Sesamoid Injuries

Sesamoids, which are bones embedded in a tendon, are found in several joints in the body. In the human foot, sesamoids are two pea-shaped bones located in the ball of the foot beneath the big toe joint. Sesamoids act as pullies for the tendons to allow the big toe to move normally. Sesamoids also allow the big toe to push off during walking or running. In addition, sesamoids serve as a weight bearing surface for the first metatarsal bone. In the case of a sesamoid injury, the damage can involve the bones, tendons, and/or surrounding tissue in the joint. Such injuries are often associated with activities ranging from running to playing basketball to dancing. There are three types of sesamoid injuries: turf toe, fractures, and sesamoiditis. Turf toe is an injury to the soft tissue surrounding the big toe joint. Fractures are breaks in the bone. Acute fractures are caused by trauma such as a direct blow, while chronic fractures are hairline breaks that are caused by repeated use. Sesamoiditis is an overuse injury that results in chronic inflammation. Nonsurgical interventions can include padding, strapping, or taping; immobilization; nonsteroidal anti-inflammatory drugs (NSAIDs); orthotic devices, physical therapy, and steroid injections. When such injuries do not respond to nonsurgical treatment, surgery may be warranted.

“Sesamoid injuries are often associated with activities requiring increased pressure on the ball of the foot, such as running; playing basketball, football, golf, or tennis; and ballet. In addition, people with high arches are at risk for developing sesamoid problems.”