Foot

What It Is

Sesamoiditis is a condition that affects the tissues around the sesamoid bones in the foot. This condition can be quite painful. The sesamoid bones are quite small, each about the size of a kernel of corn, and their function is to assist the actions of the tendons. They act like pulleys, giving the tendons a smooth surface to slide over (AAOS, n.d.).

Sesamoiditis is irritation or inflammation of the tendons around the sesamoid bones; it is a form of tendinitis (AAOS, n.d.). It is common among ballet dancers, runners and baseball catchers (AAOS, n.d.), and can affect anyone who puts a lot of weight through the ball of the foot.

Sesamoiditis Anatomy

Most bones are connected by joints to the other bones. The sesamoid bones are not like that though. These tiny bones are embedded in tendons or muscle (AAOS, n.d.). They help the tendons pull more efficiently when the big toe bends (Artioli et al., 2025). In the foot, these bones are in the flexor hallucis brevis muscle and its tendons. The function of that particular muscle is to flex your big toe down.

With sesamoiditis, the pain is under the big toe on the ball of the foot, and it may develop gradually (AAOS, n.d.). A sudden onset of pain under the big toe after an injury may instead be a sesamoid fracture. Your doctor may use X-rays to check for a fracture and, if needed, other scans (AAOS, n.d.). Fortunately, most sesamoid problems go away without surgery (AAOS, n.d.).

The most common sesamoid bones to cause problems are the ones around the big toe.

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Sesamoiditis

1. Rest and Pain Relief

Stop the activity that is causing the pain and rest the foot (AAOS, n.d.). Each step puts pressure on the ball of the foot, so putting your feet up for a few days can help. The American Academy of Orthopaedic Surgeons says aspirin or ibuprofen can be taken to relieve the pain of sesamoiditis (AAOS, n.d.). (This medicine information comes from the American Academy of Orthopaedic Surgeons (OrthoInfo), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

2. Therapy

Taping your big toe so that it stays bent slightly downward is one of the treatments for sesamoiditis (AAOS, n.d.). I can assess your foot, tape your toe and show you how to do it yourself, and guide you back to activity with hands-on work and exercise. See the My Approach tab for how I work.

When the pain settles, return to activity gradually and avoid activities that put your weight on the balls of the feet (AAOS, n.d.).

3. Ice

Rest and ice the sole of the foot (AAOS, n.d.). Wrap an ice pack (or a bag of frozen vegetables) in a tea towel and apply it for up to 20 minutes every 2 to 3 hours (NHS, 2024). Never put ice directly on the skin.

Tips

Wear the Right Shoes

Wear soft-soled, low-heeled shoes. Stiff-soled shoes like clogs may also be comfortable (AAOS, n.d.).

Use a felt cushioning pad to relieve stress. As you return to activity, continue to wear a cushioning pad of dense foam rubber under the sesamoids to support them (AAOS, n.d.).

When you are exercising make sure that you are wearing sports shoes of good quality, and replace them when they wear out.

Orthotics

Orthotics (shoe inserts) and cushioning pads can help ease the pressure on these tiny bones (AAOS, n.d.). I can help you work out what you need and how to get it, and point you to a chiropodist or podiatrist if you need a custom orthotic.

Treatments you may want to discuss with your family doctor or nurse practitioner

Options outside my scope

Steroid injection: a doctor may recommend an injection of a steroid medicine to reduce swelling (AAOS, n.d.).
Fracture brace: if symptoms continue, a doctor may suggest a removable short-leg fracture brace (AAOS, n.d.).
Surgery: for long-standing sesamoiditis that has not improved with other treatment, surgery to partly or completely remove a sesamoid bone may be considered (AAOS, n.d.).

How I can help (see the My Approach tab)

Hands-on work for the foot and calf

Taping your big toe, and showing you how

Footwear and padding advice and a gradual return to activity

Treatment

My Approach

Sesamoiditis is irritation of the tendons around the small bones under your big toe, and it usually flares when the ball of the foot takes more load than it's ready for. My aim is to calm it down, take pressure off the area, and then build your foot and leg back up so they cope with walking, running, dancing or sport again.

I start by assessing your foot and ankle, how your big toe moves, how you take weight through the ball of the foot when you stand, walk or run, the strength and flexibility of your calf, and your activities and footwear. If the pain started suddenly after an injury, I'll suggest you see a doctor first to check for a fracture.

When It's Sore

Cutting back the activities that load the ball of the foot, while keeping you active with things like swimming or cycling
Keeping pressure off the sore spot and working the calf, the sole and the muscles that bend the big toe
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home
Taping your big toe so it stays bent slightly downward, and showing you how to tape it yourself

As It Settles

Gentle, pain-free movement for the big toe and ankle
Strength for the small muscles of the foot and the calf, starting with toe exercises and building to heel raises, balance and single-leg work
A home programme to do between visits
A gradual return to running, dancing or sport, building the load back up step by step

Soft-soled, low-heeled shoes and padding can take pressure off the area. I can help you work out whether an orthotic would help and how to get one, and point you to a chiropodist or podiatrist if you need a custom orthotic.

If the pain keeps getting worse despite rest, you can't put weight on the foot, or there's new swelling or bruising, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most people come once or twice a week at first, then weekly, with a reassessment at about 4 to 6 weeks, then less often as they manage more on their own. Sesamoiditis usually settles over weeks to a few months, with a gradual return to full activity.

What I Focus On

Assessment

Offloading & Taping

Calf & Foot Release

Foot & Calf Strength

Gradual Return to Activity

Sources

References

American Academy of Orthopaedic Surgeons (n.d.) Sesamoiditis and sesamoid fracture. OrthoInfo. Available at: https://www.orthoinfo.org/diseases--conditions/sesamoiditis/ (Accessed: 7 October 2026).
Artioli, E. et al. (2025) 'Hallux sesamoid nonunion: a comprehensive systematic review of current evidence', Journal of Personalized Medicine, 15(8), p. 342. doi: 10.3390/jpm15080342
NHS (2024) Sprains and strains. Available at: https://www.nhs.uk/conditions/sprains-and-strains/ (Accessed: 7 October 2026).

Massage therapy · Kitchener–WaterlooSesamoiditis

What It Is

Sesamoiditis Anatomy

Self-Care & Treatment

How to Treat Sesamoiditis

1. Rest and Pain Relief

2. Therapy

3. Ice

Tips

Treatments you may want to discuss with your family doctor or nurse practitioner

My Approach

When It's Sore

As It Settles

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooSesamoiditis

What It Is

Sesamoiditis Anatomy

Self-Care & Treatment

How to Treat Sesamoiditis

1. Rest and Pain Relief

2. Therapy

3. Ice

Tips

Treatments you may want to discuss with your family doctor or nurse practitioner

My Approach

When It's Sore

As It Settles

Typical Course

References

Related Conditions

Achilles Tendinopathy

Extensor Hallucis Tendinopathy

Extensor Tendinopathy of the Foot

First Metatarsophalangeal Joint Sprain

Book a session