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Sesamoiditis: A Pain Under the Big Toe!

March 15, 2015 by Rebalance Toronto

physiotherapy for sesamoiditis toronto - pain under big toeAre you experiencing pain under your big toe? Are you having trouble walking or running because of it? Are you a runner or dancer? Do you often wear high heels? You might have sesamoiditis.

What is Sesamoiditis?

Sesamoid bones are bones that are embedded in tendons. The largest and most commonly known sesamoid bone in the body is the kneecap, or patella. Two other tiny seasamoid bones (approximately the size of a pea) are found underneath the big toe. They act as pulleys to improve the force transmission through the tendon and help the big toe “push off” during walking and running. When the force is too great or too repetitive this area can become irritated and inflamed causing pain, weakness and ultimately difficulty walking, running, dancing and more.

What Causes Sesamoiditis?

You have 26 bones in each of your feet. Together that’s 52 bones, or one-quarter of all the bones in your body! Feet are complex but are impeccably designed to bear weight and to carry you around where you need to go. Due to this complexity, there is a lot of opportunity for dysfunction, which ultimately can lead to pain such as sesamoiditis. The sesamoid bones can become irritated with activities that involve repetitive forces to the forefoot such as dancing or running. Also, if foot mechanics are altered (you over-supinate or you wear high heels often) this can also transmit excessive force through the sesamoid bones causing inflammation. If you think you might have sesamoiditis it’s important to seek help from a physiotherapist, chiropractor are sports medicine doctor as soon as possible.

What are the Symptoms of Sesamoiditis?

Individuals with sesamoiditis often complain of a gradual onset of dull, longstanding pain beneath the big toe joint. This pain typically comes and goes. It worsens in shoes with higher heels or during certain activities where more force is being transmitted through the big toe such as walking quickly, running, jumping or ballet to name a few.

What are the Best Exercises to Help with Sesamoiditis?

For optimal results it is always best to get a custom exercise and rehabilitation program to treat your sesamoiditis from a qualified physiotherapist, chiropractor, or sports medicine doctor. In general the following exercises are recommended to help treat or prevent sesamoiditis.

Foot Strengthening

Foot Mobilization (using a yoga tune up ball)

Calf Stretching

Big Toe Curls

For this exercise wrap a low-tension resistance band around your big toe. Then slowly bend and straighten this toe against resistance. Keep to movement slow and coordinated. Repeat 20x 3xday.

How Long Does it Take to Recover from Sesamoiditis?

If you have sesamoiditis it can take 2-3 weeks for complete healing to occur with proper care. If you have a more serious injury like a sesamoid fracture, it will take 6-8 weeks with no weight bearing for the injury to fully heal. Sesemoiditis can bother people for months if left untreated so it’s important to start treatment with a physiotherapist or chiropractor to help improve recovery time.

What Should I Avoid Doing if I Have Sesamoiditis?

If you have sesamoiditis you should avoid doing any activity that causes pain for the first few weeks. It is important to remember that this sesamoiditis is caused by inflammation due to irritation of the tendons around the sesamoid bone and rest is the primary treatment. Dancing, running, and other high impact activities are sure to irritate the sesamoid and should be avoided. Often with seamoiditis even walking can cause irritation so shoes with proper support are very important. Similarly, wearing high heels, or shoes that don’t offer good foot support and place extra pressure on the area should also be avoided if you have sesamoiditis.

What Can I Do to Prevent Sesamoiditis?

To help prevent sesamoiditis it is important to wear shoes that fit properly and support the arches are you feet. This also means replacing old shoes, especially work out shoes that are worn out. Another good way to prevent sesamoiditis is to stretch after activity and warm up well before exercising, this is especially important with high impact exercise like running.

How can a Physiotherapist or Chiropractor Help with the Treatment of Sesamoiditis?

The first step to recovery is a comprehensive assessment by a physiotherapist, chiropractor, or sports medicine doctor. The pain and inflammation might be below the big toe but the root of the problem may be elsewhere in the body. Once the root problem is established, the first step in treatment is usually rest from the aggravating activity. Ultrasound, laser, taping, hands on therapy, and ice may be used in different combinations to relieve symptoms. Exercises will also play a large part in the rehabilitation process. Orthotics or other shoe inserts can be helpful in off-loading the painful area.

If you think you might have sesamoiditis or a related condition, then contact us today to book an appointment with one of our highly skilled physiotherapists or chiropractors. Our team of sports medicine physicians, physiotherapists, chiropractors and massage therapists are here to help get you on the road to recovery and back to the activities you love.

Written By: Heather McNeil – RPTa

Rebalance Toronto

Rebalance Sports Medicine is a multidisciplinary clinic in downtown Toronto offering physiotherapy, chiropractic, registered massage therapy, sports medicine, naturopathy, Pilates and more.

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