Sesamoiditis Causes, Symptoms & Treatment Options

The sesamoid complex in the foot consists of a pair of bones that are embedded into the muscle under the big toe. They act as weight absorbers for the ball of the foot and come into play during sporting activities such as running or jumping.

The tibial sesamoid is the larger of the two and sits within the medial head of the flexor hallucis brevis muscle; the fibular sesamoid is the smaller bone and is situated within the lateral head.

Sesamoiditis is an inflammation of the sesamoid bones, a painful condition that can cause further complications if left untreated.

Sesamoiditis is usually the result of repetitive trauma and is very common in running sports but can also be caused by high-impact trauma such as a slip or stumble, or a sudden and forceful bending upward of the big toe. Misalignment of the foot during training can put undue stress on the sesamoid causing sesamoiditis. Poor shoe wear, including wearing high heels, can also be a cause or contributing factor.

Sesamoiditis is a common injury in the following sports:

• Aerobics
• Dance
• Football
• Gymnastics
• Soccer
• Baseball
• Softball
• Track and field
• Other running or jumping sports.

Typical symptoms of sesamoiditis can include:

• Nonspecific pain in the foot or great toe
• Pain with pushing off
• Tenderness to palpation of the sesamoid
• Swelling or redness around the big toe

It is recommended to contact your doctor if you:

• Find it difficult to bend the big toe
• Have difficulty bearing weight on the foot or walking
• Suffer from pain under the great toe
• Experience tenderness under the great toe

To determine a diagnosis, your doctor may deploy the following imaging techniques:

• X-ray
• Bone scan
• CT scan
• MRI
• Ultrasound

The majority of sesamoiditis cases do not require surgical intervention. The following non-invasive treatments may be recommended by your doctor:

• Rest
• Applying ice to the affected area
• NSAIA (nonsteroidal antiinflammatory analgesic) pain relief drugs such as ibuprofen or aspirin
• Taping the broken toe to a healthy one for support
• Soft tissue therapy

Orthotics (special heel or shoe inserts to support your injury

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Sesamoiditis

Surgical intervention might be necessary if non-operative treatment fails. Possible surgical treatment for sesamoiditis can include:

• Partial or complete sesamoid resection or removal
• Shaving down a prominent tibial sesamoid

In extreme cases, an operation on the sesamoids may involve the excision of both sesamoids, but this is rare, due to the higher risk of complications down the line, such as misalignment

Typically, 3-6 weeks is enough time to recover from sesamoiditis in the case of non-operative treatment, but if surgical intervention was needed, then expect a longer recovery period of 3-6 months.

You can return to sporting activity when you have regained your full range of motion and strength and no longer experience pain.