sesamoids in a straight line; loading the sesamoids around a sharp bend is a significant cause of damage to sesamoids.
Thanks for this. Do you think FHL might be involved as well given it crosses over the sesamoid?
A good description of the anatomy of the FHL and the sesamoids is found here:-
radiopaedia.org/articles/hallux-sesamoid
There is likely some squeeze on the flexor hallucis longus as it glides in its joint-fluid-lubricated groove that runs between the sesamoids. But I do not think it would be greatly involved. More usually the problem with the FHL is pain at a spot halfway between the Achilles and the back of the medial (inner ankle) bone. This pain is easily confused with Achilles pain.
Ways to tell if FHL strain is contributing to pain at the ball of the big toe include (all of these answer the question, "are you overusing your FHL? -
A painful ball of big toe in the sesamoid region may be at least partly caused by FHL overuse if:-
(1) your wear out the part of your shoe immediately under the pad of the big toe
(2) you feel pain behind the medial ankle bone (describe above)
(3) you find the Flexor hallucis longus muscles painful upon massage
On one foot mysesmoid bones never merged so instead of the 2 bones you should have I have 3. On the other foot the 4 bones that you start with as a child never merged into the 2 you should have as you are older. So on my other foot the sesmoid is in 4 pieces. Had great pain growing up playing sports it caused me to stop playing. Im 20 now and my warehouse job + work boots have caused the pain to come back. Going to give these a try!
No harm in giving it a try.
All the best!
Has anyone tried these and they actually work?
Alguien que lo ponga en español que me ayudara
I understand your frustration but am unable to help...
possible solutions:-
translate.google.com/?sl=es&tl=en&op=translate
editor.flixier.com/
A friend who is bilingual?
Or is there a viewer with any ideas?
@@BruceThomsonDoesPilates You could turn on auto subtitles, the default is english (like closed caption). Then you are able to choose another language, Español is in the list.
Hola! podes activar la opción de subtitulos automáticos, te van a aparecer en inglés. Lo que podes hacer después es elegir cualquier otro idioma, para hacer esto tenes que ir a los ajustes del video (el engranaje, donde también se cambia la definición del video y otras cosas), ir a subtitulos > opciones y ahi elegir Español.
I feel the exercise at 6.35 mostly in my claves - is that ok? Is it still effective for Sesamoiditus ? Although I still do feel my toes working to grip
@BruceThomsonDoesPilates please see above
So much informations thank you
Thanks for your feedback. Go well.
is 6.37 a progression to 4.27?
You asked a one-dimensional question (progressing or not progressing?). But I chose to give you a multi-dimensional answer (progresses in one way and regresses in another).
I hope the following makes sense.
(Note: isometric means "no movement")
4:27 loads the sesamoids and surrounding tendon ***in a more or less straight line with no movement***. Isometric strengthening with the tendon more or less in a straight line is the number one strength exercise for tendon and sesamoid damage. If done every day for a month or two, it will heel the tissues of the tendon. The load is on one foot, so there is ***more than if we were standing on two feet***.
6:37 loads the sesamoids and surrounding tendons in a small range of controlled movement, from
straight line tendon to slightly bent tendon. Since this is on two feet, the load is half or possibly less than half than that of the 4:27 exercise.
So in reply to your question:
*Since 6:37 halves the load it is a regression (an easier exercise)
*Since 6:37, it takes the loaded tendon and sesamoids into a gentle bend, and it is a progression.
The first is a high-load exercise, which provides a tissue-healing stimulus
The second is a low-load exercise that gently mobilises the area. As such, it introduces the possibility of loading the tendon with a progressive amount of bend (by lifting higher), and so gently re-introduces the sesamoids to the challenges of typical everyday movement.
If you want to progress the first, then do it for longer (but it's high load, so don't risk lifting the heel too high; you'll only get the healing stimulus if you don't lift high). If you want to progress the second, then explore lifting the heels higher and gripping more with the big toes (but not so hard and high that you are pushing into severe pain).
Both exercises are important, but for slightly different reasons.
@@btpilatesonzoom534 thank you so much, insanely useful - I've made. sure to like and subscribe
@@Maizeak Thank you!
Do you recommend orthotics?
My doctor said: “never be barefoot for sesamoid fracture”