Sesamoiditis is a painful condition that occurs at the base of the big toe joint, known as the first metatarsophalangeal joint or 1st MTPJ.
There are two bones that naturally exist on the bottom (plantar) big toe joint. They sit under the joint and inside two tendons on the bottom of this joint. Their job is to increase the efficiency of the tendons and allow them to pass around the joint – they are similar to the knee cap (patellae).
What causes sesamoiditis? – These small bones can be damaged for many reasons, including sudden trauma or structural and biomechanical deviations. If the joint is very prominent on the bottom, it can hit the ground with greater force damaging these bones or the underlying joint that sits deep in the sesamoid bones. If the foot is very high-arched, this can lead again to these bones taking excess force during walking and sport.
Flat feet (excess pronation) can lead to excess pressure on this region, especially at the toe-off. Athletes, such as basketball players and sprinters, and dancers, who spend long periods on the ball of the foot, are more susceptible to this problem.
Treatment – It is essential to have this condition treated early. In some situations, if the inflammation is left to persist for an extended period, the bones can develop avascular necrosis and actually die. This often requires surgery to remove the dead bone. Luckily this is not common.
X-rays and biomechanical assessment allow diagnosis and early intervention. Treatment often initially involves:
- rest
- shoe advice
- the prescription and manufacture of custom-made insoles, called orthotics, to deflect any excess forces and allow this joint to function without pain.
At Sydney’s Bio Allied Health our team of podiatrists can help with the diagnosis and treatment to allow the resolution of pain and prevention of avascular necrosis.
Read more articles about foot and ankle conditions