The Center for Podiatric Care and Sports Medicine

Five Surprising Sesamoiditis Foot Health Facts From White Plains Foot Doctors

Posted by on Monday, September 4th, 2017

Got pain in your big toe? Having trouble keeping up with your regular activities without forefoot pain? Sesamoiditis is a tricky condition that affects your overall foot health and comfort, but White Plains foot doctors are here to clue you in on the mysterious world of sesamoid bones and the injuries that pertain to them. Stop by our Westchester County office for advanced treatments that prompt fast healing for busy athletes.

We treat sesamoiditis and sesamoid fractures at our office in White Plains.
We treat sesamoiditis and sesamoid fractures at our office in White Plains. Image Source: Wikimedia user Alison.

1. One Person Can Have Up to 42 Sesamoid Bones

You may have never heard the term “sesamoid” before, but there are actually quite a few of these seed-shaped bones in your body. A sesamoid is a bone embedded within a tendon or muscle that acts as a pulley, providing a smooth surface for tendons to glide upon and increasing the tendon’s ability to transfer force. The knee cap is the largest sesamoid in the body, and most of these bones are about the size of a pea. The number of sesamoid bones varies from person to person. Most sesamoids develop in response to tension or stress.

In the feet, there can be many sesamoids, including:

  • Hallucal sesamoids
  • Interphalangeal joint sesamoid of the great toe
  • Lateral sesamoid
  • Lesser metatarsal sesamoids
  • Medial sesamoid
  • Os peroneum
  • Sesamoid within the anterior tibial tendon
  • Sesamoid within the posterior tibial tendon

2. Runners and Dancers Most Commonly Suffer From Sesamoiditis

“Sesamoiditis” refers to a chronic inflammation of the sesamoid bones and associated tendons caused by increased pressure exerted upon the bones. This inflammatory condition can affect anyone—male or female, young or old—but our sesamoiditis patients most commonly tend to be runners, ballet dancers, tennis players, baseball catchers, and basketball players. Repetitive impact, with much emphasis placed on the forefoot, is often responsible for inflaming the bones and tissues of the foot. We call sesamoiditis an “overuse injury” for this reason. In some of the worst cases, the sesamoid bones have fractured.

3. Sesamoiditis Develops Gradually and Worsens Over Time

Sesamoiditis feels like a dull, chronic ache beneath the big toe joint and on the ball of the foot. The pain is most significant when the forefoot is flexed or during the push-off phase of the gait cycle. Fast running and walking up and down stairs exacerbates the pain. Overuse injuries are sneaky because the pain can come and go, depending on what activities you engage in or what shoes you are wearing. Swelling and bruising may occur if sesamoiditis happens in tandem with an acute injury or stress fracture. In rare instances, the great toe becomes numb or has difficulty bending and straightening. Over time, your gait may change and you may find yourself limping. Pain escalates all the way up the kinetic chain to the knee, hip, and lower back.

4. Most Sesamoid Injuries Heal Within 4 Weeks

Mild sesamoid injuries can be resolved in one week by ceasing pain-causing activities, icing the sole of the foot, wearing comfortable but stiff (and low-heeled) shoes, taping the toe, and/or wearing a dense foam rubber pad under the big toe. Most patients should “take it easy” for a month, if possible, gradually returning to activities over the course of 4-6 weeks.

5. Stress Fractures Account For 40% of Sesamoid Injuries

Stress fractures are often responsible for sesamoid injuries. Increasing pain and point tenderness are clinical tell-tale signs, but radiographic imaging of one or both feet is necessary to definitely identify the jagged, disconnected edges of bone consistent with a fracture. X-rays, CT scans, or bone scans can also tell your podiatrist if you are experiencing osteocondritis (a joint disorder) or avascular necrosis (blood loss to the bone).

For severe pain, we can give you cortisone injections to bring the inflammation down swiftly. Wearing a removable brace for 4-6 weeks will keep pressure off your big toe if a stress fracture has occurred. Surgery for sesamoid injuries is rarely done, but if the condition fails to resolve after conservative care, we can remove part of all the affected sesamoid bones, scrape away excess scar tissue, or perform a bone graft to unite non-healing bone fragments together again. After foot surgery, you can expect 2-3 weeks of crutches and a month of casting, followed by up to 8 weeks in a removable walking cast. It may be 6 months before all pain subsides and you are able to engage in your old activities again. “Last resort surgery” that involves removing all the sesamoid bones will result in permanent limited mobility, but we can avoid that type of surgery in nearly all cases.

Sesamoiditis Treatment in White Plains

For the very best treatment of your sesamoid bones, come see the foot and ankle specialists at The Center for Podiatric Care and Sports Medicine in White Plains or Manhattan. We offer state-of-the-art diagnosis, treatment, long-term therapy, and surgical care all under one convenient roof. Contact us to learn more or set up an appointment.

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.