It may seem weird but there are two tiny bones embedded in the tendon under your big toe, and these bones can become irritated and can lead to the injury called sesamoiditis. This injury is caused by any activity that makes you push off on the front of your foot. Every time you push off the front of your foot these bones are involved and when activity is vigorous or the amount of activity has increased these bones can become irritated and sometimes fractured. This injury is very common to dancers and gymnasts. Some of our favorite gymnasts like Shawn Johnson and Gabrielle Douglas are very prone to this injury due to their amount of activity.  Since these bones are located inside a tendon the irritation causes the tendon to become inflamed which adds to the pain. Even though there is a lot of pain associated with this injury there is no visible swelling or bruising on the foot. So how can this be diagnosed if there are no visible symptoms? This injury is unique in that the pain isn’t immediate, it is very gradual. It will start out as an ache and over time as the activity is continued the pain will become worse and worse.

Treatment for this injury is almost always noninvasive, rest, ice and pain killers are the most used forms of treatment. Steroid injections are a common treatment for athletes to reduce the pain and swelling. The big toe can also be taped to the toe next to it to reduce the amount of pressure placed on the big toe when pushing off from the front of your foot. 

Of course we would always rather prevent an injury then treat it, so how do professional athletes like Shawn Johnson and Gabrielle Douglas prevent themselves from getting and injury like this? This is done by giving your sesamoid bones cushioning and support, this is done by orthotic insoles. These are inserts that can be placed in your shoe to help prevent extra strain from being place on these bones.

You can talk to your local podiatrist, Dr. Shah at Affiliated Foot and Ankle Care in Monroe and Edison NJ, about either preventing or treating this injury!

By Nrupa Shah