Understanding Sesamoiditis: What Your Feet Are Trying to Tell You

When you think about the hardest-working parts of your body, your feet might not be the first to come to mind, but they should be. Every day, they carry you through thousands of steps, balancing your weight and adapting to all kinds of terrain. 

Quietly hidden within the tendons and ligaments of your feet you’ll find small supportive structures called sesamoids. These are tiny bones that play a big role in foot mechanics, and when they become inflamed, it leads to a painful condition known as sesamoiditis. 

Sesamoiditis is a condition that involves inflammation or irritation of the sesamoid bones and the surrounding tendons in the foot. It’s often caused by repetitive stress or overuse, particularly in activities that put pressure on the ball of the foot.

What Are Sesamoid Bones?
One example of a sesamoid bone includes the kneecap, the most prominent sesamoid bone in the body. Additionally, two smaller sesamoid bones are in the foot near the big toe.

Unlike most bones, sesamoid bones aren’t connected to other bones by joints. Instead, they’re enclosed within tendons and work like pulleys to help your muscles and tendons glide smoothly.

Because sesamoid bones play an important role in weight-bearing and movement, they are the most prone to stress and inflammation, especially in athletes, dancers, high-heel wearers, or anyone who spends a lot of time on their feet.

What Are Common Sesamoid Injuries?
The three most common sesamoid injuries are turf toe, fractures, and sesamoiditis. Turf toe occurs when the big toe is hyperextended, causing a strain. Fractures generally result from sudden trauma or repetitive stress, leading to pain and difficulty walking.

Other sesamoiditis symptoms include:

• Tenderness under the big toe that worsens with activity
• Swelling or bruising near the ball of the foot
• Difficulty bending or extending the big toe 

Many people suffering from this type of strain also report feeling off balance, as though they’re walking on a marble. 

By recognizing sesamoiditis symptoms early, you have the opportunity to begin treatment, including rest, icing, and exercises that reduce inflammation and improve mobility. These small but fundamental bones should be treated promptly to prevent worsening symptoms and complications.

Diagnosing Sesamoiditis

To start, your podiatrist will conduct a physical examination to check for tenderness around the ball of the foot and move your big toe in various directions to analyze flexibility and pinpoint areas of pain. This will help to determine if your sesamoid bones are inflamed or if mobility is restricted.

If necessary, your doctor may order an X-ray of one or both feet to compare bone structures and rule out a fracture.

Sesamoiditis Treatment

The starting point for recovery involves rest and modifying your activities to reduce stress on these tiny bones. Avoid placing repetitive pressure on the ball of your foot to give these supporting structures time to heal and prevent further irritation.

Physical therapy is another key component of a comprehensive sesamoiditis treatment plan. Physical therapy helps by:

• Aiding patients in their recovery from current symptoms and reducing the risk of future occurrences.
• Working to address issues with body mechanics or movements that may have contributed to the condition.
• Improving alignment and balance to protect the embedded bones of the tendons.

Advanced medical interventions may be necessary for cases where conservative treatments aren’t enough. Options like corticosteroid injections can reduce inflammation, while shockwave therapy works to stimulate healing in the affected area. 

Ultimately, a personalized treatment plan tailored to your specific needs is the best way to ensure a full recovery and long-term foot health.

3 Sesamoiditis Prevention Tips

Following are three practical tips to protect these specialized foot bones.

1. Choose Shoes That Work With Your Feet, Not Against Them

Your footwear is your first line of defense toward prevention. 

• Choose shoes with low to moderate heels, ideally under 2 inches, to evenly distribute your weight and reduce pressure on the ball of your foot. 
• Wide toe boxes are another must-have. They allow your toes to spread naturally, minimizing strain on the big toe joint.
• Consider investing in custom orthotics or cushioned insoles, which help redistribute pressure away from the ball of your foot and reduce stress.
  

2. Rotate Your Activities

Repetitive stress is a major contributor to sesamoiditis. Taking a break from cyclical activities and adding a mix of high-low-impact exercises like swimming, cycling, or yoga into your daily routine gives your feet a chance to recover from recurring activities and reduces the risk of overuse injuries.

3. Sesamoiditis Exercises to Strengthen the Foot

Building strength and flexibility in your feet can help ease symptoms.

• Start with these Toe Yoga Exercises
• Practice Toe Spreading: Sit barefoot and spread your toes as wide as you can, holding the stretch for a few seconds. 
• Add Calf Raises by standing on the edge of a step, raising your heels, and lowering them slowly. 
• Finally, try Big Toe Pushdowns: Press your big toe into the floor while lifting your other toes to improve stability and alignment.

Visit The Foot and Ankle Group for Sesamoiditis Care

Your feet deserve expert care, and at The Foot and Ankle Group, we go beyond treating symptoms; we focus on finding and addressing the root cause of your pain. 

With a personalized treatment plan designed just for you, we’ll work together to get you back on your feet pain-free. Don’t wait—schedule an appointment today.