Sesamoid Injuries and Sesamoiditis Treatment Guide

Sesamoid pain in the foot occurs directly under the big toe joint and can be debilitating. If you are in the Seattle area, make an appointment to see us right away.

If you are not in the Seattle area you can try our self-treatment recommendations for sesamoid pain. If you don’t have improvement within two weeks, however, be sure to see a podiatrist.

Video: Best Treatments for Sesamoiditis 

What Is a Sesamoid?

sesamoiditis treatmentFirst, here’s a little anatomy lesson to get things started. A Sesamoid is a bone embedded within a tendon and there are any number of them throughout the body. The foot contains 26 bones, 33 joints and 31 tendons. Taken together, this represents a large number of Sesamoids. If any of these are injured, it can be quite painful because they are located in a regularly flexing joint.

Sesamoid bones are tiny bones within the tendons that run to the big toe. These bones help to aid in the bending of the big toe. Every time you push off against the toe, the Sesamoids are involved and eventually they can become irritated, even fractured. Sesamoid problems often don’t heal on their own – if you have pain under the ball of your foot, contact us today for an appointment.

What Is a Sesamoid Injury?

A Sesamoid injury may involve just the joint or can include the bones, tendons, and surrounding tissue as well. Sesamoid injuries are commonly associated with over-use by athletes, and with repetitive, high pressure activities, such as running, ballet, basketball, golf, tennis, football, and any other activity that generates high stress on the balls of the feet. High heeled shoes, which also create pressure on the balls of the feet, can also cause a Sesamoid injury, as can uncommonly high arches in the feet.

What Are the Most Common Types of Sesamoid Injuries?

The four most common Sesamoid injuries are:

  • Sesamoiditis – This is a common over-use injury with inflammation of the Sesamoid bones and related tendons.
  • Turf toe – This is a common football injury affecting the soft tissue immediately surrounding the big toe joint. Pain tends to be immediate and severe, with swelling of the big toe and limited movement.
  • Metatarsalgia –This is a non-specific pain across the ball of the foot. The most common cause of metatarsalgia is a condition called “capsulitis”, which is an inflammation of the joints of the ball of the foot
  • Stress fractures – This is commonly caused by over-use of a Sesamoid bone.

Perhaps we can put in a call out box to draw attention to this fun fact: Foot Trivia: Did you know that your feet account for ¼ of all the bones in your body? [ok]

What is Sesamoiditis?

The term Sesamoiditis is used to describe an injury to any of the multiple Sesamoids in the body – most commonly inflammation due to over-use. The condition can be quite painful and regular because it’s within a flexing joint. The most common symptom of Sesamoiditis is pain in the ball of the foot and under the big toe at the ball of the foot that ranges from a mild ache to an intense throbbing.

One of the major causes of Sesamoiditis is increased activity. Speedwork, hill work, or even increased running mileage can cause this. Also, if you have high arches, you will naturally put more pressure on the balls of your feet.

What is the Treatment for Sesamoid Injuries?

Treatment for Sesamoid injuries and Sesamoiditis is almost always noninvasive and surgery is rarely necessary but may be an option if conservative options fail. Our first goal is to reduce pressure on the Sesamoid bones.

Common treatment therapies for Sesamoiditis may include:

  • Temporary walking cast to relieve pressure
  • Custom orthotics or arch supports
  • Proper shoes
  • Shoe modifications
  • Ice therapy
  • Anti-inflammatory medications
  • Steroid injections to reduce inflammation
  • Non-weight bearing period
  • Physical therapy
  • Padding or strapping

In extreme cases, surgery may be recommended as a last resort, though this is rare.

How Custom Orthotics Reduce Pressure on Painful Sesamoids

Custom functional orthotics, if properly prescribed and fitted, will dramatically reduce pressure on the ball of the foot and the Sesamoids – leading to decreased pain and less chance of pain returning. Orthotics for Sesamoiditis are prescribed specifically to help take weight off of the painful Sesamoid and to distribute the force onto the arch or onto the non-painful metatarsal heads. This requires an orthotic that conforms extremely close to the arch of your foot.

These are called total contact foot orthotics. In addition, special pads are added to further reduce pressure on the Sesamoids. You can read here how these orthotics must be made to properly treat the Sesamoid injury. In order to ensure best outcomes from your orthotics, we start with a detailed examination, slow motion video analysis of your foot mechanics then take a mold of your foot in a very specific position. The orthotics are prescribed to best reduce force and trauma to your Sesamoids.

Why Are Ballet Dancers Prone to Sesamoiditis?

Do you have a young ballet dancer in your family complaining of ball of foot pain? If so, your child may be suffering from Sesamoiditis. This over-use injury is common in dancers, even young ones, causes inflammation of the Sesamoid bones and related tendons. The pain can range from a dull ache to an intense throbbing sensation and will require treatment because it will rarely go away on its own.

Ballet, in particular, will increase pressure on the Sesamoids, with frequent positions en relevé. This causes swelling, inflammation, and pain at the ball of the foot. Since young dancers have less padding at the ball of the foot, they are particularly prone to Sesamoiditis, which may make it difficult to bend or straighten the affected big toe.

Sesamoiditis will require your young ballet dancer to rest the affected foot before resuming rehearsal and performances but it should not end her dancing career. If your young ballet dancer complains of persistent ball of foot pain, do not procrastinate getting treatment. Left untreated, Sesamoiditis may lead to a chronic condition that will prohibit the further enjoyment of ballet.

Make an appointment to see us in our Seattle office as soon as possible for treatment and relief of ball of foot pain in young ballet dancers. Each of the Seattle podiatrists at the Foot & Ankle Center of Washington are well-known specialists with expertise in treating children’s feet including Sesamoiditis.

Contact the Foot and Ankle Center for Your Foot Pain

If you are experiencing pain in the big toe joint or ball of foot pain, you may be suffering from a Sesamoid injury. If so, you should visit your podiatrist immediately. For patients who live in the Seattle area, a visit to our office will provide you with relief from your pain and discomfort.  Contact us today by calling (206) 344-3808 for an appointment in our convenient downtown Seattle office near Swedish Medical Center.

The doctors at the Foot & Ankle Center of Washington, Dr. Larry Huppin and Dr. Doug Hale, are nationally recognized experts in the treatment of Sesamoid injuries.