Kneecaps are the biggest sesamoid bones in your body. They are not connected to any other bone, they are simply connected to tendons or placed within muscle. Your knee cap is a lot bigger than the sesamoid bones in your foot, which are the size of a corn kernel! Beware, though. These bones may be small, but they create mighty pain when they are irritated or fractured, a condition called sesamoiditis.
What is Sesamoiditis?
Sesamoiditis is a term that explains any irritation of the sesamoid bones. These two, small, pea-shaped bones are located in the tendons underneath the first metatarsal bone. One sits on the outer side of the bone and the other is located more toward the ball of the foot. Because the bones are located within the tendons, this condition is also a type of tendinitis.
Gradual Pain in the Ball of Your Foot
When these bones are doing their job, they act like pulleys and give the tendons more leverage to control the toe muscles when you push off to take a step. When they don’t work, they create pain on the middle or inner part of the ball of your foot. Since the two bones are located within the tendon, the irritation, inflammation, and pain can also extend to these tendons.
With this condition, pain will gradually become more intense. You may be able to see swelling or bruising. In more advanced stages, the pain will turn into severe throbbing and it will be hard to even bend and straighten the toe.
If you visit Sierra Foot & Ankle, we will diagnose your condition by feeling the part of your foot that is giving you pain. We might have you try to move your big toe around to see what kind of pain that produces. We’ll also bend your toe upwards and see if the pain increases with that. To better determine the problem with your big toe, we may need an X-ray, since there is a variety of problems that involve the ball of the foot and your big toe.
Your sesamoid bones can become irritated or fractured with any activities that require you to push off on the big toe. Activities like ballet, running, and other professional sports are common capitulators of this condition.
Take it slow when you are starting hill training, speed work, or just adding miles to your daily run. Amping up your activity level too quickly can also irritate your sesamoids and the ball of your foot, leading to sesamoiditis. Having a naturally high arch puts extra pressure on this area as well.
Stop Activity, Ice the Pain, and Pad the Area
For treatment, stop any activities that are aggravating the problem. Rest and ice the foot frequently. We may recommend that you consider taking anti-inflammatory medications to reduce pain and inflammation. When you are active, make sure you wear soft-soled shoes with low heels. We might suggest some padding in form of felt or foam cushioning under the ball of your foot. For a more advanced procedure, we can try steroid injections directly applied to the area.
Our Plan for Fractured Sesamoids
Fractures of the sesamoid bones will require a brace or special shoe to immobilize the area. We might tape your toe and also give you a pad or custom orthotics to cushion the joint. In some cases, surgery will be necessary.
If you have tried every conservative treatment without improvement of the condition, call Victoria Melhuish, DPM for help with your sesamoiditis. To make an appointment with us in Carson City, call Sierra Foot & Ankle at (775) 783-8037.