The sesmoid bones are two small bones on the bottom of your foot near the first toe joint. Most of the bones in your body are connected to bone, but the sesmoid bones are attached to tendons/muscle. Like the knee cap (patella), it is not connected to the bone around it and acts as a pulley during gait. The semoids are very small bones which endure stress during long periods of activity. There are two sesmoid bones on the first metatarsal.

What is Sesmoiditis?

Sesamoiditis is a term used for pain underneath the first joint. More specifically, the pain is due to inflammation of the sesmoid bones or the tendon surrounding the bones. Pain only occurs when pressure is applied directly on the bones. This occurs in one of two ways:

  1. When you stand on the balls of your foot or
  2. During gait when the heel of your back-foot is lifting from the ground and the pressure from the heel begins to be transferred to the ball of the foot

How it occurs

When you take a step forward, weight transfer from the outside portion of the heel, up the midfoot and through the 1st toe joint. With every step you take, pressure is transferred through the sesmoid bones. Sesmoiditis is considered as a “bruised” bone because it becomes painful and inflamed after repetitive pressure from long periods of standing and walking. Dancers and runners commonly suffer from sesmoiditis because of the time they spend on the balls of the feet. People who wear high heels are also prone to sesmoditis also because of the constant pressure applied to the sesmoid bones with every step they take.

Sesmoid Fractures

Sesmoid fractrues differs from sesmoiditis because a fracture is a break in the bone. Sesmoiditis is inflammation in the area. Usually pain is immediate if a fracture is suspected, along with redness and swelling. With sesmoiditis, pain may develop gradually. It may be painful for a couple of days and then subside and redevelop again. If you think you have sesmoditis or a fracture, it is important to come and see a professional as soon as possible! Symptoms can become severe if left untreated!

What we do to treat Sesamoiditis

We will assess your foot to find the root cause of sesamoiditis. Your foot may be structurally predisposed to unequal pressures on the first joint or may be related to the footwear you’re wearing. Removing the causative factor will cure the pain.

  • Stretching exercises will be given.
  • Footwear recommendations will be given.
  • Biomechanical assessment will be performed to assess if your gait is increased the load on the first joint.
  • Orthotics may be prescribed to offload the joint so it can heal.
  • Topical/or oral anti-inflammatory medications may be prescribed.
  • Shockwave Therapy Treatment may be initiated.

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