Sesamoiditis is a common foot problem characterised by chronic inflammation around the underside of the joint at the base of the big toe. It’s typically triggered by overuse of the sesamoid bones, which are tiny and prone to becoming irritated. As a result, sesamoiditis is a major cause of pain in the ball of the foot, particularly among athletic people.

Although anyone can develop sesamoiditis, the risk is greater for individuals who take part in high-impact activities such as running, dancing and football. This is especially true of sporty children/teenagers, whose foot bones are softer and still developing. Indeed, sesamoiditis was responsible for 62.6% of sesamoid issues diagnosed in young athletes taking part in a recent study published by the Clinical Journal of Sport Medicine.

So if you demand a lot from your feet or have a young sports star in the family, it’s particularly important to familiarise yourself with sesamoiditis and how to deal with the problem. If you’re at all worried, please book an appointment today at one of our London podiatry clinics for 5* foot care.

The Sesamoid Bones Are Exposed to Considerable Pressure

Sesamoid bones are embedded within tendons at various joints around the body. They’re unusual because they’re independent rather than connected to other bones so have little support. Despite this, sesamoids have a crucial job: they act as pulleys, facilitating movement by providing ‘a smooth surface for the tendons to slide over, increasing the ability of the tendons to transmit muscle forces’, as orthopaedic resource OrthoInfo explains.

When talking about sesamoiditis of the foot, we’re concerned with the two pea-sized sesamoid bones under the first metatarsophalangeal joint (i.e. the main big toe joint), as shown in a helpful diagram from Foot Health Facts. The medial sesamoid is nearer the foot’s inner edge, while the lateral sesamoid is nearer the second toe. They sit side by side within the tendon connected to the flexor hallucis brevis muscle, which flexes the big toe to help your foot push off the ground when walking, running or jumping.

Because they’re in the ball of the foot, the sesamoids are exposed to considerable pressure every time you take a step. As scientific journal Medicina points out, they transmit ‘between 50% and 300% of body weight, depending on the type of movement and applied load’. So these tiny bones and the surrounding area can easily get irritated and inflamed, especially if overworked.

The medial sesamoid is most vulnerable to sesamoiditis. It’s slightly larger and less cushioned than its partner, so is under more strain.

Main Causes of Sesamoiditis

Sesamoiditis is often caused by:

• Demanding, repetitive activities that involve running, pivoting, jumping, and landing on hard surfaces, such as ballet or marathon training
• Suddenly increasing your activity levels (for example, training more frequently/intensely without building-up your stamina) or taking up a tough sport such as rugby
• ‘Pushing through the pain’ when feet feel overworked
• Having high arches, as they increase the strain on the balls of your feet
• Wearing unsupportive footwear – high heels push your weight forwards, putting extra pressure on the sesamoids; flip-flops don’t protect them against shock

Key Symptoms of Sesamoiditis

Sesamoiditis can affect one or both of the sesamoid bones in one or both feet.

Symptoms include:

• Pain in the ball of your foot by the bottom of the big toe. It tends to start as a dull ache then gets sharper over time and may radiate into the toe.
• Tenderness and swelling; you may also notice bruising
• Difficulty bending the big toe and bearing weight on the ball of the foot
• Altering your gait to avoid putting pressure on the sore area

How Podiatrists Diagnose and Treat Sesamoiditis

Our podiatry team can help you to overcome sesamoiditis and stop it spoiling an athletic lifestyle.

Sesamoiditis can usually be diagnosed with a foot examination that pays close attention to inflammation and the first metatarsophalangeal joint’s mobility levels. A biomechanical assessment of lower limb function and gait analysis may also be beneficial, especially if you’re limping. Imaging tests check for/rule out other issues, such as fractures.

Lifestyle changes and conservative treatments are usually sufficient. They include:

• Reducing/pausing strenuous activities
• Resting and icing the foot
• Oral/topical anti-inflammatories
• Felt padding to reduce pressure on inflamed sesamoids
• Strapping the big toe to limit movement
• Shockwave therapy to reduce pain and promote healing
• Supportive, well-cushioned shoes
• Custom orthotics to direct pressure away from the sesamoids, avoid further irritation and make walking more comfortable
• Foot-strengthening exercises

Sesamoiditis is painful, and you want to stop it becoming a stubborn, long-term problem.

Call Feet By Pody today on 0207 099 6657 for expert help.