Sesamoiditis

Sesamoiditis is when the small bones under your big toe joint get inflamed and painful. This pain is felt under the big toe joint and is common in young, active people. The pain can come and go but can be very uncomfortable, especially when walking.

What are the Sesamoids?

The sesamoid bones are two small bones under your big toe joint. They help the tendons that bend your big toe. There is one on the inside of the foot (medial sesamoid) and one near the second toe (lateral sesamoid). The medial sesamoid usually causes the most discomfort.

Signs and symptoms of Sesamoiditis:

• Pain under your big toe when walking, especially when bending the toe
• Pain during weight-bearing activities
• Pain that eases when not putting weight on the foot
• Pain when pressing on the area
• Swelling

Causes of Sesamoiditis:

Sesamoiditis often happens due to sudden changes in activity or increased load on the big toe joint, leading to small injuries. Factors that can contribute include:

• Sudden weight gain
• Wearing unsupportive shoes or sandals
• Impact or trauma from overuse
• Repeated stress from sports
• Sudden increase in activity
• Regularly wearing high heels
• Osteoarthritis or osteoporosis
• Large sesamoid bones
• High arches or flat feet

How to help with Sesamoiditis:

There is no quick fix, but making simple changes can help manage the pain:

• Rest and elevate your foot
• Apply an ice pack to the painful area for up to 20 minutes every 2-3 hours
• Wear shoes with cushioned heels and good arch support
• Use insoles in your shoes
• Do regular stretching and foot exercises
• Try low-impact exercises like swimming
• Lose weight if needed

Things to avoid:

• Walking or standing for long periods
• Wearing high heels and tight, pointy shoes
• Wearing flip-flops or backless slippers
• Walking barefoot on hard surfaces

Choosing the right shoes:

Avoid high heels and opt for supportive, comfortable shoes. Soft, cushioned, lower-heeled shoes with a stiff toe spring can help reduce bending of the big toe and ease symptoms. Shoes with flexible soles offer less support and can increase stress on your feet. Make sure shoelaces are tied properly and avoid hard, flat, or unsupportive shoes.

Padding:

To cushion and relieve pressure on the sesamoids, you can use a pad in your shoe or directly on your foot. These pads are usually made of semi-compressed felt.

Managing Pain:

Use a pain scale from 0-10 to identify your pain level. Aim to stay in the mild pain zone by pacing your activities. If you experience severe pain, you might be overdoing it and should reduce your activity level.