Perhaps you have never heard of a sesamoid, but at Blue Ridge Foot & Ankle Clinic we see many people who are experiencing foot pain as a result of sports and leisure activities that put pressure on the ball of the foot, such as basketball, running, football, golf, tennis, or ballet, which can result in a sesamoid injury.
What are Sesamoids?
A sesamoid is a bone embedded in a tendon. In the foot, the sesamoids are two pea-shaped bones located in the ball of the foot, beneath the big toe joint. Sesamoids act as a pulley for the tendons, helping the big toe move normally and also providing necessary leverage for the big toe when it pushes off during walking and running. These sesamoids are also the weight-bearing surface for the long bone connected to the big toe, called the metatarsal bone.
Sesamoid injuries can involve the bones, tendons, and/or surrounding tissue in the joint. There are three main kinds of sesamoid injuries:
- Turf Toe: This injury of the soft tissue surrounding the big toe joint usually occurs when the big toe is extended beyond its normal range. You may feel a “pop” at the moment of injury and will usually feel a sharp pain, followed by swelling.
- Fracture: A break in a sesamoid bone can either be acute–caused by a trauma or impact to the bone–which results in immediate pain and swelling at the site of the break; or chronic–due to repetitive stress or overuse–which is characterized by ongoing pain that increases with activity and is relieved with rest.
- Sesamoiditis: This injury is a chronic inflammation of the sesamoid bones and tendons that is usually caused by overuse and activities that put increased pressure on the sesamoids. Its symptoms are a dull, longstanding pain beneath the big toe joint that usually worsens with particular activities or certain shoes.
Diagnosis and Treatment
Our board certified foot and ankle surgeons, Dr. Stewart M. Chang and Dr. Kevin P. Murray are experts in the central VA area in diagnosing sports related injuries. After a thorough examination of the foot and big toe area, the doctor may evaluate your walking and the wear pattern of your shoes. Digital x-rays, which can be done in either our Charlottesville or Fishersville office, may also be ordered. Once the diagnosis is confirmed, there are a variety of non-surgical treatments available, with surgery reserved for those people who do not respond to those treatments.