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What is a sesamoid bone?

 

A sesamoid bone is independent bone embedded into a tendon, abnormal as most bones are connected via joints. Sesamoid bones provide a mechanical advantage to the joint as they improve efficiency of movement and power production, thus are very important for normal function.

Our most well-known sesamoid bone is the patella, or knee cap, but the sesamoids in our feet are also very important for ensuring normal gait and proper power production.

The sesamoid bones are located under the base of the big toe in each foot to form the bunion joint. The word sesamoid derives from the Greek translating of “sesame-seed like” identifying the small, smooth structure of the bones.

Why are there sesamoid bones in my feet?

The sesamoid bones are very important to the function of the foot as they help absorb impact and increase the forces generated through gait. The bones act similarly to pulley, increasing the leverage of tendons and forces produced by gait.

As a consequence of this role and their position under the foot, the sesamoid bones are under massive pressure each time we push off our big toe in walking. If this load increases above the structural threshold or in the presence of gait dysfunction, inflammation or injury is possible.

What is Sesamoiditis, how does it happen?

A common ailment affecting the ball of the foot and big toe, sesamoiditis is the condition when the sesamoids become inflamed or irritated.

There are a number of factors which can contribute to the development of sesamoiditis which include:

  • Poor Biomechanics/Malalignment can cause of overload of the sesamoid bones and surrounding soft tissue. Both collapsed and high arches can contribute to the development of symptoms.
  • Acute overtraining or sudden increases in training load will increase forces travelling through the feet before the structures can adapt and manage them. This can cause inflammation and overuse injuries of the sesamoid bones.
  • Trauma to the ball of the foot, such as landing from a height, can cause inflammation or fracture of the sesamoids.
  • Poorly Fitting or Inappropriate Footwear can cause poor alignment or increase pressure through the sesamoids. This is common when consistently wearing hard-soled or high-heeled shoes.

Signs and Symptoms of Sesamoiditis?

The symptoms associated with sesamoiditis are quite clear and when reported to a Podiatrist will lead to a quick diagnosis.

The primary symptom of sesamoiditis is pain under the base of the big toe. Pain experienced from sesamoiditis progresses gradually as opposed to an immediate onset indicating fracture.

Initially, pain will be experienced when the bending and straightening the big toe. As the condition progresses, the area under the big toe will become tender with any activity.

In longstanding cases patients may report pain all the time. The pain is usually worse when the patient is on their feet. There may also be swelling, bruising or inflammation of the area.

How to Treat Sesamoiditis?

Unsurprisingly, the first step in treating sesamoiditis is diagnosis. Whilst an assessment of symptoms is usually sufficient to diagnose the injury, medical imaging (x-ray, ultrasound, or CT scans) may be necessary to evaluate the severity and optimal treatment.

Once diagnosed, sesamoiditis is typically treated by addressing the cause of pain. Treatment is usually conservative, however, if unsuccessful surgical intervention may be required.

Treatment will prioritise deloading the sesamoid bones and immediately stopping activity which aggravates the injury. Application of ice and use of an oral anti-inflammatory will help to relieve pain and can be used in conjunction with immobilization strapping to initially treat the disease.

Custom orthotics may be required to treat sesamoiditis if poor alignment or foot structure are the root of the injury. Application of a foam pad and soft, low heeled shoes are also recommended. Our podiatrist will also develop a gradual return-to-activity program to ensure correct recovery and prevent recurrence of pain.

Do I need a Referral to See a Podiatrist?

For basic appointments you do not need a referral to see our Pivotal Motion Podiatrist. Though referral may occur via a physiotherapist or GP when podiatry issues are reported, you do not require any paperwork to book a standard appointment.

Referrals will be necessary if you are attending as part of an Enhanced Primary Care treatment plan or bill through WorkCover, DVA or Third Party. These instances can be articulated when booking an appointment and our reception staff will be able to direct you on the best course of action and material required.

How do I Book a Podiatry Appointment for Sesamoiditis?

As with many podiatry issues and injuries it is important to get Sesamoiditis attended to quickly to improve management and functional outcomes. If you think you are suffering Sesamoiditis or have other issues with your feet, book on our online booking gateway or call 07 3352 5116.