Sesamoiditis is an inflammation type injury that affects the tendons surrounding the sesamoid bones. The sesamoid bones are two small pea shaped bones that sit under the big toe joint.
The sesamoid bones and surrounding tendons function as a kind of pulley system to assist toe flexion and propel the body forward from the toes when you take a step.
Although the sesamoid bones are small they play an important role in the efficient function of the big toe joint and the ball of the foot. Given the enormous workload these sesamoid bones and surrounding soft tissue perform, it’s hardly surprising that sesamoiditis is common.
What Is Sesamoiditis?
Sesamoiditis is particularly common amongst highly active young people and athletes.
Activities that involve jumping, sudden acceleration, running and climbing are particularly hard on the sesamoid bones.
Essentially, sesamoiditis is a type of tendonitis caused by the tendons rubbing repeatedly over the sesamoid bone and triggering a painful inflammation in the soft tissue surrounding the bone.
What Causes Sesamoiditis?
Any repetitive activity that delivers a high impact force or significant weight to the entire big toe joint may lead to sesamoiditis.
Sudden increases in your training intensity, speed work and hill training are typical sesamoiditis triggers. Sometimes a hyper-extension injury to the big toe may cause sesamoiditis.
People with a particular type of foot bones or bone structure are more prone to sesamoid injuries. If you have feet with high arches, you may be more likely to develop sesamoiditis due to the way the foot transfers significantly higher force to the outside of the foot and the ball of the foot.
In severe cases, a sesamoid fracture may occur in the medial sesamoid (or tibial sesamoid) bone. Medical experts must take care to diagnose fractures correctly because some people naturally have a bipartite medial sesamoid that may give the appearance of a fracture.
Erica Dash podiatrists have the skills, experience and advanced diagnostic tools, including ultrasound imaging, to provide a rapid accurate diagnosis of all sesamoid pain.
What Are The Symptoms Of Sesamoiditis?
The gradual onset of a dull ache or pain beneath the big toe joint and the ball of the foot are common indications of developing Sesamoiditis. Typically, this pain increases with specific activities. Usually, there is no external sign of bruising, swelling or inflammation.
As sesamoiditis worsens, you may find it difficult and painful to walk or flex your toe joint area, forcing you to favour that foot. Usually, the sesamoiditis pain will ease with rest.
Typical symptoms of sesamoiditis include:
- Ache under the ball of the foot (particularly under the big toe)
- Onset of discomfort is usually gradual
- Bruising, redness or swelling is not usually obvious
- Bending or straightening the toe triggers pain
A sharp stabbing pain will usually differentiate a stress fracture in the sesamoid bone from inflammatory sesamoiditis.
Typical symptoms of fractured sesamoid include:
- Instant sharp pain under the ball of the foot
- Bruising and swelling are frequently more obvious
What’s The Best Sesamoiditis Treatment?
Because of the possibility of a sesamoid fracture, it is important to obtain a proper diagnosis. Visiting a qualified podiatrist as soon as possible is the best way to ensure you receive the best treatment and the best recovery outcome. Rest, ice, compression, and elevation are helpful to begin with, and will help to alleviate sesamoiditis discomfort and inflammation.
Nonsteroidal anti-inflammatory drugs will also help relieve pain and swelling in the inflamed sesamoid area. Athletic taping or strapping helps to immobilise the joint and protect it from further damage and, at the same time, allow the inflammation to subside.
We use video gait analysis to identify gait and mechanical misalignment issues that might be triggering your sesamoiditis.
We may recommend custom orthotics that fit inside your shoes and provide support for your arches, encourage healthy pronation, increase shock absorption and transfer weight more efficiently through the sesamoid bones.
More Treatment Options
Dense foam rubber pads under the big toe can help transfer weight away from the inflamed area, and relieve pressure on the sesamoid bones.
Shoe modification or using comfortable and cushioning footwear and sports shoes can help prevent the reoccurrence of your sesamoid injury.
Steroid injections may be helpful in more severe cases to reduce inflammation and promote healing. Soft tissue massage, shockwave therapy or dry needling services are effective healing therapies that stimulate blood circulation, and reduce bruising and inflammation so you can get back on your feet as quickly as possible.
If you have pain or discomfort in the big toe area or you think you have sesamoiditis, come and visit the friendly experts at Erica Dash podiatry. We’re here to help you.
Shockwave is a great alternative to treatments such as dry needling if you’re needle phobic and not keen on dry needling. We also have effective treatment offers for kids.