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What Is a Sesamoid?

A sesamoid (from which we get “sesamoiditis”) is a bone that is embedded within a tendon or muscle, rather than connected to the rest of the skeleton via ligaments. This allows them to “sit on top of” and move independently of neighboring bones. The most obvious example of a sesamoid is your kneecap, which both protects the knee joint and gives your quadriceps the leverage it needs to extend the leg.

There are also two tiny sesamoids located in the ball of the foot, near the base of the big toe. These small bones are about the size of corn kernels, and they act like pulleys for your foot. They help with bearing weight evenly. They also enable smoother movement and greater power and leverage for the big toe when you push off to walk, run, or jump.

What Is Sesamoiditis?

When we talk about sesamoiditis, we’re almost always specifically referring to the two tiny bones in the forefoot we just talked about. If the sesamoids are forced to sustain excess weight or pressure over a period, both the bones themselves and the tendon surrounding them can become inflamed.

The most common symptoms include:

  • Pain is focused under the ball of the foot, specifically near the base of the big toe.
  • Pain typically develops gradually but eventually becomes a chronic, dull ache.
  • The big toe may be stiff and difficult to move.
  • Swelling and/or bruising are sometimes (but not always) noticeable.

Under more extreme stress, one of the sesamoids may fracture. If this is due to an acute injury, pain will generally be immediate and significant.

How Is Sesamoiditis Treated?

We will need to perform a physical examination and may need to take diagnostic images to confirm the diagnosis. Fortunately, most sesamoid injuries can be treated conservatively.

Common aspects of treatment may include:

  • Temporary rest from physically demanding sports or activities
  • Use of over-the-counter medications to control pain
  • Steroid injections if pain is more serious
  • Switching to more comfortable, cushioned, and supportive shoes
  • Using prefabricated insoles, custom orthotics, or a brace to relieve pressure on the sesamoids
  • Taping or splinting the toe in a slightly flexed position to promote healing

Surgical repair of the bones or tendon is almost never necessary but may be considered in the most extreme cases or when conservative remedies don’t provide relief.

Is your big toe stiff? Are you experiencing pain or aches in the balls of your feet? Fill out our online form or give Gulf South Foot & Ankle a call today at our New Orleans area office closest to you.