Sesamoids in the foot are two pea-shaped bones beneath the big toe joint found in the ball of the foot. Joint with tendons, the sesamoids act as pulleys to facilitate movement of the big toe. When walking, running and jumping, sesamoids help the big toe push off and bear weight for the big toe bone when the foot hits the ground.
The damage of a sesamoid injury could affect the bones, tendons and the surrounding tissue. Risk of a sesamoid injury is increased with activities that place extra pressure on the foot such as soccer, ballet, tennis and basketball. Wearing ill-fitting shoes and high-heels bring additional strain to the joints and could also cause injury to the area.
This sesamoid injury involves a sprain of ligaments around the big toe joint. It happens when the foot is bent too far forward, causing a hyperextension of the joint. Usually, it is a result of a sudden impact when engaging in sports. Patient might hear a “pop” sound when it happens, followed by a sharp pain and swelling.
A fracture happens when the bone is broken. There are two types of sesamoid bone fractures.
An acute fracture occurs when a direct blow causes a break in the sesamoid bone. Pain and swelling would be immediate.
It is a chronic fracture when repetitive stress causes a hairline break in the sesamoid bone. Patient would feel constant pain in the ball of the foot. With rest, the pain can be alleviated. But once activity resumes, the pain would recur and get aggravated.
Caused by increased pressure to the sesamoids, this injury is an overuse injury that produces a dull, longstanding pain beneath the big joint toe where the sesamoid bones are. Both the bones and joint tendons are inflamed. The pain recurs upon activity and wearing inappropriate shoes.
Treatments for sesamoid injuries are generally non-surgical. Only if the injury does not show any significant improvement with non-operative treatment, surgery would be considered. Depending on the severity of the injury, one or more of these conservative methods may be used.
- Cast immobilization
- Physical therapy
- Padding of insoles or taping of toe joint
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)