Sesamoiditis is inflammation and irritation of the sesamoid bones—two small bones located under the ball of the foot at the base of the big toe. These bones act like pulleys to help the tendons move smoothly and provide leverage during push-off when walking or running.
When these bones or the tendons around them become overloaded, it leads to pain, swelling, and impaired mobility. While sesamoiditis is common in dancers and athletes, it also affects people who walk on hard surfaces or wear stiff, unsupportive shoes.
Common Symptoms
- Pain directly beneath the big toe joint (ball of foot)
- Discomfort when pushing off, walking barefoot, or wearing high heels
- Swelling or bruising under the toe
- Increased pain during activity or prolonged standing
- Tenderness with pressure on the sesamoids
What Causes Sesamoiditis?
At Bayshore Podiatry Center, we use the Tissue Stress Model to understand the root cause: the sesamoid bones are experiencing more stress than they can handle. This can result from:
- High-impact activity (running, jumping, dancing)
- Poor foot mechanics (e.g., high arches or excessive forefoot loading)
- Tight calf or Achilles tendons
- Wearing unsupportive shoes or walking barefoot
- Limited first toe joint motion or joint dysfunction (hallux limitus)
Diagnosis: How We Confirm It
We begin with a thorough physical exam and weightbearing assessment, followed by:
- In-office X-rays to check for bone abnormalities or fracture
- Diagnostic ultrasound or MRI (if needed) for soft tissue involvement
- Gait and footwear evaluation
How We Treat Sesamoiditis in Tampa
Treatment is focused on offloading the injured tissue, reducing inflammation, and restoring strength and mechanics:
✅ Offloading Strategies:
- Padding or taping to relieve pressure on the sesamoids
- Custom orthotics with forefoot modifications
- Shoe modifications (rocker-bottom shoes, stiff soles)
✅ Inflammation Control:
- MLS laser therapy for pain and tissue recovery
- Ice, rest, and activity modification
- Short-term immobilization (in severe cases)
✅ Rehabilitation:
- Strengthening of foot intrinsic and lower leg muscles
- Calf/Achilles stretching protocols
- Joint mobilization (if hallux motion is restricted)
✅ Advanced Therapies:
- Shockwave therapy for chronic or recurrent cases
- Wharton’s Jelly injection for severe degeneration or delayed healing
✅ Surgical Referral (Rare)
- Surgery is rarely needed but may be discussed in cases of sesamoid fracture or chronic degeneration not responding to conservative care.
When to Seek Help
If your pain under the big toe joint doesn’t improve with rest, or if it limits your ability to walk or exercise, it’s time for a professional evaluation. Delaying care can lead to chronic joint issues or long-term dysfunction.
Step Off the Pain—Let’s Fix the Root Problem
At Bayshore Podiatry Center, we take a biomechanical, tissue-specific approach to treat sesamoiditis effectively. Our goal is to relieve your pain while restoring safe, confident movement.
👉 Suspect sesamoiditis? Schedule your appointment today and let us help you get back on your feet—pain-free.
Bayshore Podiatry Center — Tampa’s Trusted Experts in Forefoot Pain and High-Performance Footcare