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Have not actually seen him yet, but know he's coming, imaging confirmed, frequent and increasing pain, any ideas about most likely most effective conservative tx please.
Regards Phill

 

1. Don't assume that being bipartite is part of the problem (though it may well be)
2. Rule out flexor hallucis longus tendonitis
If "sesamoiditis":
3. "Moblisation" of the sesamoids and 1st MPJ to increase movement often big help
4. Offload: adhesive felt if very painful or accomodation in a full length orthotic (prefab or prescription) if not so painful

 

Hi Craig,
I am expecting to see something else or the 1st mpj contributing to pain, as you infer, plenty of assymptomatic bipartite sessamoids out there I would think. Thanks for your input.
Regards Phill

 

The whole role of 1st MPJ mechanics in the symptoms of "sesamoiditis" is something I am just starting to appreciate ---- but still not sure completly what is going on.

There was also this thread we had on sesamoid pathology:
http://www.podiatry-arena.com/podiatry-forum/showthread.php?t=595