Sesamoids are a unique type of bone that is either embedded in muscle or connected only to tendons. These small bones are found in just a few spots in the human body and one of them is your feet. Two corn-kernel size sesamoids are located in the bottom of your foot on either side of the big toe. The job of the sesamoids is to create a smooth surface for the tendons to slide on as they transmit muscle forces to the foot. They help with weight bearing and offer leverage when the big toe pushes off. When they don’t function properly, the sesamoids can cause severe pain and discomfort.
What Can Go Wrong?
Like any other bones, sesamoids can fracture. More frequently, we at Paul Klein, DPM FACFAS see patients in whom the tendons surrounding the sesamoids have become inflamed, causing a type of tendonitis called sesamoiditis. The sesamoids can become irritated if there is an excessive amount of repetitive force exerted on them. That’s why sesamoiditis is a condition that frequently affects runners, catchers, dancers, golfers, basketball and tennis players. Patients with high arches and those who spend significant time in high heels are also at greater risk due to stress put on the forefoot. Signs that the sesamoids have become inflamed include: pain in the ball of the foot or under the big toe, limited range of motion and trouble bending and straightening the toe, bruising or swelling of the affected area.
Fortunately, surgery is not usually needed to treat sesamoid problems. Once our podiatrist, Dr. Paul G. Klein, has made a diagnosis of sesamoiditis, several non-invasive treatment options are available, including:
- Taking a break from activities that put pressure on the sesamoids
- Icing, oral and injected medication to reduce swelling and pain.
- Cushioning in shoes to protect the sesamoid area.
- Choosing shoes that are have low heels and soft soles.
In extreme cases or where symptoms do not go away with the above treatments, the foot doctor may recommend wearing a removable leg brace for 4-6 weeks to immobilize the foot and give the sesamoids sufficient time to fully heal.