Sesamoids
(ball
of
the
foot
pain)
|
Definition
Most
bones
in
the
human
body
are
connected
to
each
other
at
joints.
But
there
are
a
few
bones
that
are
not
connected
to
any
other
bone.
Instead,
they
are
connected
only
to
tendons
or
are
embedded
in
muscle.
These
are
the
sesamoids.
The
kneecap
(patella)
is
the
largest
sesamoid.
Two
other
very
small
sesamoids
(about
the
size
of
a
kernel
of
corn)
are
found
in
the
underside
of
the
forefoot
near
the
great
toe,
one
on
the
outer
side
of
the
foot
and
the
other
closer
to
the
middle
of
the
foot.
Sesamoids
act
like
pulleys.
They
provide
a
smooth
surface
over
which
the
tendons
slide,
thus
increasing
the
ability
of
the
tendons
to
transmit
muscle
forces.
The
sesamoids
in
the
forefoot
also
assist
with
weightbearing
and
help
elevate
the
bones
of
the
great
toe.
Like
other
bones,
sesamoids
can
break
(fracture).
Additionally,
the
tendons
surrounding
the
sesamoids
can
become
irritated
or
inflamed.
This
is
called
sesamoiditis
and
is
a
form
of
tendinitis.
It
is
common
among
ballet
dancers,
runners
and
baseball
catchers.
Symptoms
Pain
is
focused
under
the
great
toe
on
the
ball
of
the
foot.
With
sesamoiditis,
pain
may
develop
gradually;
with
a
fracture,
pain
will
be
immediate.
Swelling
and
bruising
may
or
may
not
be
present.
You
may
experience
difficulty
and
pain
in
bending
and
straightening
the
great
toe.
Signs
and
Tests
On
physical
exam,
a
doctor
will
look
for
tenderness
along
the
affected
tendon
and
pain
when
the
muscle
to
which
the
tendon
is
attached
is
used
against
resistance.
There
are
specific
tests
for
specific
tendons.
The
tendon
can
be
inflamed
and
the
overlying
skin
may
be
warm
and
red.
Expectations
(prognosis)
During
the
examination,
the
physician
will
look
for
tenderness
at
the
sesamoid
bones.
Your
doctor
may
manipulate
the
bone
slightly
or
ask
you
to
bend
and
straighten
the
toe.
He
or
she
may
also
bend
the
great
toe
up
toward
the
top
of
the
foot
to
see
if
the
pain
intensifies.
Your
physician
will
request
X-rays
of
the
forefoot
to
ensure
a
proper
diagnosis.
In
many
people,
the
sesamoid
bone
nearer
the
center
of
the
foot
(the
medial
sesamoid)
has
two
parts
(bipartite).
Because
the
edges
of
a
bipartite
medial
sesamoid
are
generally
smooth,
and
the
edges
of
a
fractured
sesamoid
are
generally
jagged,
an
X-ray
is
useful
in
making
an
appropriate
diagnosis.
Your
physician
may
also
request
X-rays
of
the
other
foot
to
compare
the
bone
structure.
If
the
X-rays
appear
normal,
the
physician
may
request
a
bone
scan.
Treatment
Treatment
is
generally
nonoperative.
However,
if
conservative
measures
fail,
your
physician
may
recommend
surgery
to
remove
the
sesamoid
bone.
Sesamoiditis
-
Stop
the
activity
causing
the
pain.
-
Take
aspirin
or
ibuprofen
to
relieve
the
pain.
-
Rest
and
ice
the
sole
of
your
feet.
Do
not
apply
ice
directly
to
the
skin,
but
use
an
ice
pack
or
wrap
the
ice
in
a
towel.
-
Wear
soft-soled,
low-heeled
shoes.
Stiff-soled
shoes
like
clogs
may
also
be
comfortable.
-
Use
a
felt
cushioning
pad
to
relieve
stress.
-
Return
to
activity
gradually,
and
continue
to
wear
a
cushioning
pad
of
dense
foam
rubber
under
the
sesamoids
to
support
them.
Avoid
activities
that
put
your
weight
on
the
balls
of
the
feet.
-
Tape
the
great
toe
so
that
it
remains
bent
slightly
downward
(plantar
flexion).
-
Your
doctor
may
recommend
an
injection
of
a
steroid
medication
to
reduce
swelling.
-
If
symptoms
persist,
you
may
need
to
wear
a
removable
short
leg
fracture
brace
for
4
to
6
weeks.
Fracture
of
the
sesamoid
-
You
will
need
to
wear
a
stiff-soled
shoe
or
a
short,
leg-fracture
brace.
-
Your
physician
may
tape
the
joint
to
limit
movement
of
the
great
toe.
-
You
may
have
to
wear
a
J-shaped
pad
around
the
area
of
the
sesamoid
to
relieve
pressure
as
the
fracture
heals.
-
Pain
relievers
such
as
aspirin
or
ibuprofen
may
be
recommended.
-
It
may
take
several
months
for
the
discomfort
to
subside.
-
Cushioning
pads
or
other
orthotic
devices
are
often
helpful
as
the
fracture
heals.
Recommendation
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Orthotics
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Full
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The
content
is
not
intended
to
be
a
substitute
for
professional
medical
advice,
diagnosis,
or
treatment.
Always
seek
the
advice
of
your
physician
with
any
questions
you
may
have
regarding
a
medical
condition.
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site
does
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advice.
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