Are 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 great 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 it?
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. 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.
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.
How can it be treated?
The first step to recovery is a comprehensive assessment. 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! 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 – RPT