Sesamoids are bones that are embedded in a tendon.
They are found in joints in several parts of the body. In healthy feet, two pea-shaped sesamoids are located under the big toe joint at the balls of the feet. The sesamoids helps a person’s big toe tendons to move normally. The sesamoids gives the first metatarsal bone a weightbearing surface and provides leverage when the person pushes off their big toe when walking, running or jumping. Sesamoid injuries tend to involve the bones and tendons as well as the tissue surrounding the joint and cause pain, swelling, chronic inflammation and limited big toe movement.
What Causes Sesamoid Injuries
Sesamoid injuries are often caused by trauma, direct impact, repetitive stress, overuse, overextending the big toe joint and activities that put increased, continued, pressure on the big toe ligaments and balls of the feet. These activities include dance, sports and wearing tight, ill-fitting or high-heeled shoes frequently. People who have high arches in their feet tend to be at greater risk for sesamoid injuries.
Types of Sesamoid Foot Injuries
Sesamoid injuries to the foot tend to have three common types. They are:
- Turf Toe
- Acute Or Chronic Fractures
- Sesamoiditis
Treating Sesamoid Injuries
Nonsurgical treatment of sesamoid injuries varies depending on the injury’s type and severity. Common treatments include padding, strapping or taping the toe area to relieve tension and cushioning the area around the inflamed sesamoid by placing a pad in the shoe. The foot may also be immobilized in a cast to prevent the person from putting weight on the foot. Ibuprofen and other oral nonsteroidal anti-inflammatory drugs can help reduce pain and inflammation.
Other Treatment Options
Some doctors use physical and ultrasound therapy to rehabilitate the joint after a period of immobilization. Steroid injections for reducing pain and inflammation is another effective treatment option. For long-term sesamoiditis treatment, custom orthopedic devices are sometimes placed in the person’s shoe to keep pressure off the joint, tendons and balls of the feet. Surgery is a last resort if the sesamoid injury doesn’t respond to nonsurgical treatment.