Sesamoiditis (Pain under the big toe joint)

Updated: Oct 7, 2019

Cause: Overuse, high arch foot, shoes with poor forefoot support.

Appearance: Pain under the big toe joint, difficulty with pushing off, pain in foot while serving

How to Diagnose: X-ray, clinical exam, MRI


- 4 week of immobilization is first line treatment due to the chronic nature of this injury.

- Ice and anti-inflammatories (if ok to take)

- Maximalist tennis shoes and custom offloading pad/orthotics help prevent recurrence

- Surgery is an option only in cases where a lengthy course of conservative care has failed. Surgery for this condition has a host of complications for the athlete trying to get back to full activity.

Long-term prognosis: Early immobilization is critical for tennis players with sesamoiditis given the nature of the sport and its stress on the athlete's forefoot. If immobilized in a timely manner full recovery potential is good. Chronic cases should be managed meticulously with offloading and inflammation management. Custom offloading pads are easy to make and work well (see gallery below)

. If surgery is required, the patient-athlete should be adequately counseled on the potential complications including chronic pain and deformity of the toe.

Who to call: Podiatrist, orthopedic surgeon

11 views0 comments

Recent Posts

See All