If your podiatrist gave you a diagnosis of Sesamoiditis and didn’t have time to discuss the details, you’ve come to the right place, we’ll take up the matter where they left off.
Sesamoiditis is an inflammation of the sesamoid bones in the body. If it was your podiatrist who gave you the diagnosis, the sesamoid bones in the foot are the ones that are causing you all the grief.
It’s funny that all the bones in the body are named specific names – except for the sesamoid bones. These are very small bones, usually about the size of a jelly bean, located on the hands, feet, and legs. These are the only bones of the body that aren’t attached to any other bone. Instead, they’re found within a muscle or tendon. Odd, isn’t it? Many people wonder, how did they get there in the first place?
Well, no one knows how the sesamoid bones appear in muscles like the gastrocnemius (calf muscle) or the Peroneus longus muscle in the feet, but they’re there in about 22% and 28% respectively of the cadavers that were examined. And when it comes to the feet, most people have two sesamoid bones located right underneath the big toe on the ball of the foot and another sesamoid bone underneath each of the other four toes. The largest sesamoid bone in the body is the patella bone, which hangs onto the Quadriceps tendon.
The point is that they’re there for a purpose. Wherever there are tendons that are subject to large compressive forces, you’ll find a sesamoid bone. Take the foot for example. When you jump, you increase the compressive force on the foot. Those jelly bean sesamoid bones absorb some of the compression forces.
Now if you’ve been jumping in your exercise routines, guess what happens. The sesamoid bones can easily get inflamed and you end up with sesamoiditis. Each sesamoid bone in the foot bears one-sixth of the weight of the forefoot. Sesamoid bones also allow tendons to slide easily during movement.
The most common sesamoid bones to develop sesamoiditis are the two attached to the big toe through the flexor hallucis longus muscle, which allows you to flex your big toe. The inflammation can extend into the joint between the big toe and the first long bone (metatarsal) of the foot.
You can develop sesamoiditis by a direct injury to these small bones. For example, if you’re out hiking and step on a jagged rock that pierces the sesamoid bone, you can expect sesamoiditis to occur. More often, sesamoiditis is due to overuse, much like carpal tunnel syndrome is from overuse of the hands in an improper ergonomic pose.
Sesamoiditis is spurred on by:
jumping on the balls of the feet (this is exactly where the sesamoids are located)
wearing high heeled shoes that place the weight on the ball of the foot
wearing thin-soled shoes
baseball catcher activities where a person is constantly squatting
There are a few other conditions that can predispose you to develop sesamoiditis:
1. High Arches in the Feet
When someone has high arches, the weight of the body is supported by the ball of the foot more often than in someone without a high arch. This means that those sesamoids on the ball of the foot are overworked.
2. Pronated feet
If your feet roll towards the outside at your ankle, you end up walking more on the ball of your foot, causing sesamoiditis.
3. Enlargement of the sesamoids
In the case of the sesamoids in the foot, bigger is not better. The bigger they are, the more body weight is placed upon them, irritating them, causing sesamoiditis.
4. Big toe tilted down instead of lying straight in alignment with the other bones of the foot
When the big toe is tilted down, the first thing to hit the pavement when you walk is the sesamoids. Every step becomes an invitation to them to inflame and even begin to wear away completely.
If you have sesamoiditis in your foot, you most likely have these symptoms:
• tenderness over the sesamoid bone that is inflamed, usually right behind the big toe
• heat over the sesamoid bone affected with sesamoiditis
• redness and swelling around the area of the sesamoids
• pain if you’re walking barefoot
• pain is alleviated when you rest
• pain is increased while running and jumping
• stiffness in the big toe
The symptoms usually come on gradually unless you have experienced a trauma to the foot.
There are several small guidelines from The Insole Store.com that you can follow which will help relieve the pain of sesamoiditis. The easiest way to obtain relief is to begin using metatarsal pads or ball of foot pads. These can be used by themselves or are already included in an insole, such as the Pedag Comfort Leather insoles.
What these metatarsal pads or ball of foot pads do is cushion the ball of the foot. They prevent your foot from sliding forward in your shoes and improve how your shoe fits your foot. Ball of foot pads can be used no matter what shoes you wear. For extra support to the sesamoid bones, you may want to consider metatarsal foot pads that are made with gel. One particular brand includes an antimicrobial top cloth, which can help reduce foot odor.
Pedag Comfort Leather Insoles are not the full length of the foot, but rather three-fourths instead. The insole is made of vegetable tanned leather and latex (hypoallergenic). It has the metatarsal pad within it, which allows the metatarsal bones to be positioned correctly anatomically, especially helpful for those who may have malalignment of the big toe. Pedag Comfort Insoles have extra padding in the heel, making every step you take like a breath of fresh air with relief.
Now if your looking for a full length cushioned insole, The Sof Sole Airr Performance Insoles should be your first choice. They are a dense padded cushioned insole with a metatarsal (ball of foot) gel pad insert in the forefoot. If having an orthotic arch is key -check out the Powerstep Pinnacle Plus Orthotic Insoles with a raised cushioned metatarsal pad built into the semi-rigid arch supports.
Other guidelines to follow for sesamoiditis include:
1. Avoid narrow shoes, which squeeze the sesamoids together, putting pressure on them. Wear shoes wide enough for your feet.
2. Don’t go anywhere without the metatarsal pads or ball of foot pads or Pedag comfort leather insoles.
3. Avoid high heels, heels greater than one inch tall.
4. Reduce your walking (or running) when you have a flare-up.
5. Give yourself a warm foot bath to soothe the area.
6. Change activities or exercise that puts too much pressure on the sesamoids.
Sesamoiditis usually doesn’t need surgical intervention, so you must take action today. Don’t let this condition continue for too long – save your sesamoids from stress, wear and tear and let The Insole Store.com help provide the proper cushion insole Today.
by Dr. Donna Schwontkowski (ret. D.C.)