What are Sesamoids?
Most bones in the human body are connected to each other at the joints but there are a few bones that are not connected to any other bone. Instead, they are connected only to tendons or are embedded in muscle. These are the sesamoids – and prolonged, unaddressed pain can lead to an irritating condition known as sesamoiditis.
The kneecap (patella) is the largest sesamoid. Two other very small sesamoids (about the size of a kernel of corn) are found in the underside of the forefoot near the big toe, one on the outer side of the foot and the other closer to the middle of the foot. These bones act like pulleys and provide a smooth surface over which the tendons slide, thus increasing the ability of the tendons to transmit muscle forces. The sesamoids in the forefoot also assist with weight bearing and help elevate the bones of the big toe.
What Happens During a Sesamoiditis Fracture?
Like other bones, sesamoids can break (fracture). Additionally, the tendons surrounding the sesamoids can become irritated or inflamed. This is called sesamoiditis and is a form of tendonitis. It is common among ballet dancers, runners and baseball catchers.
Some of the associated signs and symptoms include pain, which is focused under the big toe on the ball of the foot, swelling in this region, and possibly difficulty and pain in bending and straightening the big toe. X-rays and other testing such as a bone scan or MRI may be necessary to confirm the diagnosis.
Treatment is generally nonoperative; however, if conservative measures fail, surgery may be recommended to remove the sesamoid bone. Conservative treatments involve activity modification (stopping the activity causing the pain), anti-inflammatory treatments, icing the affected area, and shoe wear modifications such as soft-soled, and low-healed shoes (with or without the use of custom or over-the-counter orthotics), with a cut-out for the sesamoid bones may be beneficial. Stiff-soled shoes like clogs may also be comfortable. If the condition is actively inflamed, immobilization in a boot or cast may provide significant relief. On occasion, steroid injections to reduce the inflammation may also be of some benefit.
Sesamoiditis Relief in Chicagoland
A fracture of a sesamoid can make everyday movements immensely irritating. To find the treatment you need, getting in touch with an orthopedic professional who has a specialized focus in the foot and its surrounding structures will allow a full recovery to take place. Dr. Vora is a board-certified orthopedic surgeon who deals with many conditions of the foot and ankle. Upon diagnosis of your foot, ankle or toe condition, Dr. Vora may recommend sesamoiditis taping or custom foot orthotics to alleviate symptoms. To explore the orthopedic services in Chicagoland that are available to you, please contact Dr. Vora and his staff
Modified from the AAOS