Sesamoiditis is a general description for any irritation of the sesamoid bones, which are tiny bones within the tendons that run to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe the sesamoids are involved, and eventually they can become irritated, even fractured. Because the bones are actually within the tendons, sesamoiditis is really a kind of tendinitis - the tendons around the bones become inflamed as well.
Main contributing factors
- Typically occurs in young people who engage in activities like running or dancing.
- Recent increase in activity levels
- Insufficient fat pad in forefoot to cushion joint
- High arched foot type puts more pressure on forefoot
- Excessive load on the sesamoids
- Muscle imbalances around the big toe
- Jumping from a height
- High-heeled shoes
- Gradual onset of pain or soreness in the medial forefoot.
- Pain may be constant or it may occur with or be aggravated by movement of the big toe joint.
- Swelling throughout the bottom of the forefoot.
Treatment for Sesamoiditis
- Activity modification or reduction, possibly complete rest.
- Joint immobilization
- Forefoot Padding to offload joint
- Non-steroidal anti-inflammatory drugs (Nurofen etc)
- If biomechanics is a contributory cause – orthotics may be considered