Sesamoiditis is inflammation of the tiny bones which are situated around the area just below the big toe joint. It is characterised by pain in the region of ball of the foot just below the great toe joint.
This condition is often confused with bruising and can be a sign of fracture which is why radiographs (x-rays) are best used to confirm the diagnosis.
In some instances these bones may appear to be fractured when infact the bones display a naturally occuring split or separation. This situation can aggravate symptoms but should not cause any problems in the absence of inflammation or pain.
There are several factors that can contribute to sesamoiditis. These include:
Incorrectly aligned or improperly functioning feet. This can cause overloading of the foot in the region of the sesamoids. This may occur with either excessive pronation (roll-in) or supination (roll-out), especially with the presence of a rigid plantar flexed first ray.
Sudden changes in training may cause overloading of the ball of the foot where the sesamoids lie resulting in overuse and inflammation of the sesamoid bones.
Trauma to the foot may cause inflammation or possibly fracture of the sesamoids.
Tight calf and hamstring muscles may contribute by increasing pressure on the metatarsal heads, thereby increasing pressure on the sesamoid bones.
Poorly fitting footwear may also contribute to injury especially where cleats, studs or spriggs are utilised.
Sesamoiditis is a condition which generally responds well to conservative treatment if treated early. Conservative treatment involves:
Your training schedule will be discussed and modified so that a successful and effective treatment can be administered.
Rest, Ice, Compression and Elevation. As with any acute injury the RICE principle applies. It is necessary in the early stages of treatment to help reduce the inflammation. Anti-inflammatory medication may also be required.
Correction of abnormal foot function.
Orthoses are designed to allow the foot to function around its normal position, allowing the sesamoids to recover initially and then to prevent future recurrence of the injury.
Stretching and physical therapy.
Mild stretching and strengthening exercises may be prescribed where necessary.
Casting or immobilisation.
This may be necessary if a fracture is present, however, this can often be avoided with good compliance of all other measures.
WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist.
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