Sesamoiditis

Sesamoiditis is a common ailment that affects the forefoot. It typically affects young people who engage in physical activity like running or dancing. The most common symptom is pain in the ball of the foot, especially on the medial or inner side. The term 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 muscles 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 within the tendons, sesamoiditis is a kind of tendinitis – the muscles around the bones also become inflamed.

Cause

Sesamoiditis is typically distinguished from other forefoot conditions by its gradual onset. The pain usually begins as a mild ache and increases gradually as the aggravating activity is continued. It may build to an intense throbbing. In most cases, there is little or no bruising or redness. Increased activity is a leading cause of sesamoiditis.

You’ve probably stepped up your activity level lately, which has forced you to put more pressure on the balls of your feet. Speedwork, hill work, or even increased mileage can cause this. If you have a bony foot, you may not have enough fat on your foot to protect your tender sesamoids. Also, if you have a high arched foot, you will naturally run on the balls-of-your-feet, adding even more pressure.

Treatment and Prevention

Treatment for sesamoiditis is almost always noninvasive. Minor cases call for a strict rest period and a modified shoe or a shoe pad to reduce pressure on the affected area. This may be accomplished by placing a metatarsal pad away from the joint to redistribute the weight-bearing pressure to other parts of the forefoot. Also, the big toe may be bound with tape or athletic strapping to immobilize the joint as much as possible and allow healing.

It is recommended to decrease or stop activity for a while. This will give your sesamoids time to heal. You should apply ice to the area for 10 to 15 minutes after exercise or any activity that aggravates the area. As with icing, anti-inflammatories will help the swelling go down so healing can begin. While the injury is healing, women should wear flat shoes daily. If home remedies do not work, see your doctor for a correct diagnosis.