A sesamoid injury can involve the tendons, bones and/or neighboring tissue in the joint. The sesamoid is a bone embedded in a tendon. They are found in different joints all over the body. In a normal foot, the sesamoids are 2 pea-shaped bones positioned in the ball of the foot, under the big toe joint.
The sesamoids assist the big toe in moving normally and provides leverage as the big toe pushes off while running and walking. It is also a weight-bearing surface for the 1st metatarsal bone which absorbs the weight placed on the ball of the foot while running, walking and jumping.
A sesamoid injury is often linked with activities that necessitate increased pressure on the ball of the foot such as basketball, running, golf, football, ballet and tennis. Additionally, individuals with high arches are at risk for sesamoid issues. Frequent wearing of high-heeled shoes is also a contributing factor.
What are the types of sesamoid injury in the foot?
There are 3 forms of sesamoid injury that involves the foot such as:
- Turf toe – the injury involves the soft tissues that surround the big toe joint. This occurs once the big toe joint is stretched beyond its normal reach
- Fracture – a break in the sesamoid bone can be acute or chronic
- Sesamoiditis – this is an overuse injury that results to chronic inflammation of the sesamoid bones and tendons. This is due to the increased pressure being placed on the big toe joint.
How is a sesamoid injury managed?
The conservative approach in managing a sesamoid injury in the foot might include one or several of the following options based on the form of injury and severity:
- Strapping, padding or taping – a pad might be placed in the shoe used to provide cushion to the inflamed sesamoid area or the toe might be strapped or taped to alleviate the tension.
- Immobilization – the foot might be placed in a cast or detachable walking cast. In some cases, crutches might be utilized to prevent placing any weight on the foot.
- Steroid injections – in some cases, cortisone is injected into the joint to minimize the pain and inflammation
- Oral medications – non-steroidal anti-inflammatory drugs (NSAIDs) are beneficial in reducing the pain and inflammation
- Physical therapy – the rehabilitation phase after immobilization can oftentimes include physical therapy such as exercises and ultrasound therapy
- Orthotic devices – customized orthotic devices which are fitted into the shoe might be recommended for long-term management of sesamoiditis to even out the pressure applied on the ball of the foot
Is surgery needed?
If a sesamoid injury does not respond to conservative measures, surgical intervention is necessary. The surgeon will determine the appropriate procedure for the individual.
Quick Note / Disclaimer
The material posted on this page on sesamoid injuries on the foot is for learning and educational purposes only. To learn to recognize and manage the injuries, register for a first aid and CPR course with Mississauga First Aid.