What is Sesamoiditis?
There are two small bones that sit beneath the big toe joint which are called sesamoids. The sesamoids sit within one of the tendons beneath the big toe joint and help to protect the tendons during walking and to stabilise the inside of the foot as we push off into the next step. They are the foot's equivalent to the knee cap (Patellar). The top surface of the sesamoids is covered in cartilage as they form part of the big toe joint.
If there is too much pressure on the sesamoids or a direct injury then the area can become inflamed (sesamoiditis). In some instances, the cartilage on the sesamoid can be damaged and result in arthritis. It is also possible to fracture the sesamoids.
What causes Sesamoiditis?
Generally, a direct injury or overuse during sport causes sesamoiditis. However, patients with a low arch or high-arched foot or a prominent joint can be predisposed to sesamoid damage/injury. In correctly fitting shoes or shoes with a higher heel can all increase stress to the sesamoid area. Some patients have enlarged sesamoids which can predispose to sesamoiditis.
How can we help?
Custom functional orthotics, if properly prescribed and fitted, will dramatically reduce pressure on the sesamoids - leading to decreased pain and less chance of the pain returning.
Orthotics for sesamoiditis are prescribed specifically to help take weight off of the painful sesamoid and to distribute the force onto the arch or onto the non-painful metatarsal heads. This requires an orthotic that conforms extremely close to the arch of your foot.
