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Sesamoids are the only bones in the body that are not connected to another bone, but rather solely connected by tendons or embedded in a mass of muscle. There are three sesamoids: the kneecap, which is the largest, and two small, pea-sized sesamoids located on either side of the big toe. Because of sesamoids’ unique no-bone-to-bone contact characteristic, they act like pulleys, increasing the tendons’ abilities to transmit muscle force, assist with the foot’s ability to bear weight, and elevate the bones of the big toe.
Sesamoiditis is a form of tendonitis where the tendons surrounding the sesamoids become irritated or inflamed, caused by fracturing of the sesamoid bones, rupturing its accompanying tendons, or incessantly bearing increased stress.
Marked by dull, intensifying pain beneath the big toe, this condition makes it difficult and painful for the big toe to push off while an individual is running or walking, and reduces the strength of the foot—lessening its weight-bearing potential and causing an affected individual discomfort.
Depending on the cause of development, sesamoiditis symptoms will vary—with immediate pain indicating the presence of a fracture to the sesamoids and gradual development of pain indicating tendonitis caused by an increase of applied stress to the affected area.In addition to the most reported symptom of pain, affected individuals may experience difficulty bending and straightening the big toe, along with the potential presence of swelling and bruising.If left untreated, sesamoiditis symptoms will intensify and turn into a constant, debilitating foot pain.
Our physicians will examine the patient’s foot to look for tenderness at the sesamoids bones, while strategically manipulating the big toe to see which movements intensify the pain. In addition, our foot and ankle specialists may take X-rays of the forefoot to confirm diagnosis.
Despite the rarity of the need for surgery, our expert podiatrists may recommend it as a treatment approach for extremely severe cases and when no other methods manage to provide the patient with relief.