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Swelling on the ball of my big toe, left side.

by Jim
(Massapequa, NY)

I was running in my minimalist shoes (Vibrams) and stepped on a rock, right on the ball of my left big toe. I am male, 40, 190 lbs and it was painful. This was Memorial Day weekend 2011. It bruised and was swollen, but after a week that was all gone. What I have been left with is a small lump on the ball of my foot that won't go away. I've been a podiatrist and had x-rays that didn't show a sesamoid fracture (at least he couldn't see one). He recommended a Darco boot worn as much as possible, two Aleve twice a day, and 15min of icing twice a day. I did that for three weeks, although I did miss some treatments. I went back and he said he felt a little progress. I'm in the boot for another two weeks, and I've been treating it on schedule to the letter. I have another week with it before I go back again. I can walk on it, and it feels fine to bend the toe up or down through normal motions. The only time I feel any discomfort is when I really press down on it while barefoot on a hard surface like tile, concrete or wood flooring. What could I have done, and what are my true options? I am not considering cortisone or surgery, as there is little to no pain.

Please help, it's been 8 weeks already!

Hi Jim,
It "appears" as if your problem is getting better albeit more slowly than you would like. This is a problem that is typical of foot injuries. They can take longer to heal by virtue of the fact that every time you step down on the foot you are basically re-injurying an injured area.
Apparently, you damaged one of your sesamoid bones which is a small bone located behind the big toe joint.
In many instances a sesamoiditis can be a troublesome condition to overcome.
If you notice you are getting better as each week passes, then you are probably on the right course. It sounds to me that you are much improved as you state "there is little to no pain". If that is the case then just continue on your the course your podiatrist has prescribed.
If for some reason your progress comes to a halt, then I would recommend a bone scan to see if there is actually a fracture or not as sometimes xrays can be misleading.
You would want to know if the bone is fractured before having a cortisone injection.

Marc Mitnick DPM
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Swelling on the ball of my big toe, left side.

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