29 Aug What is Sesamoiditis?
Sesamoiditis is the inflammation of two small bones located in the ball of the foot called sesamoids. This condition commonly affects young people who take part in activities that require repetitive movement of the big toe area. Such activities include dancing, football, baseball or running.
What is the function of sesamoids?
Sesamoids are located within tendons that lie under the big toe joint of the foot. They primarily act as a pulley system. They distribute the pressure and stress while lowering friction within the tendons and the first metatarsal joint as one walks.
How does one develop Sesamoiditis?
- With repetitive joint motions and direct pressure application on the big toe, the sesamoids can develop fractures and become inflamed.
- Certain injuries that force movement of the big toe either upward or downward can lead to injury of the sesamoids, inadvertently causing sesamoiditis.
- Wearing unsupportive footwear, or shoes such as heels that focus a significant portion of the body’s weight on the big toe area can also lead to sesamoiditis.
- Suddenly increasing the intensity and duration of physical activities can put a lot of strain on the sesamoids, leading to sesamoiditis.
Symptoms of Sesamoiditis
Feeling of a sharp pain originating from the big toe joint at the bottom of the foot when one is walking on their feet (especially barefoot).
A dull pain that gradually gets worse with an increase in movement of the big toe joint. Without treatment, the fractures within the sesamoids can worsen, causing paralyzing pain.
Since the sesamoids are located within the tendons in the first metatarsal joint, definitive signs such as redness or swelling may not be clearly visible to the naked eye.
Podiatrists incorporate the use of imaging techniques such as Magnetic Resonance Imaging (MRI) to identify the cause of pain. An MRI will also clearly highlight the small fractures within the sesamoid, a task that is too minute for X-Ray Imaging to detect.
Treatment of Sesamoiditis
Successful treatment involves a combination of both rest and either of the following treatment methods.
It is advisable and much easier to treat sesamoiditis immediately after experiencing the symptoms stated above. The general goal of treatment is to redistribute direct pressure at the bottom of the foot to facilitate the healing process.
Such methods can include:
- Padding of the big toe joint to take weight away from the site of injury.
- Use of an orthotic device that will redistribute pressure across the ball of the foot. Such devices can include orthotic insoles and metatarsal pads. A pneumatic walking boot can be recommended. The pneumatic walking boot works to take away pressure from the big toe area as you walk.
- Anti-inflammatory medication can be prescribed to lessen the extent of inflammation in the sesamoid. Such drugs can include NSAIDs. Use of icing packs over the injured site can also lessen inflammation.
- In critical cases, a podiatrist may inject steroid compounds to decrease inflammation of the sesamoid when other conservative methods have failed.
- However, one must practice extreme caution while carrying this out. Steroids can limit the healing of a stress fracture that may be present within the sesamoid.
- One can turn to surgical treatment as a last resort. Surgery would involve rejoining the fractured sesamoid or a complete removal of the troublesome sesamoid.
- Since sesamoiditis is caused by the repetitive pounding and pressure application on the big toe joint, a reduction in such strenuous activities is recommended.
- Wearing supportive footwear is also a great option.
- Incorporating orthotic insoles and metatarsal pads within your footwear can also work to limit the amount of strain experienced by the sesamoid as you walk.
Visit your local podiatrist for adequate diagnosis and treatment of sesamoiditis if the symptoms stated above are familiar to you.