Sesamoid injuries in the foot

A sesamoid is a bone embedded in a tendon. They are found in several joints in the body. In the foot the sesamoids are two pea-shaped bones located in the ball of the foot beneath the big toe joint.

Acting as a pulley for tendons, the sesamoids help the big toe move normally and provide leverage when the big toe "pushes off" during walking and running. They also serve as a weight-bearing surface of the first metatarsal bone , which is the long bone connected to the

big toe and absorbs the weight placed on the ball of the foot when walking or running.

Sesamoid injuries can involve the bones, tendons, and surrounding tissue in the joint. They are often associated with activities requiring increased pressure on the ball of the foot like running, basketball, football, golf, tennis and ballet. Also people with high arches are at risk for developing sesamoid problems.

There are three types of sesamoid injuries:

Turf toe is an injury of the soft tissue surrounding the big toe joint. It usually occurs when the big toe joint is extended beyond its normal range. There is immediate, sharp pain and swe

lling. It may affect the entire big toe joint and limits the motion of the toe. Sometimes a pop is felt at the moment of injury.

Fracture: A break in a sesamoid bone can be either acute or chronic. An acute fracture is caused by trauma, a direct blow or impact to the bone. Produces immediate pain and swelling at the site of the break but usually does not affect the entire big toe joint. A chronic fracture is a stress fracture which is a hairline break usually caused by repetitive stress or overuse. A stress fracture produces longstanding pain in the ball of the foot beneath the big toe joint. It is aggravated with activity and relieved with rest.

Sesmoiditis is an overuse injury involving chronic inflammation of the sesamoid bones and the tendons involved with those bones. It is caused by increased pressure to the sesamoids. It is a dull, longstanding pain beneath the big toe joint.

The podiatrist may try padding in the shoe to cushion the inflamed area or the toe may be taped or strapped to relieve the area of tension. Or the foot may be placed in a cast. Crutc

hes may be used to prevent placing weight on the foot. Oral medications like nonsteroidal anti-inflammatory drugs like ibuprofen are often helpful. There may be physical therapy ordered for strengthening and ultrasound. Steroid injections into the joint to reduce pain and inflammation may be used and custom made orthotics may be prescribed for long-term treatment

check out our online store at www.vailfoot.com for powersteps to help support your foot if you are unable to come into the office for custom made orthotics.

If you live in the area and experiencing pain in the ball of your foot give Dr. T. F. Vail's office a call at 419-423-1888 to set up an appointmnet.