Monday, January 22, 2018

Distressed by Sesamoiditis?


Mark Fraser

What is Sesamoiditis?

Sesamoiditis is the inflammation of the sesamoid bones, along with the surrounding tissues. The sesamoid bones are a pair of tiny bones, whose function is to act as a support to hold the tendons further away from the joint. Varying in size from individual to individual, the bones are usually about the size of a jelly bean.

As with any inflammation of tissue and bone, sesamoiditis can cause intense pain. The pain usually gets worse over a period of time, helping with the diagnosis and differentiation of it from other ball of foot problems.


• Pain is focused under the great toe on the ball of the foot. The pain may develop gradually; but with a fracture, it will be immediate.

• Swelling and bruising may or may not be present.

• You may experience difficulty and pain in bending and straightening the great toe.


There are many reasons why this condition can occur, some of which are preventable; others that are not and are due to defects in the bones themselves. Having bony feet puts you at more risk for sesamoiditis, as you have less foot padding to absorb the shocks when walking, and as these bones are weight bearing.

The condition is commonly caused by performing similar actions that involve the toe over and over again. The most common causes are as follows:


• Direct injury to the sesamoid bones, by hurting your foot or stepping on a rock while walking or running barefoot.

• Trauma caused by repetitive and excessive movements involving the toe. This type of injury develops over a period of time and includes:

• Running

• Jumping and falling/landing directly on your heel.

• Squatting for several minutes to hours.

• Dancing without shoes, or using shoes with very thin soles.

• Walking and standing for longer hours while wearing high heel shoes.

• Using high heeled shoes, with a narrow toe box, or very short toe box.

Changes that occur with age

1. Osteoporosis develops when bones become weak due to loss of calcium deposits inside the bone. This creates pain and inflammation of the sesamoid bones, and their surrounding tissues.

2. Osteoarthritis is another disorder that precipitates sesamoiditis, since it initiates the appearance of bone spurs on sesamoid bones.

Heredity factors

1. Enlarged sesamoid bones are required to bear unusual amounts of the body’s weight, every time one walks or moves forward. Sooner or later, due to too much weight and pressure put upon them, their condition starts to decline and weaken until they become inflamed and intensely painful.

2. Feet with high arches are also commonly stiffer than normal, and will not permit the high arch to make contact with the ground when stepping down.

3. A pronated foot forces one to walk on the inner aspect of the foot, rather than on the arch.

4. A plantar-flexed first metatarsal is another triggering factor. This happens when the first metatarsal head is skewed down in the forefoot, instead of lying straight.

Diagnosis and treatment

Due to the small size of the bones, it is sometimes difficult to diagnose the condition with an X-ray. A bone scan, therefore, is the most reliable way of getting an accurate diagnosis, and also determining the severity of the condition.

If there is chronic and intense pain in the ball of their foot, it may be a case of sesamoiditis. This is relatively common, and results from the inflammation and irritation of the tiny sesamoid bones, along with surrounding tissues and ligaments. Treatment is usually straightforward, with rest the best way to ease pain.

Sesamoiditis treatment is possible in the comfort of your own home, and pain can be relieved with low-cost corrective devices. Home diagnosis of the condition is possible, although it is better to seek the advice of a doctor or podiatrist for an accurate diagnosis.

Other options

• Take something for the pain.

• Ice the sesamoid bones.

• Choose lower-heeled shoes.

• Wear an orthotic insole or metatarsal pad.


In cases where sesamoiditis symptoms have already settled, but the pain is still there, surgery is recommended. In other cases, if the sesamoids are fractured and do not heal correctly, removal might be necessary. If surgery is considered, it should be deliberated and given much thought, since it will affect the performance of the toe permanently. Enlarged sesamoids can also be reduced via surgery to relieve discomfort, and avoid the need to remove the sesamoids completely.

Your feet mirror your general health . . . cherish them!

Leana Huntley is an

English-trained foot health practitioner attached to ALMAWI Limited The Holistic clinic. Contact the Clinic at or visit the Website at