Sesamoiditis: If You Are On Your Feet Often, You Need To Read This.

What is Sesamoiditis?

The quick answer is sesamoiditis is inflammation of the sesamoid bones and the surrounding tissues. It is a painful foot condition where pain is usually felt under the first metatarsal also known as the big toe and also at the ball of the foot where the metatarsal heads lie. 

Where are the Sesamoid bones in the feet?

There are two sesamoid bones at the ball of the foot at the big toe. The sesamoid bones are tiny bones under the first metatarsal(the big toe) that work as a fulcrum for the flexor hallucis brevis muscle which helps flex (bend) the big toe downward. 

The sesamoid bones help affect the angle of pull for the flexor hallucis brevis to make the muscle more efficient. When you stand on your tip toes, the Sesamoid bone support much to the body's weight.


What Causes Sesamoiditis?

There are two main causes of sesamoiditis. The first is when an abnormal amount of stress is put on the sesamoid bones, usually if someone repeatedly walks or lands on the ball of the foot.

The second is if one has abnormally large sesamoid bones, which naturally causes an abnormal amount of force to go through the sesamoid bones. 

Here is a list of causes for abnormal stresses to the sesamoid bones:

  • tired/overused feet
  • high heels
  • naturally high arched feet
  • over-pronating when running or jogging
  • abnormally large sesamoid bones.

What are the Symptoms of Sesamoiditis?

The symptoms of sesamoiditis are either a dull ache under the big toe, a sharp pain under the big toe, or a pain in the ball of the foot. 

Most of the discomfort occurs when weight is put through the base of the big toe. It is important to know where you specifically feel the foot pain to identify whether you have sesamoiditis or other foot pain. 

To identify if you have sesamoiditis make an appointment with your doctor.

Test and Diagnosis

Through a thorough MD and Physical Therapy examination involving an injury/medical history, palpation, and special tests to rule out other foot injuries an accurate diagnosis could be made. 

The most accurate way to diagnose sesamoiditis is with a bone scan.

What is the Remedy for Sesamoiditis?

Ice, anti-inflammatories, and gentle massage can lessen the pain, but it does not treat the cause. 

At Jacksonville Orthopedic Institute, the doctors and physical therapists look for the cause and develop a plan of care to address the pain and cause. 

The therapist may administer exercises focused on strengthening foot intrinsics that would address weak arches. To address over-pronation of the foot during evaluation or a treatment session, a physical therapist may analyze the patient’s walking or running pattern to see if hip and knee strengthening need to be addressed in the patient’s plan of care.  If the hips or knees are weak, it can cause deviations the in the patient’s walking or running pattern that lead to over-pronation of the foot. 

Home Remedies

Rest at home will help treat sesamoiditis. It is important to keep off your feet as much as possible to give the irritated tissues some relief. 

Ice and  anti-inflammatories to help calm the tissues.

WEAR FLAT SHOES!  Sorry high heels until the pain has subsided. 

The flat shoes help take some pressure directly off the sesamoid bones. It is only recommend to wear the flat shoes until the pain has subsided. Once the pain has subsided, wearing well supported arch shoes may decrease the risk of recurring symptoms..

How can I Prevent Sesamoiditis?

The best way to prevent sesamoiditis is to wear shoes with proper support.  Custom orthotic inserts through Footmaxx may also decrease the risk of irritating the sesamoid bones if there are issues with the arch and foot posture.

You can also ask a doctor about having a gait analysis performed to determine if you are prone to sesamoiditis or any other issue. 

Jacksonville Orthopedic Inst. (JOI) offers gait analysis and custom orthotic fabrication.  We can help!

JOI is the official Sports Medicine Provider for the Jacksonville Jaguars.

By: Jon Stiffler, Sports Center Manager 

To make an appointment by an office or telehealth visit, please click below or call JOI-2000. 


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