Sesmoiditis

Sesamoiditis is an umbrella term to describe painful inflammatory condition of the sesamoid bone and surrounding soft tissue, and generally without acute trauma. The two small sesamoid bones are embedded within the tendon under the big toe joint. The big toe takes high force during running and gait, leading to damage the structure around sesamoid bones and cause inflammation.

Symptoms include:

Pain, swelling, stiffness with bending the big toes

Aggravating Factors:

• Excessive forefoot loading
• High heels
• Increase in activity, (and/or decrease in recovery)
• Poor biomechanics (eg. ankle equinus, hallux limitus)

Assessment :

 The podiatrists at toe-tal will diagnose the condition through physical examination and biomechanical assessment, and go through all the necessary treatments listed below to help get you on the right path. 

Treatment – It is important to follow a rehabilitation program so your injury doesn’t reoccur.

1. REST until all pain has resolved (could become permanent damage) – talk to Podiatrist about when you can return to activity). Avoid activities that put weight on the balls of your feet ( Skipping, running), and STOP the activity that is causing the pain. This will give the sesamoids time to heal.
2. Take non-steroidal anti-inflammatory drugs (NSAIDs) for pain (if allowed to take) maximum 7 days
3. Tape the 1^st joint so that it remains slightly downward (plantar flexion). Podiatrist will teach you how to do this
4. Correct any biomechanical concerns
5. Footwear modification – (the podiatrist at toe-tal will modify your shoes with a shoe pad under the sesamoids in order to redistribute the pressure away from them and to other areas around it)
6. Orthotic therapy
7. Wear soft soled shoes or out gel insoles in enclosed shoes to provide cushioning and relieve stress
8. Return to activity gradually, also wearing cushioned pad to support the sesamoids