Sesamoiditis (Ball of Foot Pain)

The ball of the foot


Sesamoids are bones that are embedded into a tendon. These bones are found in many joints throughout the body. In your foot the sesamoids look like two little pea-shaped bones that are found within the ball of the foot on the underside of the big toe's joint. The purpose of the sesamoids is to act like a pulley for tendons providing mobility and leverage to the toe while walking and running.

Your foot works to evenly distribute your weight and the sesamoids help alleviate tension to the first metatarsal bone which then absorbs any weight to the ball of the foot while running, walking, and jumping.


Sesamoid injuries often involve the tendons, bones, and surrounding joint tissues. Participating in activities that increase pressure on the sesamoids, such as running, football, basketball, golf, ballet, and tennis, can put increased pressure on your sesamoids. People with high foot arches and people who wear high heels are also at increased risk.

There are three main sesamoid foot injuries:

Turf toe
Turf toe is when the surrounding soft tissue of the big toe's joint is injured. This injury happens when the big toe's joint is extended beyond what is normal. A "pop" can be felt when the injury happens and generally causes immediate swelling and sharp pain. 

An acute fracture is the result of trauma or direct impact with the bone. Acute sesamoid fractures cause immediate swelling and pain but do not affect the whole joint. Chronic fractures are hairline breaks caused by stress or overuse. These fractures cause pain in the ball of the foot that comes and goes.

Caused by overuse, sesamoiditis involves chronic inflammation within the sesamoid bones and tendons. Certain activities and shoes cause the pain to come and go.

Symptoms of sesamoiditis include:
  • Straightening and bending the big toe may be difficult and cause pain
  • Bruising and swelling could also be present
  • Pain, particularly under the big toe and ball of the foot
  • Pain may progress gradually with sesamoiditis, whereas fractures will cause immediate pain


Sesamoditis can cause a great deal of discomfort and pain. Don't let your injury get worse, give us a call at Mid Nebraska Foot Clinic and receive immediate help. 

Non surgical treatment is always the first option for sesamoid injuries.

These treatments include:
  • Taping, padding, or strapping. Padding may be applied inside the shoe to alleviate pressure to the inflamed sesamoid area. The toe may also be strapped or taped to relieve tension.
  • Immobilization and non-weight-bearing. A cast or cast-like walking boot may be applied. Crutches may also be recommended to help keep weight off the foot.
  • Oral medications. Anti-inflammatory drugs can be very helpful in reducing inflammation and pain.
  • Physical therapy, including range-of-motion exercises, strengthening, and conditioning, as well as ultrasound therapy may follow immobilization.
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