Sesamoiditis is a condition that is a form of tendonitis, that occurs in the ball of the foot just behind the big toe. Here, the body has two small sesamoid bones that are not connected by a joint to any other bones, but rather are imbedded in the soft tissue. They act like pulleys, providing a smooth surface for tendons to slide over, therefore increasing the ability to transmit muscular forces from the connecting muscle. The sesamoid bones in the foot assist with weight bearing and help lift the bones of the big toe. Sesamoid bones can break (fractures) and the tendons around them can also become irritated and inflamed. When this happens, it is called Sesamoiditis. This condition is common in dancers, runners and baseball catchers or any athlete who spends a lot of time on the forefoot. Pain will typically be focused at the ball of the foot behind the big toe. There may or may not be some swelling and/or bruising. There may be some pain with moving the big toe and also with weight bearing activities, particularly on the forefoot.
Your Physiotherapist or Athletic Therapist can fully assess your foot. If there are any signs of fracture, they may ask that you consult your doctor to consider an x-ray. Typically, Sesamoiditis can be treated clinically through manual therapy, exercise therapy and modification or rest from the offending activity. In extreme cases that do not resolve otherwise, your doctor may want to refer you to a surgeon to consider removing the sesamoid bone(s). Treatment will typically include releasing the muscles and tendons around the bones and surrounding area and ensuring all nearby joints are moving well. Your Physiotherapist or Athletic Therapist will send you home with a series of exercises to help accomplish these same goals and also educate you on the use of heat and/or ice, the importance of rest, and modification of, or slow return to, activity. Sometimes, foot supports or taping can be helpful in this condition.
Registered Massage Therapy can also be helpful to loosen the muscles of the foot and calf to help remove some of the causes of the problem.
As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.
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