Quick answer: Sesamoid Problems Foot Sesamoiditis Fractures Avascular Necrosis is a common foot/ankle topic that affects many patients. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Call (810) 206-1402.
Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
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Howell Office
4330 E Grand River Ave
Howell, MI 48843
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Bloomfield Township Office
43494 Woodward Ave, Suite 208
Bloomfield Township, MI 48302
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When to See a Podiatrist
If foot or ankle pain has been bothering you for more than a few weeks, home care alone may not be enough. Balance Foot & Ankle offers same-week appointments at our Howell and Bloomfield Township clinics — no referral needed in most cases. Bring your current shoes and a short list of symptoms and we’ll build you a treatment plan in one visit.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Township
Differential Diagnosis: What Else Could It Be?
Not every case of sesamoiditis is straightforward. In our clinic we routinely rule out three look-alike conditions before confirming the diagnosis. If your symptoms don’t match the classic presentation, one of these may explain the pain — which is why physical exam matters more than self-diagnosis.
| Condition | How It Differs |
|---|---|
| Sesamoid stress fracture | Acute or gradually worsening sharp pain, tender directly over one sesamoid, positive findings on MRI. |
| Hallux rigidus | Stiff, painful big toe joint with limited dorsiflexion — pain is AT the joint, not UNDER the ball. |
| Turf toe (plantar plate injury) | Acute hyperextension mechanism, diffuse swelling of the 1st MTP, positive 1st MTP drawer test. |
Red Flags — When to See a Podiatrist Now
Seek same-day evaluation at Balance Foot & Ankle if you notice any of the following:
- Sudden sharp onset (possible fracture)
- Bruising or swelling under the big toe
- Pain at rest or at night
- Inability to push off during gait
Call (810) 206-1402 or request an appointment. Our Howell and Bloomfield Township offices reserve same-day slots for urgent foot and ankle issues.
In Our Clinic: What We See
Clinical perspective from Dr. Tom Biernacki, DPM — Balance Foot & Ankle, Howell & Bloomfield Township, MI:
In our Balance Foot & Ankle clinic, sesamoiditis patients are usually dancers, runners, or women who have spent significant time in heels. They describe pain directly UNDER the big toe joint — not at the joint (that’s hallux rigidus) — which worsens with push-off. On exam we palpate each sesamoid separately (tibial and fibular) and assess for sensitivity. We always get X-rays to look for sesamoid fracture or bipartite sesamoid (a normal variant). Treatment uses a dancer’s pad to offload the sesamoid, stiff-soled footwear to reduce push-off stress, and activity modification.
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your sesamoiditis, our podiatry team at Balance Foot & Ankle can help with same-week evaluations and advanced in-office care.
Same-week appointments available. (810) 206-1402
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Shop Doctor Hoy’s →What is Stress fracture?
Stress fracture is a common foot/ankle condition that affects mobility and quality of life. Understanding the underlying cause is the first step in successful treatment. Our podiatrists at Balance Foot & Ankle perform a hands-on biomechanical exam, review your activity history, and use diagnostic imaging when appropriate to identify the root cause—not just treat the symptom. Many patients have been told to “rest and ice” without a deeper diagnostic workup; our approach is different.
Symptoms and warning signs
Common signs of stress fracture include pain that worsens with activity, morning stiffness, swelling, tenderness when palpated, and difficulty bearing weight. If you experience sudden severe pain, inability to walk, visible deformity, numbness or color change, contact our office the same day or visit urgent care—these can signal a more serious injury such as a fracture, tendon rupture, or vascular compromise. Diabetics with any foot wound should seek same-day care.
Conservative treatment options
Most cases of stress fracture respond to non-surgical care: structured rest, supportive footwear changes, custom orthotics, targeted stretching and strengthening protocols, anti-inflammatory medications when medically appropriate, and in-office procedures such as ultrasound-guided injections. We also offer advanced therapies including laser therapy, EPAT/shockwave, regenerative injections, and image-guided procedures. Treatment is sequenced from least invasive to most invasive, and we explain the rationale at every step.
When is surgery considered?
Surgery is reserved for cases that fail 3-6 months of well-structured conservative care, when there is structural pathology (severe deformity, complete tear, advanced arthritis), or when imaging shows damage that will not heal without intervention. Our surgeons have performed 3,000+ foot and ankle procedures and prioritize minimally-invasive techniques whenever appropriate. We discuss recovery timelines, return-to-activity milestones, and realistic outcome expectations before any procedure is scheduled.
Recovery timeline and prevention
Recovery from stress fracture varies based on severity and chosen treatment path. Conservative cases often improve within 4-8 weeks with consistent adherence to the protocol. Post-procedural recovery may range from a few days (in-office procedures) to several months (reconstructive surgery). Long-term prevention involves footwear assessment, activity modification, structured strengthening, and regular check-ins with your podiatrist if you have a history of recurrence. We provide written home-exercise plans and digital follow-up support.
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Same-week appointments available in Howell and Bloomfield Township, Michigan.
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Or call: (810) 206-1402
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.