Sesamoiditis: Why the ball of your foot is killing you

Pain underneath the ball of the foot is a common injury we treat regularly

A common complaint we see when dealing with patients who exercise regularly or who have just started getting back into exercise is that they are experiencing pain underneath the ball of their foot. To be more precise, the pain is coming from the joint just before the big toe.

The ball of the foot has a number of structures that can get damaged due to high load. Of these are the sesamoid bones. The sesamoids are 2 pea-shaped bones which sit within a tendon beneath the big toe joint. Every time you put pressure on your forefoot to move forward, the sesamoid bones are subject to that pressure and load. And like any bone, the sesamoids can fracture or the tendons surrounding the sesamoids can get aggravated and inflamed. When this occurs, it is called sesamoiditis.

Foot posture and underfoot pressure distribution may also be factors causing sesamoiditis and can compound symptoms caused by exercise.

Symptoms of sesamoiditis

Most patients experiencing sesamoiditis identify the following symptoms:

  • sharp stabbing pain, like a bruise but worse;
  • inability to put body weight on the ball of the foot;
  • that the pain causes them to walk differently;
  • pain in the area even when not standing;
  • that the pain is made worse with activity.

Depending on severity, these symptoms may eventually resolve with rest. However, when patients return to activity there is a high rate of reoccurrence. Left untreated, sesamoiditis can progress to stress fractures, leading to long layoffs from sport or activity.

We can help

At The Foot Group, our qualified podiatrists can help. Using our state of the art Zebris Gait analysis machine, we can measure the precise pressure peaks and distribution underneath the feet when walking and running. We also monitor the function and efficiency of the biomechanics of the foot to enable us to provide a deeper understanding of why this pain is occurring and how to appropriately treat it.


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