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Sesamoiditis describes the inflammation around two small bones that are located beneath that joint called the sesamoids. Unusually, the sesamoids are not directly attached to the bones around the big toe but are embedded within a tendon that runs beneath the bottom of the big toe. This is similar to the knee cap. The sesamoids work to strengthen and support the tendon they are embedded in (Flexor Hallucis Brevis) in fulfilling its role during every step you take.

What causes sesamoiditis?

Many causes can result in sesamoiditis, with the common denominator being an excess load and pressure in the area of the sesamoids. These include both biomechanical factors (the way your foot functions) and traumatic factors (direct blows/injuries). These can range from having your foot stood on or dropping something on your foot, excess force through the big toe joint, hyperextension of the big toe and generally abnormal foot biomechanics and function. The sesamoids already take on a big load as the foot pushes off the ground.

What are the symptoms?

Symptoms of sesamoiditis may include:

  • Pain beneath the big toe joint on standing and walking
  • Pain on bending the big toe upwards (dorsiflexion)
  • Swelling and redness at the big toe joint
  • Gradual onset of pain
  • Immediate pain if there is a sesamoid fracture

What should I do?

Treating sesamoiditis begins with reducing the initial painful symptoms and then working to offload forces away from the sesamoids so they can recover. It’s important to remember that if the cause of the sesamoiditis is the way your foot is moving, then it’s important to address and correct these abnormalities or the injury may occur again in the future.

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