3 Problems with Sesamoids

At NY Foot Health, we know that pain in the ball of the foot can be quite debilitating. Often the source of this significant discomfort is two tiny bones known as sesamoids. Sesamoids are bones embedded in tendons. In the foot, two of these corn kernel-size bones are at the base of the big toe. The sesamoids act like pulleys helping the tendons move the big toe and giving it leverage as the toe pushes off. These bones play a pivotal role in your ability to walk, run, jump, and make many other common motions.

Injury or inflammation of the sesamoids can involve the sesamoid bones themselves or the surrounding tendons or joint tissue. Patients who participate in activities that put repetitive pressure on the ball of the foot, such as running, golf, tennis, and basketball, have a higher incidence of sesamoid problems. People with high arches and those who wear high heels frequently are also at greater risk.

Three causes of sesamoids not functioning correctly are:

  1. Sesamoiditis—when the sesamoids and tendons in them become chronically inflamed, usually due to overuse, it causes sesamoiditis. Signs of this disorder are a dull pain beneath the big toe joint that may increase or abate depending on the activity or shoes you are wearing.

  2. Turf Toe—this is usually an acute injury that occurs when the big toe joint is suddenly and forcefully overextended. It gets its name from sports played on AstroTurf, which causes the toe to “stick” on the surface and jam. A turf toe injury usually causes sharp pain and sometimes the sensation of a “pop” when it occurs. Swelling and a limited range of motion are other signs of this injury.

  3. Fracture—like other types of bone breaks, a sesamoid fracture can be acute such as when you drop a heavy object on the foot, or it suffers some other direct impact, or it can be chronic, like a stress fracture. In the case of the former, there will be immediate and more severe pain and swelling at the site of the break. With a stress fracture, the pain is usually duller and comes and goes. It may get worse with activity and better with rest.

If you experience ball of foot pain, it’s important to see your podiatrist to find the cause and appropriate treatment. If you don’t currently have a podiatrist, use our online directory to find one near you. To learn more about common foot injuries, contact us or subscribe to our free e-newsletter.