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Sesamoiditis


Experiencing a painful sensation in the ball of your foot, just behind your big toe?  You may very well be suffering from Sesamoiditis.  This ailment is generally defined by pain and inflammation to the sesamoid bones and surrounding tendons and tissue.  The bones themselves are positioned just behind the big toe and above the ball of the foot.  Common complaints of those who suffer from sesamoiditis are pain just behind the big toe, intermittent swelling of the ball of the foot, intermittent pain and pain during walking, running or jumping.  Given the fact that the culprits are two small bones that reside within the ball of the foot, the disease is most common in those who run frequently, dance, squat or wear high heeled shoes.  If you find yourself experiencing pain of this type, and you do one of the aforementioned activities on a frequent basis, aim to reduce the frequency as soon as possible.  Recognizing the symptoms early and treating the affected area withhome remedies may just save you more expensive or even surgical repairs down the road.  In order to further zero in on whether you are suffering from sesamoiditis or not, look for these symptoms: Sesamoiditis generally comes on slowly, with slight pain occurring infrequently and then growing both in intensity and frequency as time moves on.  If you feel that you are experiencing a dull painful sensation when extending your big toe upward, or performing any of the above tasks, begin a home remedy regimen right away.  If however you got here too late and you are experiencing chronic pain, expect chronic inflammation of the sesamoid bone region, swelling and a general sense if discomfort while walking, running or jumping.  You can still try out some of our home relief product recommendations, however a trip to the podiatrist is likely in order, to diagnose the underlying cause of your pain.


What is a Sesamoid Bone?


Now that you know a bit about the disease itself, let’s understand the Sesamoid Bones a little better.  Once we understand the purpose of the bones it will be easier to grasp the gravity of an injury to this area.

The sesamoid is a bone that is embedded within a tendon.  Sesamoid bones are found in a number of joints in the body, but tend to flare up mostly in the foot.  The typical foot holds two sesamoid bones, small in stature (the size of a bean) and located around the ball of the foot, just behind the first metatarsal of the big toe.

The sesamoid bone acts as a pulley for the tendons that surround the big toe.  They assist the big toe to move normally and assist in the act of “pushing off.”  The sesamoid bone also serves as a weight bearing bone for the first metatarsal (which is the long bone that is connected to the big toe).  The bones themselves in turn provide important shock absorption when weight is placed upon the ball of the foot while running or walking.  For a more in depth description, check out our sesamoid bone page which provides an anatomical overview of the bones themselves and their function.


Sesamoiditis Causes


Direct Injury to The Sesamoid Bones


Many times sesamoiditis can be caused simply by aggravating the sesamoid bone through brunt force trauma such as stepping on a hard object or running without shoes.  This cause is relatively rare, but is seen in certain cases.

Another method of injuring the sesamoids is through “Micro-Trauma.”  Micro-Trauma is caused by overuse of the sesamoid area, which is positioned just above the ball of the foot.  A person who engages in repetitive activities which require extensive time on the balls of their feet may develop sesamoid micro-trauma.  Some examples of such activities include:



  •  Dancing
  •  Squatting (Think a catcher’s stance)
  •  Running or Leaping on the balls of the feet
  •  Wearing heeled shoes for extended periods



Age Related Causes


As with any other part of the body, age takes a significant toll on the sesamoid bones.  Conditions such as osteoperosis can contribute as a cause of sesamoiditis. Osteoarthritis is also known to assist in the onset of sesamoiditis.

 Osteoporosis: As the bones lose calcium and in turn become weaker, the sesamoids may not be able to handle the continual stress that is placed on them during every day activities.  When this occurs, the sesamoid bone begins to develop small stress fractures, which in turn cause inflammation, swelling and pain.

 Osteoarthritis: This condition may cause the formation of miniature bone spurs on the sesamoid bone.  The spurs themselves act as an irritant to the surrounding tendons that hold the sesamoid bone in place.  The result of course is inflammation, swelling and pain.


Hereditary Causes


As with any ailment, there are certain people who are either born with or otherwise genetically predisposed to sesamoditis.  You will find below some common defects that are directly related to sesamoditis:


 Enlarged Sesamoid Bones: A person born with enlarged sesamoid bones will realize the pain from their first day walking.  The increased size of the bones causes them to attract a disproportionate amount of body weight during each step.  This excessive weight distribution will eventually lead to deterioration, which in turn leads to inflammation and pain.


 Overpronation: Overpronation is a condition whereby a fallen or collapsed arch causes a person’s ankle to roll inward with each step. causing excess pressure and use can cause micro fractures and/or irritation.



Sesamoiditis Symptoms


Now that we know all about the sesamoid bone and sesamoiditis, what are the symptoms you should look out for?

Sesamoiditis Symptoms Show Up Gradually: Don’t expect to wake up one day and realize that you have sesamoiditis.  The symptoms themselves show up slowly over time, rather than all at once.  Patients generally complain of very slight aches and pains that gradually increase in intensity over time.


Early Stage Symptoms



  •  Sesamoid tenderness upon direct pressure
  •  Mild pain during barefoot walking
  •  Increased pain level while jumping or running
  •  Pain disappears quickly with rest
  •  Slight swelling under the sesamoids (ball of the foot)



Late Stage Symptoms



  •  Consistent pain in the sesamoid area (ball of the foot, or behind the big toe)
  •  Sharp pain when running or jumping even with well padded footwear
  •  Sharp pain when applying pressure to the sesamoid area
  •  Increased and longer lasting swelling of the affected area
  •  Pain when bending the big toe upward (plantarflexion)
  •  Swelling of the entire big toe area (1st metatarsophalangeal)



Pain Behind The Big Toe: Patients typically describe a painful sensation behind the big toe joint, just under the ball of the foot on the medial side (inner side).  If you are experiencing this type of pain in the location pictured above, then you may have sesamoiditis.


Limited Movement of the Big Toe: The onset of sesamoiditis has been known to cause swelling in the affected area, just behind the first metatarsal on the ball of the foot.  This swell has been known to inhibit movement of the first metatarsophalangeal.  This movement is called plantarflexion and dorsiflexion, which describes the ability to bend the big toe up and down.  Patients suffering swelling as a result of sesamoiditis may find it difficult to move the big toe at all.

If this type of pain sounds familiar, you may want to read up on some of the sesamoiditis treatments that we recommend.


At Elite Clinic our podiatrist offers a wide range of treatments to help alleviate the pain and symptoms associated with this condition, call us on 01698 813001 to book podiatry appointment, or you can text appointment or any questions you may have about this condition or it treatment to: 07852 296 632


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