Sesamoiditis
Sesamoids are small bones found throughout the
body. Sesamoid bones provide attachments for
tendons, and act as fulcrums or pulleys for muscles.
Two common sesamoids that can become irritated are
on the bottom of the big toe. They can become
irritated or fractured, producing pain on the bottom
of the big toe. Pain localized to a specific
location is the most common symptom of sesamoiditis.
The flexor hallucis longus muscle uses the
sesamoids as anchors during running or pulling with
the big toe. The sesamoid bones are attachment sites
for the flexor hallucis brevis, adductor hallucis,
and abductor hallucis muscles.
 Common Causes of Sesamoiditis
Sesamoiditis commonly occurs from direct trauma
or repetitive use. Running, jumping from a height,
ballet, and poorly fitting shoes can cause the
condition. Increased pounding activities on hard
surfaces are the most common causes.
Home treatments for Sesamoiditis
Rest and ice for several weeks will allow the
irritation to heal. Use of doughnut-shaped padding
under the big toe will help to relieve direct
pressure on the sesamoids. Less flexible shoes,
playing and working on softer surfaces will increase
the speed of healing.
Treating Sesamoiditis in the Office
If the pain continues, your provider will
evaluate you for the possibility of fracture or
arthritis, which can be determined by a simple
X-Ray. Because of the attachment of the flexor
hallucis brevis, sesamoid fractures have a higher
tendency for displacement of the fracture, leading
to a high rate of delayed or nonunion healing.
 In office treatments will focus on decreasing the
inflammation around the sesamoid. Specific taping to
provide stability and relief to the area is common.
Your provider may address the foot and lower leg
muscles if they contributed to causing sesamoidits.
Presence of hallux vargus (big toe pointing to
the side) or bunions can complicate treatment.
Orthotics may be helpful in some cases. Difficult
cases may require cortisone injections or surgery.
Sesamoiditis is a frustrating injury that takes
time to heal. Proper rest and treatment will provide
the greatest benefit and shortest healing time.
Back to Chiropractic Resources
 Dr. Carson Robertson is in private practice at
Alpha Chiropractic. His clinic services the
chiropractic, massage therapy, and physiotherapy
needs of the Chandler, Ahwatukee, and Gilbert area.
He has a special interest in athletics, running, and
soft tissue injuries. Carson Robertson DC can be
reached at (480) 812-1800. |
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