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Sesamoiditis Painful Toe And Foot Condition

Our sesamoid bones are bones that are IN ie embedded in a tendon.

Comparatively, most of the bones in our body are connected to each other at the joints (usually 2 or more bones form a joint). Sesamoid bones, on the other hand, are not connected to any other bones - they are connected to tendons or are embedded in muscles.

In our foot, the sesamoid bones are two small, pea-shaped bones, located at the ball of the foot, just underneath your big toe joint.

Sesamoid bones behave/function

• like pulleys, by providing a smooth surface for the tendons to glide over and
• helps with weight bearing/absorbing the weight placed on the ball of the feet when walking, running or jumping

What causes sesamoiditis?

Like any other bones in our body, the sesamoid can also sustain injuries including:

• bone bruising
• bone cracks
• bone fractures

The tendons that encase the sesamoid bones can also become

• inflammed
• irritated

- which then becomes sesamoiditis, which is a form of tendinitis (similar to tennis elbow, golfer's elbow, shoulder impingement etc)

Generally, sesamoiditis is a painful condition that is caused by increased pressure to our sesamoids and are associated with activities requiring increased pressure on the ball of the foot, such as jogging, running, basketball, squash, football, golf, tennis, and ballet.

Sesamoid bones are commonly injured with/in dancers, particularly in those who fail to perform proper landing, which when done right, will absorb the energy of the landing through partially flexed knees. Without such absorption proper technique, sudden deceleration with high impact of the sesamoid bones will lead to injury especially to the sesamoid bones.

Also, individuals with low arch or high-arched foot or a prominent joint can also have higher risk of sesamoid damage and/or injury.

Of course, wearing ill-fitting shoes or shoes with a higher heel will also increase stress to the sesamoid bone/joint.

Symptoms of sesamoiditis

• Achey, dull pain under the great toe on the ball of the foot
  
• Sometimes there may be some redness and/or swelling underneath the big toe joint
• There may be stiffness in moving the big toe joint
• Difficulty when walking or wearing shoes
• Difficulty in walking generally
  

Treatment: Non-surgical Approach

• Please immediately stop participating in any activities that aggravates the pain
• See a doctor (see the doctors we work with here) and take some nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce pain and inflammation.
• Whenever possible, try to rest the foot and toe. Better still, elevate and apply cool/cold therapy too. Note: never apply ice directly to skin, instead, use an ice pack (we do sell them in our clinic) or wrap the ice in a plastic bag then a towel first.
• For shoes and footwear, try to wear soft, cushy soles and low-heeled shoes. Try to avoid the stiffer-soled shoes.
• You can apply a soft gel pad in the shoe near your sesamoid/big toe area to cushion, unless it's already too tight (then wear a larger size shoe instead)
• Take your time to slowly progress return to active lifestyle and activity, and continue to use the gel or foam pad to support
• You may consider a H&L injection, which is an injection for local and direct treatment.
• You may also consider custom orthotics to help take the pressure off the ball of the foot