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Sesamoid injury

A sesamoid injury is any injury to the sesamoid bones. The sesamoid bones are two small bones that sit next to each other underneath the head of the first metatarsal (the ball of the big toe).

What is a sesamoid injury?

A sesamoid injury describes an injury to either one or both the sesamoid bones. The sesamoid bones are two small round bones, about the size of a small pea, that sit within a tendon just beneath the big toe. This is known as the first metatarsal head.

What causes a sesamoid injury?

The sesamoids can be injured any number of ways; however, the most common cause of sesamoid injury is either overuse or direct trauma. Some people are more at risk of developing a sesamoid injury, they include:

  • Those with a high arched foot
  • Those with a low arched foot
  • Those with a prominent first metatarsal head
  • Those who wear Ill-fitting footwear/high heeled shoes
  • Those who participate in sport/activity that places a lot of stress on the big toe joint

What are the signs and symptoms of a sesamoid injury?

The signs and symptoms of a big toe sprain will vary depending on the type of injury. With all sesamoid injuries however, pain will be felt at the site of the sesamoids. The sesamoid bones are positioned at the head of the first metatarsal, which is the ball of the foot behind the big toe joint.

Some common signs and symptoms sesamoid injury include:

  • Swelling
  • Bruising
  • Pain/tenderness
  • Restricted movement

What types of sesamoid injury are there?

There are three main types of sesamoid injury, they are:

Turf toe:
Turf toe (or big toe sprain) is a hyper-extension injury of the big toe. Turf toe occurs when the big toe is extended beyond its normal range of movement. When the big toe hyper-extends, the ligaments that hold the joint together are over-stretched and this causes pain.

Sesamoiditis refers to inflammation of the sesamoid bones, as well as the tendon in which they are embedded. Sesamoiditis appears as a result of too much pressure being placed on the big toe joint and consequently; the sesamoids.

Stress Fracture:
Stress fractures to the sesamoids can be either chronic or acute. A chronic fracture (stress fracture) is one that has developed over time as a result of repetitive stress. An acute fracture is one that has been caused by a direct trauma, which leads to an actual 'break' in the sesamoid bone.

How is a sesamoid injury diagnosed?

Sesamoid injuries can be diagnosed by a podiatrist. Our podiatrists are experts in the foot and lower limb; they will therefore be abler to distinguish one type of sesamoid injury from another. A diagnosis will be based on the signs and symptoms, a thorough and comprehensive history, and an examination of the joint and sesamoids themselves. Our podiatrists will then be able to devise a treatment plan specific to you.

Benefits of podiatry for a sesamoid injury

If you have a sesamoid injury, following assessment and treatment at you can expect the following benefits:

  • Reduction in pain
  • Reduction in inflammation
  • Improvement in foot and lower limb mechanics
  • Improvement in gait
  • Cause, not just the symptoms treated
  • Improvement in range of movement

What would podiatry for a sesamoid injury involve?

Our podiatrists would first need to obtain a thorough history from you, which will include both a medical history and a history of the problem itself. This will then be used along with an assessment and examination of the foot and sesamoids to form a diagnosis. In order to alleviate the symptoms of a sesamoid injury you will require a Biomechanical assessment . A biomechanical assessment allows the podiatrist to assess the way the foot is functioning and includes a gait analysis (an analysis of the way you walk and/or run) so that Orthoses can be prescribed. Orthoses helps to put the foot back into normal alignment so that it functions correctly, re-directing pressure away from high pressure areas and reducing pain.


A sesamoid injury describes an injury to either one or both of the sesamoids (two small bones that sit within a tendon at the ball of the big toe).

There are three main types of sesamoid injury:

If you think you may have injured your sesamoids visit a podiatrist who will be able to devise a treatment plan specific to you. The aim of which will be to alleviate any pain and inflammation and promote healing, so that you can continue with your activities pain free.

To arrange an assessment with one our podiatrists please email or call 0330 088 4222.

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