Sesamoiditis
Sesamoiditis is a common ailment that affects the forefoot, typically in
young people who engage in physical activity like running or dancing. Its most
common symptom is pain in the ball-of-the-foot, especially on the medial or
inner side. The term is a general description for any irritation of the sesamoid
bones, which are tiny bones within the tendons that run 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, and eventually they can become irritated, even
fractured. Because the bones are actually within the tendons, sesamoiditis is
really a kind of tendinitis - the tendons around the bones become inflamed as
well.
Sesamoiditis typically can be distinguished from other forefoot conditions by
its gradual onset. The pain usually begins as a mild ache and increases
gradually as the aggravating activity is continued. It may build to an intense
throbbing. In most cases there is little or no bruising or redness. One of the
major causes of sesamoiditis is increased activity. You've probably stepped up
your activity level lately, which has forced you to put 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. Also, if you have a high arched foot, you will
naturally run on the balls-of-your-feet, adding even more pressure.
Treatment for sesamoiditis is almost always noninvasive. Minor cases call for
a strict period of rest, along with the use of a modified shoe or a shoe pad to
reduce pressure on the affected area. This may be accomplished by placing a
metatarsal pad away from the joint so that it redistributes the pressure of
weight bearing to other parts of the forefoot. In addition, the big toe may be
bound with tape or athletic strapping to immobilize the joint as much as
possible and allow for healing to occur. It is recommended to decrease or stop
activity for awhile. This will give your sesamoids time to heal. You should
apply ice to the area for 10 to 15 minutes after exercise, or after any activity
that aggravates the area. As with icing, anti-inflammatories will help the
swelling go down so healing can begin. While the injury is healing, women should
wear flat shoes on a daily basis. If home remedies do not work, see your doctor
for a correct diagnosis.
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