Foot Conditions A-Z
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.
The sesamoids are two pea-shaped bones on the underside of the feet, directly below the big toe. 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.
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 below the big toe joint. 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.
- 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.
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.
Prevention and Treatment
IPFH suggests that the simplest way to avoid sesamoiditis and help ensure your feet are optimally protected is to wear only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional. Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help protect against injuries to the skin/soft tissue of the foot due to impact, pressure and shear forces.
Treatment may include any or all of the following, as prescribed by your doctor:
- padding, strapping, or taping
- limiting activities and keeping weight off the feet
- physical therapy
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 doctor when you have any pain in the forefoot that lasts more than a few days or recurs.