Sesamoiditis

Sesamoiditis

The sesamoids are two pea-shaped bones on the bottom of the feet, under the first metatarsal heads (bones in the foot), behind the big toe joints.. They help support the body weight and elevate the bones of the big toe. They act like pulleys by providing a smooth surface over which the tendons move. This action enhances the tendons’ ability to convey muscle forces in walking and running.The forefeet are the main weight-bearing areas of the foot. They incur the greatest amount of impact and shear force when we walk and run, and they are the source of much of our foot pain.

While most bones in the human body are connected to each other at joints, the sesamoids are not connected to any other bones; instead, they are connected to the tendons. When the sesamoids become irritated or inflamed, the result is sesamoiditis, which actually is a form of tendinitis. Sesamoiditis is usually characterized by a dull, persistent pain in the affected area. The pain comes and goes, depending on your footwear and level of activity.

Related Foot Conditions

Two conditions may occur in conjunction with sesamoiditis:

• Turf Toe - an injury of the soft tissue around the big toe joint, characterized by sharp pain and swelling. It often happens when the big toe joint is extended beyond its normal range of movement during sports that require quick moves on rigid surfaces. The condition affects the entire toe joint and limits its range of motion.
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• Metatarsalgia - generalized pain in the ball of the foot.  It occurs in the same area of the foot as sesamoiditis but is typically the result of pressure, trauma or repetitive damage to the heads of the metatarsal bones. Sesamoiditis and metatarsalgia may be mistaken for one another or may occur simultaneously.
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Causes

The most common cause of sesamoiditis is overuse, especially from activities that put high levels of pressure on the ball of the foot, such as running, football, golf, and dancing, as well as sports such as tennis, basketball, and volleyball. However, any repetitive impact or trauma to the forefoot—including frequently wearing high heeled shoes—can cause it as well. In addition, people with high arches or inflexible feet are at risk for developing sesamoid problems.

Treatment

Treatment may include any or all of the following, as prescribed by your Podiatrist:

• padding, strapping, or taping
• orthotics
• limiting activities and keeping weight off the feet
• immobilization
• physical therapy
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Medical Considerations

Since they are bones, the sesamoids can fracture.  When this occurs, more aggressive treatments may be needed, including surgery. Because several conditions may occur together with—or may be mistaken for—sesamoiditis, see your Podiatrist when you have any pain in the forefoot that lasts more than a few days or recurs.