A sesamoid is a bone that is embedded in the tendon and can be found in various tendons in the body. In a normal foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. The sesamoid helps the toe move normally and provide leverage when the big toe pushes off during walking and running. It also serves as a weight-bearing surface for the first metatarsal bone absorbing the weight placed on the ball of the foot when walking, running, and jumping.
Different Types of Sesamoid Injuries
Turf toe. This type of injury is one of the soft tissue surrounding the big toe joint and occurs when the big toe is extended beyond its normal range. Turf toe causes immediate pain and swelling and affects the entire big toe joint. Sometimes a “pop” is felt during the time of injury.
Fracture. A fracture or break in the sesamoid bone can either be acute or chronic. An acute fracture is caused by trauma, such as a direct blow or impact to the bone. It causes immediate swelling and at the site of the break but does not usually affect the entire toe joint. A chronic fracture produces longstanding pain in the ball of the foot beneath the big toe joint.
Sesamoiditis. This is an overuse injury involving chronic inflammation of the sesamoid bones and the tendons involved with those bones. Sesamoiditis is caused by increased pressure on the sesamoids. Sesamoiditis is often associated with dull, longstanding pain beneath the big toe joint.
There are two different categories of treatment for sesamoiditis. One is non-surgical, the most common approach, and surgical, which is used as a last resort. The non-surgical options are:
Padding, strapping, or taping. A pad may be placed in the shoe to cushion the inflamed sesamoid area. Or the toe may be taped or strapped to relieve the area of tension.
The foot may be placed in a cast or removable walking cast. Crutches may be used to prevent placing weight on the foot.
Anti-inflammatory drugs may also be used to help rude pain and swelling.
The rehabilitation period after immobilization may also include physical therapy such as exercising and ultra-sound therapy.
In some cases, cortisone is injected in the joint to reduce pain and inflammation.
Custom orthotics that fit into the shoe can also be prescribed for long-term treatment of Sesamoiditis to balance the pressure placed on the ball of the foot.
When sesamoid injuries fail to respond to non-surgical treatment, surgery may be required. The Podiatrists at Total Foot Care and Wellness will determine the type of procedure that is best suited to the individual patient.
If you believe you have a sesamoid injury, please contact us and book an appointment.