Sesamoiditis

Most of the bones in the human body are connected to one another by joints. However, there are a few that do not follow this rule. These are in contact with tendons or are enclosed by muscles. These are the sesamoid bones.

The kneecap (patella) is the largest sesamoid. Two other very small sesamoid bones are located on the underside of the foot, near the big toe. They provide a smooth surface over which the tendons can glide, and they also help the tendons to generate more muscle strength. The sesamoid bones in the forefoot also help to bear body weight. Just like other bones, the sesamoid bones can fracture, and the tendons around them can become irritated or inflamed. This is known as sesamoiditis and is a form of tendonitis. It is particularly common among ballet dancers, runners and volleyball players.

The pain is concentrated beneath the big toe, at the ball of the foot. With sesamoiditis, the pain develops gradually, in contrast to a fracture, where the pain is acute (sudden). Swelling may or may not be present, and bending and stretching the big toe can be difficult and painful.

The treatment of sesamoiditis is usually conservative, that is to say, without invasive measures such as surgery.

Stop the activity or strain that caused the symptoms. Take the weight off the sole of the foot and, if necessary, ‘ice’ the affected area. Never apply ice directly to the skin; use an ice pack or wrap it in a towel instead.

In many cases, the podiatrist can identify and treat the cause of the injury. By relieving pressure on the painful sesamoid bones by means of a sole therapy or to provide immediate relief with a taping or felt therapy.