The Center for Podiatric Care and Sports Medicine

Open, Sesamoid!

Posted by on Friday, February 17th, 2012

If you were rating bones by the melodiousness of their names, the sesamoid bone would rate very highly. Quick, come up with a challenger. Okay, I guess phalanges (toe and finger bones) is pretty good, but we’re not here to talk about hands, we’re here to talk about feet!! And the sesamoid bones are part of your feet–a small part, but when something goes wrong with them, wow, do they hurt.

First, what are your sesamoid bones and where are they? The sesamoid bones are tiny, pea-sized bones found beneath the muscles that run under the joint of your big toe. When you flex your big toe, the sesamoid acts as a little fulcrum that gives those muscles extra power. They also relieve pressure on your feet and cut down on friction between the soft tissue under the toe and the muscles and toe joint. The sesamoid is small, but it helps your foot do a lot.

Anything that works that hard is bound to run into problems, though. Sesamoiditis is an inflammation of the bone and soft tissues that surround it. This is most likely to occur in women who wear high heels frequently as that keeps the toe joint in such an extreme position constantly. People who do activities that repeatedly flex their toes are also at risk, such as runners (hand raised here, ouch…) and dancers–especially dancers. See the kind of beating Broadway dancers put on their feet–in high heels. Eight shows a week. That’s a lot of rolling and pounding on that little bitty sesamoid bone. Age also can cause sesamoiditis, as the padding under our feet thins, and bones become more fragile.

It’s easy to tell if you have sesamoiditis. Do you feel pain under the joint of your big toe when you run, dance, stand on your toes, or even just walk? Does it ease up when you stop those activities? If you answered yes to these questions, then congratulations! You probably have sesamoiditis.

Of course now the question is, “What should I do about my sesamoiditis?” With most cases of inflammation, the easy answer would be, “Stop doing whatever is causing the inflammation.” This, though, is one of the things that make foot injuries such a challenge–we use our feet every day, for the most simple, basic activities and most people aren’t going to stop walking just because they have some pain (give people a choice between inconvenience and pain, and I have a feeling a shocking number will choose pain). Professional dancers can’t afford to stop dancing, and serious runners are usually just too runner-stupid to stop running when they feel pain.

Nevertheless, if you can cut back on activities that are aggravating the sesamoid, that’s the best course. You can also take nonsteroidal antinflammatory drugs such as ibuprofen, and you can ice your feet to help reduce the inflammation.

To help take pressure off your bones, you can buy foot pads that are cut to fit the area under your big toe. For chronic cases of sesamoiditis, podiatrists may recommend custom orthotics that have a padded area under the big toe built in. It’s also a good idea to wear flat shoes while trying to recover from sesamoiditis.

People who have extremely painful sesamoiditis may need an injection of a steroid to help ease the inflammation quickly. If you try resting your foot and taking all these other actions and your pain still doesn’t go away, then you should see a podiatrist to have your problem investigated fully; you might have a stress fracture  and that will require specific treatment that should be guided by a doctor.

If you have sesamoid pain or any other foot problem, contact us at The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.

If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.