What is Sesamoiditis?
Sesamoiditis is where there is inflammation and pain in sesamoid bones and surrounding soft tissues. Pain is felt under the big toe joint. Young active people are most commonly affected. While sesamoiditis pain can come and go it can cause great discomfort especially when walking.
What are the Sesamoids?
The sesamoid bones are two small bones that sit within one of the tendons that runs underneath your big toe joint. They act as a pivot for the tendons that bend the big toe. There is a medial sesamoid (nearest the inside of the foot) and a lateral sesamoid (nearest the second toe) The medial sesamoid tends to be the one that causes discomfort.
What are the signs and symptoms of Sesamoiditis?
You may experience any or all of the following:
- Pain underneath your big toe when walking, especially when your big toe bends
- Pain on weight bearing activity
- Pain eases with non-weight bearing activity
- Pain on direct pressure of area
- Swelling
What causes Sesamoiditis?
In most cases Sesamoiditis develops as a result of sudden changes in activity or how often and how much load is being placed through the big toe joint. This will cause small injuries and lead to injury.
You may have contributing factor related to Sesamoiditis:
- Sudden increase in weight
- Wearing unsupportive footwear such as shoes or sandals
- Impact/ trauma -tired/ overused feet
- Repeated loading from sports
- Sudden increased activity such as starting a new job or leisure activity
- Sudden bending of you big toe
- Regular walking wearing high heels
- Osteoarthritis
- Osteoporosis
- Large sesamoid bones
- High arched feet
- Flat feet
Treatment For Sesamoiditis at Cumberland Physiotherapy Parramatta
1.Rest and Activity Modification:
Avoid activities that increase pressure on the ball of the foot, such as running or jumping.
Use cushioning and padding to reduce stress on the affected area.
2. Ice Therapy:
Applying ice packs to the sesamoid area for 15-20 minutes several times a day to reduce inflammation.
3. Footwear Advice:
Wear supportive shoes with a wide toe box.
Use custom orthotics or insoles designed to offload pressure from the sesamoids.
4. Manual Therapy:
Techniques to reduce pain and improve joint mobility, such as soft tissue massage and joint mobilisations.
5. Stretching and Strengthening Exercises:
Stretching exercises for the Achilles tendon and plantar fascia.
Strengthening exercises for intrinsic foot muscles to improve foot stability.
6. Taping or Padding:
Using athletic tape or pads to offload pressure during activities.
7. Gradual Return to Activity:
Slowly reintroducing activities with proper footwear and support.
It’s important to consult a healthcare professional or physiotherapist such as Matthew West at Cumberland Physiotherapy Parramatta for a personalised assessment and tailored treatment plan.