What is sesamoiditis?
Sesamoiditis is an overuse injury that results in foot pain localized to the ball of the foot near the big toe. The pain usually comes and goes and may be aggravated by certain activities or types of footwear.
What is a sesamoid?
Unlike most other bones in the human body, sesamoids are not connected to any other bone. Instead, the sesamoids are embedded in muscle or connected to tendons. A pair of sesamoid bones are found in the feet. They are semi-lunar in shape, each is about the size of pea, and they are located on the underside of the forefoot near the big toe. They act as a pulley for the ligaments of the foot while also aiding in absorbing the weight placed on the ball of the foot.
What causes sesamoiditis?
Sesamoiditis in young healthy adults is generally an overuse injury that results in chronic inflammation of the sesamoids. It is most commonly caused by repeated stress on the ball of the foot from activities such as running, jumping, and squatting. In older adults, sesamoiditis may be caused by degenerative changes such as osteoarthritis.
Who can this affect?
- Baseball catchers
- Individuals who wear high heels or have high-arched feet
- Individuals who participate in any activity that requires increased pressure on the ball of the foot
What are the symptoms?
- Pain on the ball of the foot around or under the joint of the great toe.
- Pain may be exacerbated by toe walking.
- Pain may be elicited with movement of the great toe.
- Swelling, bruising, and/or heat may be present.
How is sesamoiditis diagnosed?
- Your doctor can usually diagnose sesamoiditis based on a thorough history and physical exam.
- An ultrasound of the foot may be used to identify bones, ligaments as well as inflammation.
- An x-ray may be indicated to rule out fractures or any other bony abnormalities.
How is sesamoiditis treated?
Sesamoiditis is usually best treated with a combination of rest, anti-inflammatories and ice, changing your activities, as well as orthotic insoles and properly fitted shoes to correct gait and support to the foot.
Non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or naproxen can help reduce pain and inflammation.
Once the pain has subsided, and if recommended by your physician, physical therapy or home exercise programs that focus on strengthening the foot as well as increasing range of motion may be started. Physical therapy can also be used to improve running form.
When can I return to my sport?
2-4 weeks of rest may be indicated to allow the pain and inflammation of sesamoiditis to subside. Activities that cause pain should be avoided. Gradual return to running and other activities is recommended after rest and therapy.
More information: Sesamoiditis
By Mattison Pearlman and Mo Mortazavi, MD
Sesamoiditis – Musculoskeletal and Connective Tissue Disorders – MSD Manual Professional Edition. MSD Manual Professional Edition. 2017. Available at: http://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/foot-and-ankle-disorders/sesamoiditis. Accessed June 12, 2017.
Sesamoiditis-OrthoInfo – AAOS. Orthoinfoaaosorg. 2017. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00164. Accessed June 12, 2017.
Sesamoid Injuries in the Foot – ACFAS. ACFAS. 2017. Available at: http://www.acfas.org/footankleinfo/Sesamoid_Injuries.htm. Accessed June 12, 2017.
Sesamoid Injuries. Aofasorg. 2017. Available at: http://www.aofas.org/footcaremd/conditions/ailments-of-the-big-toe/Pages/Sesamoiditis.aspx. Accessed June 12, 2017.