Sesamoiditis: When Little Round Bones Hurt
A bone doesn’t have to break to hurt. They are a living tissue just like other parts of your body, and they are subject to the same stresses and react with the same pain when something goes wrong. When you walk, run, jump or dance, you put a lot of pressure on your bones. This is especially true in your feet, which form the base for the entire bone structure that holds you up. When you understand how your bones work, you learn what can cause a problem like sesamoiditis.
Pulleys and Pressure Points
Your foot has many bones, and two of them look like small peas. They are located under the big toe joint in the ball, surrounded by the tendon that holds the foot and toe bones together. In this position, they absorb stress every time you walk, run or jump. This is because the first metatarsal—the long bone in your foot that connects to the big toe—rests on the sesamoid bones with each step. These small bones also act like pulleys for the tendons as you move your toe, letting them glide smoothly as you use your toe to push off for the next step.
How Much Is Too Much?
As an overuse injury, sesamoiditis occurs when too much stress on these bones causes them and the tendons to become swollen or inflamed. The pain may come on gradually and then become chronic, happening every time you exercise. Your foot feels better when you rest, then acts up again when you move a lot or wear certain shoes. The pain is usually a dull ache under your big toe joint in the ball of your foot. If you feel sharp pain and can’t put weight on your foot, you’ll want to get it checked out, because these little round bones can break, too.
Certain activities put you more at risk of developing this condition: running, crouching on the balls of your feet (think baseball catcher), or jumping and landing (ballet dancers, basketball players). Certain shoe types also aggravate the problem by forcing pressure on your forefoot (high heels) or not providing enough cushioning.
Treat Your Sesamoids Kindly
Contact The Plateau Foot & Ankle Clinic in Sammamish if you think you may have sesamoiditis. We will examine your toe, move it to determine pain levels and range of motion, and find out what is causing the pain. We may X-ray it if a break is suspected.
There are many conservative treatments for this condition, the first being to stop doing whatever is causing the problem, to give it time to heal. Rest and icing can relieve pain and swelling, and we may recommend an appropriate pain reliever or steroid injection. We may also use taping or bracing to alleviate pressure on the bones. As it heals, wear shoes with soft soles and cushion the area with felt pads. Once we determine it is safe to begin your activities, ease into them gradually so you don’t reinjure yourself, and make sure the sesamoids are properly cushioned.
Dr. Howard Schaengold specializes in sports medicine and has successfully treated all types of foot pain. Call us at (425) 868-3338 and set up an appointment in Sammamish for a consultation. We provide expert care for the communities of Issaquah, Redmond, Bellevue, and Snoqualmie as well. Wherever you live, The Plateau Foot & Ankle Clinic is eager to help you find relief from all your foot pain.