Sesamoids are bones found inside tendons throughout the body that act as a pulley which stabilize a joint. The knee cap or patella is an example. In the foot, there are two sesamoids under the great toe. Due to the ground pressure on the ball of the foot, there is a high incidence of injury to one of the two of these sesamoids. There is movement of the sesamoids beneath the 1st metatarsal head that occurs during any activity. When a sesamoid is injured from acute or repetitive stress, a stress fracture may occur within either sesamoid.

Sesamoiditis may be caused from acute or chronic stress placed on the ball of the foot. In a majority of cases, there is little swelling, redness or bruising to the skin. Throbbing and pain is usually worse after increased activity and improved with rest.

Treatment of Sesamoiditis

  • Shifting the weight off the painful area using taping and padding
  • High heels should be avoided
  • Changing activity from weight-bearing activities to swimming may eliminate some of the tenderness in the foot
  • Analgesics medications such as ibuprofen and Tylenol are helpful during healing

If these conservative methods are ineffective surgical excision of the fractured sesamoid is sometimes required.

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