A sesamoid bone is a bone that is inside a tendon where the tendon passes over a joint. Tendons are strong bands of tissue that attach muscle to bone.
The ball of your foot contains two small sesamoid bones. These bones act as pulleys for the tendons and help flex or curl your big toe. When you run or jump, the sesamoid bones carry much of your body weight. They can get irritated or broken (fractured).
What is the cause?
A sesamoid fracture can be caused by landing too hard on the foot after a jump or fall. Cracks in the bone can be caused by wear and tear on the foot over time.
Sesamoid bones can get irritated by repeated stress on the ball of your foot. This can happen, for example, from:
Running, jumping, or dancing
Wearing high-heeled shoes
Tight calf muscles, high-arched feet, or feet that over-pronate (flatten out when you walk)
Some people naturally have a split in one or both sesamoid bones. The edges of the 2 pieces of bone may rub against each other and cause irritation.
What are the symptoms?
Symptoms may include:
Pain when you move your big toe, especially if you lift up the big toe
Tenderness to touch on the ball of your foot
Pain when you stand, walk, run, or jump
Swelling of your foot
How is it diagnosed?
Your provider will ask about your symptoms, medical history, and activities and examine your foot. Tests may include X-rays or other scans.
How is it treated?
Treatment includes rest and protecting the area from overuse. Your provider may recommend:
Wearing a pad that supports the bones
Shoe inserts called orthotics. Some shoe inserts limit the motion of your big toe. You can buy orthotics at a pharmacy or athletic shoe store or they can be custom made.
Taping your big toe to give support and limit movement
A removable walking cast to wear until the pain is gone
Your provider may give you a shot of steroid medicine. In some cases the painful sesamoid bone may need to be removed with surgery.
Sesamoid injuries may be painful for weeks to months. Sesamoid fractures may take 4 to 8 weeks to heal.
How can I take care of myself?
To keep swelling down and help relieve pain:
Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on your foot every 3 to 4 hours, for up to 20 minutes at a time.
Keep your foot up on a pillow when you sit or lie down.
Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age.
Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don’t take more than 3000 milligrams (mg) in 24 hours. To make sure you donâ€™t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
Use crutches as directed by your provider.
Ask your healthcare provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
How can I help prevent a sesamoid injury?
The best way to prevent a sesamoid injury is to wear well-made shoes that fit your feet and give good arch support and cushioning. This is especially important if you exercise or walk a lot or if you stand for a long time on hard surfaces. Get new athletic shoes before your old shoes stop supporting and cushioning your feet.
You should also:
Avoid repeated jarring to the foot.
Do leg and foot stretching exercises regularly.
Follow the safety rules and use the protective equipment recommended for your work or sport.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-22 Last reviewed: 2013-07-19
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Sesamoid Injury of the Foot: References
DeLee, Jesse C., David Drez, and Mark D. Miller, Orthopaedic Sports Medicine: Principles and Practice, Saunders; 3rd ed. 2009.
Greene, Walter B., M.D., and Griffin, Letha Y. (Ed), Essentials of Musculoskeletal Care, 4th ed. Amer Academy of Orthopaedic. 2010.
Kisner, Carol, and Lynn Colby, Therapeutic Exercise: Foundations and Techniques, F. A. Davis Company; 6th ed, 2012.
Oâ€™Connor, F., et al. ACSMâ€™s Sports Medicine: A Comprehensive Review. Lippincott Williams & Wilkins. 2012.