Brief Outline of Sesamoiditis
The tendons surrounding the sesamoid bones can become irritated and inflamed, causing a condition similar to tendinitis. Runners, dancers, and catchers in baseball are all susceptible to this injury. Increasing activity too quickly causes additional trauma to the small sesamoid bones.
Anatomy and Physiology of Sesamoiditis
A sesamoid is a small nodular bone that is not attached to another bone, but instead is embedded in a tendon or joint. The knee cap is the largest sesamoid bone in the body but there are also two small ones in the forefoot. The sesamoid bones in the foot are located along the plantar fascia surface of the first metatarsal head, with one on the lateral aspect, and the other more medial. The sesamoid bones are spherical and embedded in the tendon of the flexor hallucis brevis. They provide a smooth surface for the tendon to travel over and help the tendon to transmit the force generated by the muscles. The sesamoid bones in the foot also help elevate the bones of the big toe and assist in weight bearing.
Cause of Sesamoiditis
Increased acitivity without proper conditioning. Little natural padding in the forefoot, leaving the sesamoid bones unprotected. High arches leading to running on the balls of the feet.
Signs and Symptoms of Sesamoiditis
Gradual onset of pain. Pain over the bone and surrounding tendon. Pain increases with activity.
Complications If Left Sesamoiditis Unattended
If left sesamoiditis unattended, this condition can worsen to the point that the pain becomes debilitating. The inflammation in the tendon can cause irritation to surrounding tissue. As with tendinitis, a complete rupture may occur if the condition is allowed to go untreated.
Immediate Treatment for Sesamoiditis
Anti-inflammatory medication or anti-inflammatory injection.
Long-term Prognosis for Sesamoiditis
Sesamoiditis responds well to anti-inflammatory treatments. Complete recovery can be expected, with no lingering effects. In rare cases where the condition does not respond to preliminary treatments, surgical intervention may be required.