Your kneecap is an example of a sesamoid, a bone that develops within a tendon. These bones also develop in the tendons of the hands and feet. Two sesamoids can usually be found near the underside of the big toe. These structures are about the size of a pea.

When there is injury to the sesamoid bone in the big toe, the pain is felt under the toe on the ball of the foot. The pain may be gradual or immediate. Gradual pain can indicate sesamoiditis or a stress fracture. If there is trauma that causes a fracture, the pain will be immediate. Swelling and bruising in the affected area is not always present. You may experience difficulty when you try to bend or straighten your big toe. You may also feel pain with movement.

Effective treatment for the condition is available; however, some patients become frustrated with the length of time it takes to see results. Conservative treatment includes:

• Avoiding activity that causes pain
• Resting the foot and using ice to reduce swelling and pain
• Limiting footwear to low-heeled, soft-soled shoes
• Managing pain with acetaminophen or ibuprofen
• Relieving the stress around the sesamoid by using a felt cushioning pad
• Taping the big toe so it remains in a slightly downward position
• Returning to activities slowly and avoiding those that put weight on the balls of the feet

Sesamoid injuries take a long time to heal, so be patient during the process, and know that you may need to continue treatment for about six months.

Surgical intervention may be necessary if the sesamoid is fractured. Your doctor will decide if the sesamoid can be repaired or if it will be necessary to remove a portion or all of it.

Sesamoiditis

The sesamoid is in the tendon, and sometimes it can become irritated or inflamed, especially with overuse. When this happens, it is called sesamoiditis. This form of tendinitis or tendinosis is common among runners, ballet dancers and professional athletes.

Persistent pain should be addressed by a professional to prevent permanent damage to your foot. Call the office of Dr. Stuart Mogul for expert care. Schedule your appointment for an examination and consultation today.