What are Sesamoid Injuries in the Foot?
Sesamoid injuries in the foot often involve the two small bones located on the underside of the big toe joint. The purpose of these two, pea-shaped bones are to act as pulleys to encourage smooth movement of the big toe. They also provide leverage when pushing off the ground during movements like running and walking.
Types of Sesamoid Injuries in the Foot:
Turf Toe – In turf toe, the soft tissue surrounding the big toe joint is injured. This typically occurs when the big toe joint extends beyond its functional range. This can cause an immediate, sharp pain, followed by swelling. Typically, the entire big toe joint is affected, thereby limiting the patient’s range of motion. An injury causing turf toe may result in an injury to the soft tissue which attaches to the sesamoid bone and can cause it to fracture. Patients with turf toe often recall hearing a “pop” sound when the injury occurred.
Fracture – In a fracture of the sesamoid bone, the extend of the break can either be acute or chronic. An acute fracture can be caused by trauma, such as a direct blow or impact to the bone, which will produce immediate pain and swelling to the area, but not the big toe joint. A chronic fracture, however, is more like a hairline break or stress fracture, which can cause longstanding pain in the ball of the foot that comes and goes and is aggravated with activities.
Sesamoiditis – Sesamoiditis is an overuse injury involving chronic inflammation of the sesamoid bones and the surrounding, supporting tendons. This condition can be caused by an increase or pressure on these specific bones in the food and is characterized by chronic pain under the big toe joint that comes and goes and occurring with the use of certain shoes or during certain activities.
Causes and Symptoms of a Sesamoid Injury in the Foot:
Sesamoid injuries can range from minor to fractures. Minor sesamoid injuries typically only involve inflammation of these two, small bones, which is also known as sesamoiditis. Common causes of sesamoid injuries in the foot stem from activities that involve repetitive movement like dancing or running. Due to the nature of these injuries, athletes are more prone to sesamoid injuries, among other populations such as those with flat feet, pronating feet, or those with gout. Wearing high heels can also lead to a sesamoid injury in the foot, along with trauma to the foot.
If you suspect a sesamoid injury in your foot, here are some symptoms that could bolster your theory:
- Pain under the big toe
- Difficulty bending the big toe
- Difficulty weight bearing or walking
- Swelling
- Redness
- Bruising
Diagnosing a Sesamoid Injury in the foot:
Your doctor will likely begin the diagnosis process by examining your foot, focusing specifically on the joint of the big toe, often pressing on it, moving it up or down, and analyzing your gait along with any patterns evident of unusual wear on the bottom of your shoes. Often, further imaging tests such as x-rays, are ordered to further examine the extent of the injury.
Treatment for a Sesamoid Injury in the foot:
Following a diagnostic procedures and tests, your doctor will read and interpret the results, and form a treatment plan best suited to your specific condition. Treatment for a sesamoid injury in the foot will often involve rest, ice and pain management via over-the-counter medications. In more severe sesamoid injuries where a fracture is present, immobilization with a cast or boot, or surgery, may be recommended by your healthcare provider to repair and promote healing.