Sesamoiditis is a condition that involves inflammation or irritation of the sesamoid bones and the surrounding tendons in the forefoot. These tiny bones are located beneath the big toe joint and play an essential role in weight-bearing and movement. 

At Palms Physiotherapy & Allied Health, we specialise in the diagnosis, treatment, and rehabilitation of foot conditions like sesamoiditis.

Causes of Sesamoiditis

Overuse

• Repetitive high-impact activities like running, dancing, or basketball.

• Prolonged periods of walking or standing, especially in unsupportive footwear.

Biomechanical Factors

• High arches (pes cavus), which increase pressure on the ball of the foot.

• Abnormal foot mechanics, leading to uneven weight distribution.

External Factors

• Wearing high heels or shoes with minimal cushioning.

• Sudden increases in physical activity levels.

Trauma

• Direct impact or injury to the ball of the foot.

Symptoms of Sesamoiditis

• Big Toe Pain: Localized pain beneath the big toe, often worsening with activity.

• Swelling and Inflammation: Swelling around the ball of the foot.

• Difficulty Bending the Toe: Pain may increase when bending or pushing off the big toe.

• Tenderness: Sensitivity to touch or pressure beneath the big toe joint.

Diagnosis of Sesamoiditis

Clinical Examination

• Palpation to identify localized tenderness over the sesamoid bones.

• Evaluation of gait and weight distribution to pinpoint biomechanical contributors.

Imaging

• X-rays: Used to rule out fractures or arthritis in the sesamoid bones.

• MRI or Ultrasound: May be recommended to detect inflammation, tendon issues, or soft tissue damage.

Treatment for Sesamoiditis

Non-Surgical Management

1. Activity Modification

   • Rest and reduce weight-bearing activities.

   • Temporary use of crutches or a walking boot to alleviate stress on the sesamoids.

2. Physiotherapy

   • Strengthening Exercises: Focused on foot and lower leg muscles to improve stability.

   • Stretching Routines: Targeting the calf and foot to reduce strain on the sesamoids.

   • Manual Therapy: Techniques to improve joint mobility and reduce pain.

3. Footwear and Orthotics

   • Switching to cushioned, supportive footwear with low heels.

   • Custom orthotics or metatarsal pads to offload pressure from the sesamoid area.

4. Pain Management

   • Use of ice packs to reduce swelling and inflammation.

   • Non-steroidal anti-inflammatory drugs (NSAIDs) under medical supervision.

Surgical Management

Surgery is rarely required but may be considered for:

• Persistent pain that does not respond to conservative treatments.

• Chronic issues with sesamoid fractures or arthritis.

Recovery Timeline

• Initial Phase: 4–6 weeks of reduced activity to allow inflammation to subside.

• Rehabilitation Phase: Gradual reintroduction of weight-bearing and strengthening exercises.

• Full Recovery: Typically occurs within 6–12 weeks but varies depending on severity and adherence to treatment.

Preventing Sesamoiditis

• Wear supportive shoes with adequate cushioning, especially during high-impact activities.

• Avoid sudden increases in physical activity intensity.

• Strengthen foot and lower leg muscles to improve stability and shock absorption.

• Use orthotics if you have high arches or abnormal foot mechanics.

At Palms Physiotherapy & Allied Health, we’re committed to providing individualized care for sesamoiditis and other foot conditions. Reach out to us for expert diagnosis, tailored treatment plans, and ongoing support.

Australian Resources for Sesamoiditis

• Healthdirect Australia – Foot Pain and Problems
  https://www.healthdirect.gov.au/foot-pain-and-problems

• Better Health Channel – Foot Injuries
  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/foot-injuries

• Sports Medicine Australia – Foot Conditions
  https://sma.org.au/resources-advice/foot-conditions

Important disclaimer: This webpage contains general information only and is not intended to be relied upon as personal clinical advice. While we aim to keep information accurate and up to date, it may not reflect the most current research or your individual circumstances. Palms Physiotherapy & Allied Health does not accept liability for decisions made based on this information without an individualised assessment by an appropriately qualified health professional. If you have concerns, please contact us to book an assessment or speak with your GP/medical team.