Understanding Sesamoiditis

Sesamoiditis is a condition affecting the sesamoid bones—small, oval-shaped bones embedded in the tendons of the foot. These bones play a key role in weight-bearing and provide a smooth surface for tendons to glide over during movement, particularly under the big toe joint.

Causes of Sesamoiditis

The primary cause of sesamoiditis is repetitive stress or trauma to the sesamoid bones, which can lead to inflammation. Those involved in high-impact activities such as running, ballet, or sports that put pressure on the forefoot are especially prone to this condition. Common causes include:

• High-Impact Activities: Activities such as running, jumping, or ballet, which place significant pressure on the forefoot, can trigger inflammation in the sesamoid bones.

• Repetitive Stress: Repeated force on the foot, particularly the big toe, from activities involving pivoting or pushing off can lead to sesamoiditis.

• Trauma: Direct injury or trauma to the foot can damage the sesamoid bones, causing pain and inflammation.

Symptoms and Signs

Sesamoiditis typically presents with pain under the big toe joint. The pain may worsen with activities that involve pushing off from the toes, such as running or walking. Common symptoms include:

• Pain and Swelling: Pain beneath the big toe joint, often accompanied by swelling and tenderness.

• Gradual or Sudden Pain: Pain may develop gradually or arise suddenly, often worsening with activity.

• Bruising: Bruising may appear in more severe cases.

Diagnosis and Assessment

To diagnose sesamoiditis, healthcare professionals perform a thorough clinical evaluation, taking into account the patient's medical history and activity levels. Imaging studies, such as X-rays, MRI, or bone scans, may be used to assess the sesamoid bones and rule out other potential causes of pain.

• Clinical Evaluation: A healthcare professional will evaluate the range of motion, palpate for pain, and assess any structural abnormalities in the foot.

• Imaging Studies: X-rays and MRIs may be used to visualize the sesamoid bones and detect any fractures or signs of inflammation.

Effective Management Strategies

Rest and Activity Modification

Reducing stress on the affected area is essential for healing. Activity modification, including rest, is a key part of managing sesamoiditis.

• Rest: Allowing the affected foot to rest and heal can significantly alleviate pain and inflammation.

• Activity Modification: Limiting high-impact activities and incorporating rest periods helps reduce the strain on the sesamoid bones.

Footwear Choices

Choosing supportive footwear with a wide toe box can reduce pressure on the sesamoid bones. Avoiding high heels or shoes with inadequate arch support is essential to prevent further irritation.

• Supportive Shoes: Proper footwear with cushioning and adequate arch support is crucial for relieving pressure.

• Avoid High Heels: High heels can exacerbate the condition by placing more stress on the forefoot.

Orthotic Inserts

Custom or over-the-counter orthotic inserts can help redistribute pressure across the foot, providing additional cushioning and support to the forefoot.

• Orthotic Inserts: These devices help alleviate pain and prevent further stress on the sesamoid bones by redistributing the load.

Icing and Anti-Inflammatory Medications

Applying ice to the affected area can reduce swelling and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be recommended to manage pain and inflammation under medical supervision.

• Ice: Applying ice for 20-minute intervals can help reduce swelling.

• NSAIDs: Anti-inflammatory medications can help relieve pain and reduce swelling associated with sesamoiditis.

Physical Therapy and Rehabilitation

Gentle stretching and strengthening exercises can help manage symptoms and improve flexibility in the foot. Rehabilitation focuses on reducing stiffness and enhancing stability to prevent recurrence.

• Stretching: Gentle stretches can reduce tension and improve flexibility in the big toe joint.

• Strengthening: Strengthening surrounding muscles improves foot stability and provides better support to the sesamoid bones.

When to Seek Professional Help

If symptoms persist despite conservative measures, or if there is severe swelling, bruising, or difficulty bearing weight, seeking professional medical advice is essential.

• Persistent Pain: If pain continues despite rest and other measures, consulting with a healthcare professional is recommended.

• Severe Swelling or Bruising: Severe symptoms require prompt evaluation to avoid complications.

Preventing Sesamoiditis Recurrence

Gradual Return to Activities

Gradually reintroduce activities that place stress on the foot, paying close attention to proper warm-up routines and incorporating adequate rest.

• Gradual Progression: A slow and steady return to physical activity can help avoid re-injury.

Footwear Assessment

Regularly assess footwear for wear and tear and ensure that shoes provide adequate support and cushioning.

• Footwear Inspection: Check shoes regularly and replace them when necessary to ensure they provide sufficient support.

Conclusion

Sesamoiditis is a painful condition, but with the right approach, it can be effectively managed. From choosing the right footwear to incorporating rest and physical therapy, a combination of strategies can help alleviate pain and prevent further complications. If you suspect you have sesamoiditis or experience persistent pain, seek medical attention to receive a tailored treatment plan.

Disclaimer:

The information on this website is provided for educational and informational purposes only and is not medical advice. Always consult with a licensed medical provider and follow their recommendations regardless of what you read on this website. If you think you are having a medical emergency, dial 911 or go to the nearest emergency room. Links to other third-party websites are provided for your convenience only. If you decide to access any of the third-party websites, you do so entirely at your own risk and subject to the terms of use for those websites.

Who we are: For trusted podiatric care in Orlando, Lake Mary, Altamonte Springs, Longwood, Apopka, turn to Dr. Carli Hoover and Dr. Sean Griffin at Central Florida Foot and Ankle Institute - a physician owned-operated group. From sports injuries to general foot health, our team offers specialized treatments tailored to your needs. Contact us now at 407-307-0006 to schedule your consultation and take the first step toward healthier feet!