The small bones embedded in tendons, known as sesamoids, are crucial for the proper functioning of several joints in the body. In the foot, two pea-shaped sesamoid bones are located in the ball of the foot, beneath the big toe joint. These bones assist in normal big toe movement, provide leverage when toe push-off occurs during walking and running, and also serve as weight-bearing surfaces for the first metatarsal bone.
Sesamoid injuries in the foot can affect the bones, tendons, and surrounding tissues of the joint. Individuals who engage in activities that require more pressure on the ball of the foot, such as sports like basketball, football, golf, and tennis, are at a greater risk for developing sesamoid problems. Ballet dancers also commonly experience sesamoid injuries. Moreover, high arches and frequent use of high-heeled shoes may contribute to developing these injuries.
Injuries to the sesamoid bone in the foot can be classified into three types: Turf Toe, Fracture, and Sesamoiditis. Turf Toe refers to an injury to the soft tissue surrounding the big toe joint that causes immediate pain and swelling. Fractures are caused by trauma or a hairline break usually due to repetitive stress or overuse of the area. Sesamoiditis is an overuse injury that occurs due to increasing pressure on the sesamoid bones, causing chronic inflammation, and resulting in pain beneath the big toe joint.
If you think you have experienced a sesamoid injury, it is important to visit a foot and ankle surgeon. Dr. Gilbert Huang DPM is an experienced surgeon trained in treating sesamoid injuries. During the consultation, the specialist will examine the foot and focus on the big toe joint, pressing on it and moving it up and down while assessing the patient’s walking and examining the shoe’s wear pattern. X-rays and other imaging studies may also be performed to determine the injury’s extent.
Treatment options for sesamoid injuries depend on the type and degree of severity of the injury. Non-surgical treatment options may include padding, strapping, or taping with a pad placed in the shoe to cushion the inflamed sesamoid area, immobilization with a cast or removable walking cast, and using crutches to prevent placing weight on the foot. Physical therapy, such as exercises and ultrasound therapy, may also help during rehabilitation, and medicines such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroid injections may be prescribed to reduce pain and inflammation. To balance the pressure placed on the ball of the foot, custom orthotic devices that fit inside the shoe may also be prescribed for long-term treatment of sesamoiditis.
When non-surgical treatment options fail to provide a suitable outcome, surgery may be required. A foot and ankle surgeon may advise the best-suited procedure for an individual case of sesamoid injury.
In conclusion, sesamoid injuries in the foot can cause debilitating pain and discomfort. Seeking medical attention is essential to determine the extent of the injury, and Dr. Gilbert Huang DPM is well-equipped to assist with sesamoid injuries. Early diagnosis and timely treatment may prevent potential long-term consequences, and hence, it is important to seek medical care if one suspects a sesamoid injury.