Most bones in the human body are connected to each other at joints, but there are a few bones that are not connected to any other bone. Instead, they are connected only to tendons or embedded in muscle.
These unique bones are called sesamoids.
Just like any other bone in the body, they can be fractured. The most problematic sesamoids are found on the underside of the foot near the big toe.
The sesamoids in the foot assist with being able to bear the full weight of standing along with elevating the big toe when walking. Since these bones are tightly knitted with surrounding tendons, they can become aggravated and inflamed. When this happens to the tendons, it is called sesamoiditis, a form of tendonitis in the feet. With this onset, there can be significant pain and reduction of mobility.
The most common patients of sesamoiditis include ballet dancers, baseball players, and runners.
Sesamoiditis can be distinguished from other foot conditions by its gradual onset. The pain usually begins as a mild ache and increases gradually as the causal activity is continued. It may build to an intense throbbing. In most cases there is little or no bruising or redness.
One of the major causes of sesamoiditis is increased activity. If your activity level has increased and has forced you to put more pressure on the balls of your feet, you will be more prone to developing sesamoiditis. If you have bony feet, you may not have enough fat on your foot to protect the tender sesamoids. If you have a high arched foot, you will naturally run on the balls-of-your-feet, adding even more painful pressure.
It is important to differentiate between a fracture to the sesamoid bone and sesamoiditis so that proper treatment and prevention can be rendered. The pain from a sesamoid injury is centered around the ball of the foot, and will come on gradually if it is tendon damage. Fractures will result in more direct and obvious pain. In addition, sesamoiditis may cause rigidity and inflexibility of the toes as well.
Normally, Sesamoiditis treatment and management of the associated pain does not require surgical interventions. It can be controlled by:
- Icing the sole of your feet. Do not apply ice directly to the skin, but use an ice pack or wrap the ice in a towel.
- Wearing soft-soled, low-heel shoes.
- If recommended, taping the great toe so that it remains bent slightly downward.
- Injection of a steroid medication to reduce swelling.
If symptoms persist, you may need to wear a removable short leg fracture brace for 4 to 6 weeks.
The most effective method of preventing sesamoiditis, as with most common foot conditions, is the use of proper fitting footwear. Modern athletic shoes provide ample cushion and toe space so as to not cause excessive pressure to the tissues of the feet. Using orthotic and gel insoles can provide extra support to those with swollen feet, who are at an increased risk of developing this nerve disorder.
Sesamoiditis can be a sneaky condition that can go unnoticed if not recognized early. By maintaining proper foot care, you can ensure you are minimizing your risk for developing sesamoiditis.
If you are experiencing any of the symptoms described above, do not hesitate to call our friendly and knowledgeable staff to solve the problem before it progresses!