Sesamoiditis is also know as or related to:
Sesamoid fracture, accessory bone, big toe pain, sore big toe joint, turf toe.
The sesamoid bones are two very small bones that are embedded in the tendons that run under the big toe joint to the tip of the toe. These act like the knee cap to help the big toe joint function.
The great toe takes a huge amount of force with running and gait and the structures around the sesamoid bones can become damaged and cause inflammation. This pain and inflammation around the sesamoid bones is referred to as sesamoiditis.
Symptoms may appear gradually over time or they may suddenly appear. Pain, swelling, stiffness with walking or bending the big toe joint are all consistent with sesamoiditis.
There can be cumulative causes where and increase in activity, a change in footwear or hard surfaces can gradually increase force and pressure through the sesamoids.
Acute causes include impact on the forefoot after falling from high surfaces or striking the forefoot.
In rare cases the very small sesamoid bones can actually become fractured. An x-ray may show the sesamoid in multiple pieces however it is common for a sesamoid bone to naturally develop in multiple pieces. An experienced podiatrist can distinguish between a fractured sesamoid and a sesamoid naturally in pieces.
High arch feet are prone to this condition as certain foot types will have the inside of the forefoot striking the ground with gait rather than the outside of the forefoot. This drastically increased the impact and force through the sesamoids.
Old compressed footwear, hard surfaces, forefoot running styles, sports that involve running on your toes and poor foot anatomy will all increase the chances of sesamoidits.
Short term initial treatments such as rest, ice, compression and avoiding bending of the forefoot are all helpful. However longer term solutions are needed to speed up recovery and prevent recurrence
Cushioning under the forefoot is helpful to reduce impact by replacing old training shoes and choosing footwear with a cushioned forefoot.
Specifically designed orthotics that allow the foot to strike on the outside and gradually load up the big toe joint are critical to help resolve sesamoiditis and prevent recurrence with a return to exercise.
Changing run technique to avoid striking on the forefoot can be helpful and by ‘speed matching’ the ground on contact. Our Shoes Feet Gear technical run coach can help with this.
Severe sesamoiditis or a sesamoid fracture can require the use of an air cast for a few weeks.