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The term is a general
description for any irritation of the sesamoid bones,
which are tiny bones within the tendons that run to the
big toe. Like the kneecap, the sesamoids function as a
pulley, increasing the leverage of the tendons controlling
the toe. Every time you push off against the toe the
sesamoids are involved, and eventually they can become
irritated, even fractured. Because the bones are actually
within the tendons, sesamoiditis is really a kind of
tendinitis - the tendons around the bones become inflamed
as well. Cause
Sesamoiditis typically can be distinguished from other
forefoot conditions by its gradual onset. The pain usually
begins as a mild ache and increases gradually as the
aggravating activity is continued. It may build to an
intense throbbing. In most cases there is little or no
bruising or redness. One of the major causes of
sesamoiditis is increased activity. You've probably
stepped up your activity level lately, which has forced
you to put more pressure on the balls of your feet.
Speedwork, hillwork, or even increased mileage can cause
this. If you have a bony foot, you simply may not have
enough fat on your foot to protect your tender sesamoids.
Also, if you have a high arched foot, you will naturally
run on the balls-of-your-feet, adding even more pressure.
Treatment and Prevention
Treatment for sesamoiditis is almost always noninvasive.
Minor cases call for a strict period of rest, along with
the use of a modified shoe or a shoe pad to reduce
pressure on the affected area. This may be accomplished by
placing a metatarsal pad away from the joint so that it
redistributes the pressure of weight bearing to other
parts of the forefoot. In addition, the big toe may be
bound with tape or athletic strapping to immobilize the
joint as much as possible and allow for healing to occur.
It is recommended to decrease or stop activity for awhile.
This will give your sesamoids time to heal. You should
apply ice to the area for 10 to 15 minutes after exercise,
or after any activity that aggravates the area. As with
icing, anti-inflammatories will help the swelling go down
so healing can begin. While the injury is healing, women
should wear flat shoes on a daily basis. If home remedies
do not work, see your doctor for a correct diagnosis.
Your podiatric
physician/surgeon has been trained specifically and
extensively in the diagnosis and treatment of all manners
of foot conditions. This training encompasses all of the
intricately related systems and structures of the foot and
lower leg including neurological, circulatory, skin, and
the musculoskeletal system, which includes bones, joints,
ligaments, tendons, muscles, and nerves. |
Sometimes known as the
"ball bearings of the foot," the sesamoids are two small
bones found beneath the first metatarsal bones. They can
inflame or rupture under the stress of exercise.
