The sesamoids are small bones in the ball of the foot that are susceptible to injury caused by overuse and increased pressure on the big toe joint.

If you notice pain around your big toe and the ball of your foot that comes and goes, then you may have sesamoiditis.

This condition is treated with surgical and nonsurgical methods depending on the severity of your condition. Seeking a podiatrist’s opinion is crucial for getting the best treatment for your injury.

Before scheduling an appointment with Dr. Frankel, read about sesamoiditis below to learn more about this condition, treatment options for sesamoiditis, and how to prevent it.

Sesamoiditis Treatment

What is a sesamoid?

Sesamoids are small bones connected to and embedded in a tendon. There are a few sesamoids found in joints throughout the body, and two of them are located in the ball of each foot.

The sesamoids in the foot help the big toe use leverage while walking or jumping and allow weight-bearing while elevating the bones of the big toe, providing a smooth surface for the tendons of the foot.

What injuries commonly occur with sesamoids?

Sesamoiditis, a form of tendonitis, is caused by overuse and increased pressure on the sesamoids. This is a common condition in athletes such as ballerinas and runners who have high-impact loads on their feet.

Turf toe and fractures are also common injuries that occur with sesamoids.

• Turf toe involves a strain or tear of soft tissue surrounding the big toe joint when the toe is hyperextended. It usually causes immediate pain and swelling around the big toe.
• A fracture of the sesamoid bone can be acute or chronic. Acute fractures are caused by trauma, such as kicking a ball, and chronic fractures are due to repetitive stress and overuse.

Sesamoiditis is characterized by pain that comes and goes, particularly with certain shoes or activities. The pain gradually develops over time, however, so it is important to see your podiatrist if you notice pain in the ball of your foot.

Symptoms of sesamoiditis include:

• Inflammation, swelling, and bruising
• Difficulty walking, running, or jumping resulting in a limp
• Difficulty bending and/or straightening the big toe

If you notice these symptoms, stop the activity that causes pain, take aspirin or ibuprofen to relieve pain, and apply ice around a towel to the affected area. Schedule a consultation with your podiatrist to treat your pain and prevent further injury from overuse.

Treatment for Sesamoiditis

To evaluate the foot for symptoms of sesamoiditis, Dr. Frankel will assess the movement of the big toe, press on the big toe as an indicator of discomfort, and watch your gait.

Treatment for sesamoiditis is divided into surgical and nonsurgical methods.

Nonsurgical Treatment

Nonsurgical treatment is the first option, especially for conditions that aren’t severe.

• Padding, strapping, or taping provides support to the big toe joint and relieves pain.
• The foot may be immobilized using a cast and/or crutches to remove weight from the foot.
• Oral medications, or anti-inflammatory over-the-counter drugs, will reduce inflammation around the sesamoids and relieve pain.
• Rehabilitating the foot after using a cast with physical therapy will strengthen the tendons and muscles around the sesamoids and improve mobility.
• Cortisone, a form of steroid injections, may be injected into the joint to reduce pain and inflammation.
• An orthotic device that is custom-fit to your shoe may be prescribed to provide support to the foot and balance pressure on the ball of the foot.

Depending on your pain and the severity of sesamoiditis, Dr. Frankel may recommend one or more of the methods above to treat your condition without surgery.

Surgical Treatment

If the sesamoiditis is severe and the methods above did not treat the condition, then you may be a candidate for surgery.

Schedule a consultation with Dr. Frankel to determine a treatment that is right for you.

Tips for Sesamoiditis Prevention

With our tips, you can help prevent sesamoiditis and protect your feet from unnecessary wear and tear.

Note: People with high arches are at risk of sesamoiditis due to the increased load of pressure on the ball of the foot. If you have high arches, pay special attention to these tips to prevent sesamoiditis.

• Wear comfortable shoes. Avoid high heels and flats that lack support and place pressure on the ball of the foot.
• For active patients, wear shock-absorbing sneakers. These sneakers will reduce the load of weight impacting the foot with each step.
• Correct your gait. Use proper posture while standing and walking. Avoid rolling your foot inward as this stresses the sesamoids.
• Alter or avoid activities that cause pain. For example, if you are a runner, try running on trails rather than hard surfaces to reduce the impact on the big toe joint.
• Wear custom-made orthotics. Orthotics will cushion your foot, providing the support it needs.

By using the tips above, you can reduce pain and weakness from overusing the tendons in your feet.

The sesamoids are an important part of foot health.

Taking care of your feet, and the tiny sesamoids in the ball of the foot improves your overall health. Preventing or treating overuse and injury in the tendons of the feet will allow you to continue to do the activities you love without pain.

Get treatment for overuse injury at Frankel Foot & Ankle.

Dr. Frankel founded Frankel Foot & Ankle to provide patients in Pennsylvania, New York, and New Jersey tri-state area with the latest advances in diagnostic technology and treatment for sports medicine conditions, foot and ankle trauma response, and innovative surgical and regenerative approaches. Contact Frankel Foot & Ankle today. With offices in Middletown, NY, Warwick, NY, and Milford, PA we are the go-to podiatrist near you!