What is Sesamoiditis?

Sesamoiditis is a common ailment of the plantar forefoot, causing pain in the ball of the foot specifically under the big toe joint. The sesamoid bones are very small bones which are located under the big toe joint within the tendons that run to the big toe. They are similar to the kneecap, acting to increase the leverage of the tendons that control the big toe. Due to their location and function, they are subjected to massive pressure and forces every time the big toe is used to push the foot forward.
Symptoms of Sesamoiditis

Sesamoiditis typically presents gradually, starting as a mild ache increasing gradually where it can become an intense throbbing. People participating in activities and sports that involve repetitive, excessive loading of the ball of the foot such as dancing, sprinting or even walking often suffer from this condition. People with boney, higher arched feet, marked flat feet or those who tend to run on the ball of their foot also tend to be more prone to sesamoiditis.

Conservative Treatment 

Treatment will vary between patients and will typically involve a period of rest from any activities likely to aggravate the problem. Immobilization strapping, ice and oral anti-inflammatory drugs may also be utilized to settle inflammation and pain and aid in the healing process. A soft full-length functional orthotic is commonly used to offload the sesamoids and deflect pressure away from the painful area. Orthotics are essential in treating an underlying causative foot condition, such as flat feet (pes planus), high arched feet (pes cavus), bunions or those with reduced plantar fatty padding. In the case of persistent severe sesamoiditis or stress fractures of the sesamoids, the use of short leg Pneumatic walker with rocker sole (walking cast) for 2 to 6 weeks may be required. 

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

Have you ever noticed that one side of the bottom of your sneaker’s heel can be more worn-down than the other after a couple months of use? It’s a very normal phenomenon, according to Jane Pontious, DPM, chair of the department of podiatric surgery at Temple University School of Podiatric Medicine. Your heel, positioned directly below your body, supports all of your weight. We all walk slightly differently, so it makes sense that some people may lean more on one side of the shoe than the other. 
Dr. Jane Pontious
However, that doesn’t make it healthy for your foot and ankle to be put in this imbalanced position in the long-term. “People will look at the sneaker and say, ‘Well, it’s new,’ and I’ll say, ‘Look at the heel. You’re no longer standing normally, so you have to replace it,’” says Dr. Pontious. 
Source: Clare Varellas, Readers Digest
Courtesy of Barry Block, editor of PM News.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.


While it might seem harmless to leave chipped polish on your nails, it's definitely healthier to remove it. "The danger with keeping your nail polish on too long is that the pigment in the nail polish can soak into the top few layers of the nail and dry it out," foot specialist Joy Rowland, DPM, told Cleveland Clinic. 
Dr. Joy Rowland
Keep this in mind, especially for toenail polish, which many women slap on and forget about until their next pedicure. Dr. Rowland recommends avoiding back-to-back polish appointments. Instead, let nails breathe for a week or two between pedicures. 
Source: Juliana LaBianca, Readers Digest
Courtesy of Barry Block, editor of PM News.
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic. 




What is Sensory Neuropathy?

Sensory neuropathy occurs if the body's sensory nerves become damaged.

People with diabetes have an increased risk of neuropathy as high blood glucose levels over long periods of time can damage the nerves.

Symptoms of Sensory Neuropathy

The symptoms of sensory neuropathy will be present at the part of your body where the nerves are affected:

  • Numbness
  • Reduced ability to sense pain or extreme temperatures
  • Tingling feeling
  • Unexplained burning sensations
  • Sharp stabbing pains – which may be noticeable at night
Complications of Sensory Neuropathy

People with sensory neuropathy will typically have difficulty sensing causes of pain and heat which can result in unnoticed injury being sustained.

Partly because the feet are less easy to see than the hands, the feet are particularly vulnerable to damage going unnoticed in people with neuropathy and developing into a serious health risk. 

Cuts, blisters and burns can develop into foot ulcers which raise the risk of needing amputation for people with diabetes and neuropathy.

At Academy Foot and Orthotics Clinic, we can assess for sensory neuropathy with the application of a 5.07 monofilament and a tuning fork which can help identify areas that might be affected due to sensory neuropathy. 
Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic. 




What Is Charcot Foot?  

Charcot foot is a condition causing weakening of the bones in the foot that can occur in people who have significant nerve damage (neuropathy). The bones are weakened enough to fracture, and with continued walking, the foot eventually changes shape. As the disorder progresses, the joints collapse and the foot takes on an abnormal shape, such as a rocker-bottom appearance.

Charcot foot is a serious condition that can lead to severe deformity, disability and even amputation. Because of its seriousness, it is important that patients living with diabetes—a disease often associated with neuropathy—take preventive measures and seek immediate care if signs or symptoms appear.


Charcot foot develops as a result of neuropathy, which decreases sensation and the ability to feel temperature, pain or trauma. Because of diminished sensation, the patient may continue to walk—making the injury worse. People with neuropathy (especially those who have had it for a long time) are at risk for developing Charcot foot. In addition, neuropathic patients with a tight Achilles tendon have been shown to have a tendency to develop Charcot foot.


The symptoms of Charcot foot may include:

  • Warmth to the touch (the affected foot feels warmer than the other)
  • Redness in the foot
  • Swelling in the area
  • Pain or soreness


Early diagnosis of Charcot foot is extremely important for successful treatment. The chiropodist will examine the foot and ankle and ask about events that may have occurred prior to the symptoms. X-rays and other imaging studies and tests may be ordered. Once treatment begins, x-rays are taken periodically to aid in evaluating the status of the condition.

Nonsurgical Treatment

It is extremely important to follow the surgeon’s treatment plan for Charcot foot. Failure to do so can lead to the loss of a toe, foot, leg or life.

Nonsurgical treatment for Charcot foot consists of:

  • Immobilization. Because the foot and ankle are so fragile during the early stage of Charcot, they must be protected so the weakened bones can repair themselves. Complete nonweightbearing is necessary to keep the foot from further collapsing. The patient will not be able to walk on the affected foot until the surgeon determines it is safe to do so. During this period, the patient may be fitted with a cast, removable boot or brace and may be required to use crutches or a wheelchair. It may take the bones several months to heal, although it can take considerably longer in some patients.
  • Custom shoes and bracing. Shoes with special inserts may be needed after the bones have healed to enable the patient to return to daily activities—as well as help prevent recurrence of Charcot foot, development of ulcers and possibly amputation. In cases with significant deformity, bracing is also required.
  • Activity modification. A modification in activity level may be needed to avoid repetitive trauma to both feet. A patient with Charcot in one foot is more likely to develop it in the other foot, so measures must be taken to protect both feet.

Brought to you by Doctor John A. Hardy, owner of Toronto's foot clinic, Academy Foot and Orthotics Clinic.

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Academy Foot and Orthotic

Toronto, ON M4K 2P1 

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