Sesamoiditis

Common Symptoms

Sesamoiditis symptoms include swelling and pain upon weight bearing specifically under the big toe. Symptoms may present over time or immediately after a traumatic event involving the big toe.

How it occurs

As seen in the image, at the bottom of the big toe joint there are two small bones called the sesamoids these bones act as an insertion point for tendons surrounding the area. The function of the sesamoid bones is to help disrupt pressure and stress underneath the foot whilst weight-bearing. Sesamoiditis occurs when the sesamoid bones and the surrounding tendons become inflamed and irritated which can occur due to a multitude of factors such as:

-          Dynamic sports resulting in overuse of the big toe to push off the ground repeatedly and forcefully

-          Foot rolls in excessively (pronation)

-          Frequent use of inappropriate footwear

What we may assess to obtain a diagnosis
Diagnosis is always subject to symptomatic complaint in conjunction with clinical testing performed by your podiatrist. Test performed may include touching (palpation) of the painful area, joint range of motion and an assessment of your walking or running (gait). 

At The Running Room and Posh Pod, we are equipped with a pressure plate treadmill (Zebris) allowing us to comprehensively assess plantar pressures within the feet. In some cases, and specific to your presentation the podiatrist may send you for radiographic imaging to rule out the presence of a stress fracture or other bone related pathologies.

Management and how long does it take?

Imaging findings will appropriately identify sesamoiditis or other underlying bone related pathologies which, will indicate the best course of management with treatment time frames varying. Sesamoiditis treatment ranges between 2-6 weeks whereas, a stress fracture of the sesamoids requires 6 weeks.

Sesamoiditis modalities may include tape/padding techniques, footwear advice, ice, custom orthotics, and foot specific exercises where applicable. In the presence of a sesamoid stress fracture, non-weight bearing through off-loading and the use of crutches is required. In the latter stages of recovery, footwear advice, custom orthotics and foot exercises maybe prescribed. In both cases use of anti-inflammatory medication may be considered in collaboration with your general practitioner.

Author: Maddie Parker

Follow us on socials where we bring value to the run community.