Sesamoiditis is a painful inflammation in the area of the sesamoid bones, two pebble sized bones located under the 1st metatarsal heads (big toe). It is sometimes confused with Hallux limitus or Hallux rigidus (limited or non-movement of the big toe at the 1st metatarsal joint), metatarsalgia or stress fracture of the metatarsal bone instead of the sesamoids.
There can be a gradual onset or a traumatic incident. For the gradual onset, pain can increase to intense throbbing without evidence of bruising or redness. There will be a limited range of motion in the first metatarsophalangeal joint (big toe) resulting in difficulty walking. Sometimes the gradual onset will be accompanied by a stress fracture in the sesamoids.
A traumatic onset, such as a fall from height where the person lands heavily on their feet, can fracture the bone(s). If so, there will be substantial swelling throughout the forefoot and a deep, tender bruise in the metatarsophalangeal joint.
Other names or similar foot conditions:
- Metatarsalgia
- Hallux rigidis
- Stress fracture
Symptoms:
- Gradual and increased pain in sesamoid area
- Swelling and pain in big toe
- Rigidity and limited ROM in big toe
- If caused by trauma, substantial swelling throughout the forefoot and a deep, tender bruise in the metatarsophalangeal joint.
Signs to look for:
- Pain upon palpation of sesamoid area
- Rigidity and limited range of motion in big toe
- Participation in activities where there is repetitive and excessive pressure on this area of the foot, such as ballet or being a baseball catcher
- Participation in high impact sports
- If a recent trauma, substantial swelling in the forefoot and a deep, tender bruise in the metatarsophalangeal joint.
Possible Causes:
- Repetitive activities as noted above
- High impact sports
- Traumatic injury
Goals:
- Take pressure off the sesamoid bones
- Create a mechanism for balancing the foot during healing
- Foot wear that will accommodate swelling and orthotics
- Foot wear that will be proactive in moving the foot forward and with ease
How We Help:
Arch Supports:
- BioOrthotics exercising support with metatarsal lift
- Lower and thinner arch support with longitudinal and metatarsal support for use when shoes cannot accommodate the BioOrthotics exercising support
Shoes:
- Extra depth, double or triple depth shoe with high toe box, firm heel counter, rocker sole and connecting shank
- Smart footwear, such as heel to toe rockers, negative heel shoes or shoes with titanium springs
- Avoid flip-flops. Only wear sandals with a back and only the Orthaheel, Alegria or Aetrex brand
- Wear heels and pumps only as long as absolutely necessary
- Go barefoot on a minimal basis only
Activities:
- Medical treatment
- Avoid repetitive foot activities and high impact sports until symptoms recede and shoes and arch supports in place
- Rotation of weight bearing and non-weight bearing exercising, such as walking (weight bearing) with swimming or bicycling (non-weight bearing)
This information does not constitute a diagnosis of your condition and does not take the place of a doctor’s care. The information has been compiled from sources available to the general public and referenced below. Copyright 2005-2010 Carole Romig
Sources Image: Foot.com Text: PodiatryChannel.com, D. Janisse, CPed, Introduction to Pedorthics