Sesamoiditis

What is Sesamoiditis?

Sesamoiditis is inflammation around the small bones which are situated under the big toe joint.It is characterised by swelling and pain on weight bearing. The pain is made worse when wearing high heels or walking on hard surfaces.

Sesamoid Picture

This condition can be confused with bruising and occasionally a sesamoid may be fractured, requiring x-ray examination to confirm the diagnosis.

Sesamoids Axial View

CAUSES

Poor foot biomechanics/alignment. This can cause overloading of the foot in the region of the sesamoids. This may occur with either excessive pronation (roll-in) or supination (roll-out).

Sudden changes in training may cause overloading of the ball of the foot where the sesamoids lie resulting in overuse and inflammation of the sesamoid bones.

Trauma to the foot may cause inflammation or possibly fracture of the sesamoids.

Poorly fitting or inappropriate footwear may also contribute to the onset of sesamoiditis especially where hard soled or high heel shoes are worn.

TREATMENT

Early treatment in usually effective in the management of sesamoiditis.

Sport and Exercise

Your exercise and activity schedule will be considered and modified so that a successful and effective treatment can be utilized.

R.I.C.E.
Rest, Ice, Compression and Elevation may be helpful in acute injuries. Anti-inflammatory medication may also be required.

Correction of abnormal foot function.

Custom made orthotics are designed to allow the foot to function normally and to reduces the direct pressure on the sesamoids. This allows the affected area to recover initially and then to prevent future recurrence of the injury.

Stretching and physiotherapy.

Mild stretching and strengthening exercises may be prescribed where necessary.

Casting or immobilisation.

This may be necessary if a fracture is present.