SESAMOIDITIS
WHAT IS SESAMOIDITIS?
Most bones in the human body are connected to each other at joints. However, the sesamoids are different—they are two small, pea-sized bones embedded directly into the tendons beneath the big toe joint. They function very much like a kneecap, acting as a pulley to provide leverage when you walk or run.
Sesamoiditis occurs when these bones and the surrounding tendons become irritated, inflamed, or even fractured due to repetitive pressure. It is a common cause of pain in the “ball of the foot” and is frequently seen in runners, dancers, and people who spend long hours on their feet.
COMMON CAUSES
Sesamoiditis is typically an “overuse” injury rather than the result of a sudden accident. It develops when excessive pressure is placed on the ball of the foot.
Common risk factors include:
- High-Impact Activities: Running, ballet dancing, or sports involving jumping that place high loads on the forefoot.
- Footwear Choices: Wearing high heels or shoes with thin soles that offer no shock absorption.
- Foot Structure: People with very high arches (which naturally place more weight on the ball of the foot) or those with bony feet (insufficient fat pads) are at higher risk.
RECOGNIZING THE SYMPTOMS
Unlike a sudden bruise, the pain of sesamoiditis often starts as a mild ache and gradually worsens. You may notice:
- Pain under the big toe: Specifically on the ball of the foot.
- Difficulty bending and straightening: Moving the big toe may feel stiff or painful.
- Swelling or bruising: Though not always visible, some swelling may occur at the base of the toe.
- “Walking on a stone”: A sensation that there is a pebble in your shoe under the big toe joint.
HOME MANAGEMENT & PREVENTION
To prevent the condition from worsening, early management is essential:
- Rest: Stop the activity that is causing the pain (e.g., switch from running to swimming).
- Ice: Apply ice to the sole of the foot for 10–15 minutes to reduce inflammation.
- Change Shoes: Switch to comfortable, flat shoes with a soft, cushioned sole. Avoid high heels completely until healed.
TREATMENT AT FOOTCARE ORTHOTICS
Because the sesamoids are under constant pressure with every step you take, this condition can be slow to heal without professional help. At our clinic, our primary goal is to “offload” the area—meaning we take the weight off the injured bones to allow them to recover.
Our treatment plan may include:
- Custom Orthotics: We design prescription insoles with specific depressions or cut-outs under the big toe joint to redistribute pressure away from the painful sesamoids.
- Padding and Strapping: Using specialized “dancer’s pads” or taping techniques to cushion the area.
- Immobilization: In severe cases or stress fractures, we may recommend a walking boot for a short period to ensure total rest.
- Shockwave Therapy: To stimulate healing in chronic cases.
We will evaluate your foot mechanics to not only treat the current pain but also prevent it from returning.