Sesamoids are small, seed-shaped bones that lie within the flexor tendons underneath the base of the big toe. They protect and absorb shock for both the joint and the tendons, by providing a smooth surface for the tendons to slide increasing their ability to transmit muscle forces.
Sesamoiditis is when the tendons surrounding the sesamoids can become irritated or inflamed. Repetitive stress and compression on the sesamoid and the first metatarsophalangeal joint is the most common cause. Fractures can also cause pain in the sesamoids.
Pain worsens with activities such as running, jumping, dancing, and any motion where the toe is pushing off the ground.
Symptoms may include:
● Pain is focused under the big toe on the ball of the foot. With sesamoiditis, pain may develop gradually, whereas with a fracture, the pain will be immediate.
● Swelling and bruising may or may not be present.
● There may be difficulty and pain when bending and straightening the big toe.
Treatment may include:
● Stop any activity that causes the pain.
● Resting and the use of ice on the sole of your foot.
● Wearing soft-soled, low-heeled shoes.
● Taping the big toe so that it remains bent slightly downward (plantar flexion).
● Orthotic devices to improve biomechanical abnormalities and evenly distribute pressure through the foot.
● Return to activity gradually.
● A Cam Walker (‘Moon Boot”) may be used if symptoms persist