What is Sesamoiditis?

Sesamoiditis occurs when there is a direct injury or too much pressure on the sesamoids causing inflammation. The sesamoids are two small bones which sit beneath the big toe joint and protect the tendons when we walk. They also stabilise the inside of the foot as we push off into the next step. 

The top surface of the sesamoids is covered in cartilage as they form part of the big toe joint. If this cartilage becomes damaged it can cause arthritis.

What causes it?

Generally, a direct injury or overuse during sport causes sesamoiditis. However, patients with a low arch or high-arched foot or a prominent joint can be predisposed to sesamoid damage/injury. 

Incorrectly fitting shoes or shoes with a higher heel can all increase stress to the sesamoid area. Some patients have enlarged sesamoids which can predispose to sesamoiditis.

What will happen if I leave it untreated?

Walking can become painful if Sesamoiditis is left untreated. Due to the pain patients, may change their gait to avoid excess pressure on the big toe. 

Long term changes to your gait can cause problems with the rest of your feet, your knees, your hips and your back. 

What can help?

Resting can be a great help when dealing with the symptoms of sesamoiditis. Resting in addition to icing the area and taking NSAID’s such as Ibuprofen can allow the inflammation to subside. 

What are the treatment options?

Custom functional orthotics, if properly prescribed and fitted, will dramatically reduce pressure on the sesamoids – leading to decreased pain and less chance of the pain returning.

Orthotics for sesamoiditis are prescribed specifically to help take weight off of the painful sesamoid and to distribute the force onto the arch or onto the non-painful metatarsal heads. This requires an orthotic that conforms extremely close to the arch of your foot.