Shoes for Sesamoiditis

Sesamoiditis is an inflammation of the sesamoid bones in the ball of the foot and the tendons they are embedded in. It is a common ailment, typically among runners, athletes, and dancers, due to frequent weight bearing on the balls of their feet.

The most common symptom of sesamoiditis is pain in the ball of the foot, especially on the medial or inner side. Sesamoiditis refers to any irritation of the sesamoid bones, tiny bones within the tendons running to the big toe. Like the kneecap, the sesamoids function as a pulley, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe, the sesamoids are involved. With repeated, strenuous use, they can become irritated, even fractured. Because the bones are embedded within the tendons, sesamoiditis is really a kind of tendinitis, as the tendons around the bones become inflamed as well.

Sesamoiditis symptoms typically can be distinguished from other forefoot conditions by their gradual onset. The pain usually begins as a mild ache and increases as the aggravating activity continues. Discomfort may build to an intense throbbing. In most cases, little or no bruising or redness is present.

One major cause of sesamoiditis is increased activity. Perhaps you’ve stepped up your activity level lately, putting more pressure on the balls of your feet. Speedwork, hillwork, or even increased mileage can cause this. If you have a bony foot, you simply may not have enough fat on your foot to protect your tender sesamoids. If you have high arches, you naturally run on the balls of your feet, adding even more pressure.

Treatment for sesamoiditis may include a strict period of rest along with the use of a modified shoe or a shoe pad to reduce pressure on the affected area. A metatarsal pad may be placed away from the joint to redistribute weight-bearing pressure to other parts of the forefoot. In addition, the big toe may be bound with tape or athletic strapping to immobilize the joint and allow for healing. Decreased activity may be recommended to give your sesamoids time to heal. Anti-inflammatories and icing the area for 10 to 15 minutes after exercise or activity may help to decrease swelling. While the injury is healing, flat shoes should be worn daily.