Just think of the great forces at work on your feet when you walk. Nearly one-and-a-half times your body weight impacts the bottom of your feet with each step. The force is greatly increased when running, jogging and jumping.
The ball of your foot at the base of the big toe is significantly impacted by this pressure. This joint is unique in the body and allows us to take special actions. Hidden under the bone behind the big toe joint are the sesamoid bones, small pea-shaped structures that are embedded in the tendon. The name sesamoid is derived from their small shape and similarity to sesame seeds.
The sesamoids are important to the function of the big toe. They absorb the pressure from weight-bearing, reduce friction and protect the tendons. The sesamoids act like your kneecap to keep these tendons from rubbing against the bones. They also help provide leverage for the big toe when pushing off for each step.
Symptoms of Sesamoiditis
Sesamoiditis, or inflammation of the sesamoids, is common in certain athletes and dancers where the tendons are strained or overworked. Repeated trauma such as from wearing high heels or poorly-fitting shoes can also cause sesamoiditis.
You will notice pain under the ball of the foot, along with bruising or swelling. It can be hard to bend or straighten the big toe.
Diagnosing and Treating Sesamoiditis
An X-ray will help determine if the sesamoids are fractured. Other tests including a bone scan, MRI or ultrasound can help find a soft tissue or tendon injury.
Most sesamoiditis cases don’t require surgery and benefit from conservative treatments including:
Avoiding the activity causing the condition as well as other movements that put pressure on the ball of your foot.
Icing the foot.
Elevating the leg.
Switch to low-heeled, soft-soled shoes with plenty of toe room.
Taking ibuprofen, with your doctor’s permission, to reduce pain and swelling.
Cortisone injection to ease swelling.
Custom-fitted orthotics to redistribute pressure away from the problem area.
If these methods don’t succeed, surgery may be required to remove the fractured sesamoid. One of the sesamoids should be left in place or the big toe may not line up properly.
Let Us Know If You Have Any Foot Pain
If you have any problems with your toenails, or neuropathy or any foot problem like heel pain or plantar fasciitis, discomfort from arthritis, an injury or just from overuse, please call Michele Kurlanski, DPM at Lighthouse Foot and Ankle Center. Dr. Kurlanski offers expert and professional podiatry services in Cumberland County, Maine. Please call us today at 207-774-0028 to schedule your appointment in our Scarborough office.