I had arrived in Boston and was ready to put the past behind me and work towards my future!

I had started in person classes and began struggling to walk about the city’s uneven sidewalks in the CAM Boot. I also realized that I was not qualified to train myself how to fix my gait after so many months of it being weird because of limping.

I decided it was time for physical therapy.

I researched around the area and found a nearby physical therapy office to where I was living. I realized that I needed a referral to be able to start there, so this is also when I found a primary care physician.

I started going on September 12th and was able to finally get out of my walking boot on September 16th. I still had pain under my toe when I walked so, I was given an insert that had a cut out under my foot, so pressure wasn’t applied to the area of pain when I walked. It was extremely helpful, but I was bummed that my pain was still there after not weight bearing and the injection.

As I continued to walk for the next week, my foot started to change drastically. The area where I had my single injection done, atrophied all of my tissue away. It was super red all the time and the skin was getting more and more paper thin.

In physical therapy I had tried electroshock therapy to see if it would reduce some of my inflammation but unfortunately my skin had a bad reaction and was red and puffy for a few hours.

I decided it was time to call my podiatrist.

I did a virtual visit with my podiatrist who did the injections and showed them what had happened to the skin. Unfortunately, my doctor did not know and requested to leave my case.

Searching for answers, I found a new doctor in Boston.

I saw an orthopedic surgeon and did more x-rays to see what was wrong. They didn’t show anything, and the doctors were very puzzled as to what was happening. I was told to keep using the cut-out inserts and to only ever wear my Doc Martens to protect my toe from bending and potentially damaging it more. I was also told to never do injections again because they believed it would cause more irreversible damage. They said the skin would likely never go back to a normal color.

When I went back to Texas for winter break (which had been extended because of COVID) I decided to pick up physical therapy there, so I didn’t lose the progress I had made so far.

The physical therapist there was very puzzled by the case, and we took it as a time to do trial and error to see what we could do about the pain specifically. Their guesses as to what was wrong was potentially an atypical case of FHL tendinopathy.

We found that my toe was hypersensitive to different surfaces and felt like “fireworks” and that pain was only lessened by doing a plantar flexion exercise. I had some tingling sensations when putting on exercise bands which thought might’ve been some sort of spinal or nerve issue. We began implementing sciatic nerve glides which removed this sensation entirely.

When I came back for the spring semester, I continued to maintain what I did have at physical therapy and kept searching.

It was about February when I started noticing increasing bruising appearing under my toe. If I walked on surfaces such as hard floor without my foot pad, I would gain more bruises just from the pressure of walking. We also noticed more nerve related issues like my foot falling asleep quickly when it was raised for exercises.

Then, another muscle started atrophying- one that ran under my big toe and continued under my arch. We began doing isolated exercises and trialed me changing into sneakers to see if this could help build up more of the muscle that was atrophying away.

I went to see a new podiatrist in March to get their opinion on the case.

They said had only seen something kind of similar to my case 20 years ago with a dancer who had 20 injections in the same spot. This doctor did multiple x-rays over the months I visited them and determined something as a part to the puzzle. The bone structure of my foot genetically, has my big toe joint in a position where it gets “locked” and can’t fully bend when walking. This creates extra pressure and stress under my big toe which is likely how my tissue atrophied away so quickly (from the pressure of my shoe rubbing under my foot when I walked).

I was told to switch back to my Doc Martens as the sneakers were making the atrophying quicker. I was also told to get the Vasyli Dananberg Orthotics to help with the “locking” issue.

The podiatrist also informed me that I needed to be VERY careful with the skin under my toe because it was so thin that bone could ulcerate through. This doctor began researching into the potential of doing fat injections or a skin graft. I kept everything on hold here as a new issue began developing.

By the end of March 2021, my hands started beginning to get stuck closed when I was grasping things, so my physical therapist recommended me to see a physiatrist & neurologist to see if maybe the stomach and foot issues were related.

I saw the physiatrist who said they didn’t believe the cases were connected. They also recommended me to see a neurologist to get an EMG done to see if that lead to any answers.

I scheduled an EMG for June 21st, 2021, and scheduled an appointment to see another orthopedic surgeon at a different hospital to get more eyes on the case.

I continued to do physical therapy and got my muscle tone up, but we had gotten to a point where we couldn’t advance further because the toe injury was becoming a hinderance.