This condition is an irritation of the sesamoid bones, which are located within the tendons that slide along either side of the bottom of the big toe. The sesamoid bones, each about the size of a kernel of corn, provide leverage for the tendons that control the big toe.
Sesamoiditis is a general description for any irritation of the sesamoid bones. Sesamoid bones are tiny bones within the tendons in the foot that run to the big toe. The sesamoid bones function as a pulley, increasing the leverage of the tendons controlling the toe.
It is a common ailment that affects the forefoot. It is most common in young people who engage in physical activity like running or dancing. When a person has sesamoiditis, the tendons around the sesamoid bones are often inflamed. Sesamoiditis is a common problem among ballet dancers and people who play the position of catcher in baseball.
Sesamoiditis Symptoms & Anatomy
The most common symptom of sesamoiditis is pain in the ball-of-the-foot and swelling. The pain often occurs on the medial or inner side. The pain may be constant, or it may occur with, or be aggravated by, movement of the big toe joint. The pain is often accompanied by swelling throughout the bottom of the forefoot.
Sesamoiditis is usually caused by repetitive, excessive pressure on the forefoot. Other causes include increased activity, stress fractures, having a high arched foot, and having a bony foot. If you have a bony foot, you may not have enough fat on your foot to protect your sesamoid bones and tendons.
Treatment options include rest, a modified shoe, or custom orthotics, shoe pads, immobilization of the toe joint to speed the healing process, ibuprofen to decrease pain and swelling.
Severe cases may require a below-the-knee walking cast for 2 to 4 weeks and the injection of steroids into the inflamed first metatarsophalangeal joint.
Learn more about the Foot and Ankle Center at Resurgens Orthopaedics.