What is Sesamoid Injury?

Sesamoid injury happens when a sesamoid bone or a surrounding tendon gets damaged during activity. A sesamoid bone is a bone that is connected to a tendon or muscle but not to a joint. Your kneecap is an example of a sesamoid bone.

Examples of sesamoid injuries include irritation, dislocation, or a crack or break (fracture) in a sesamoid bone. Most sesamoid injuries affect the sesamoid bones under the big toe. These bones help you to move forward during weight-bearing activities.

What are the causes?

This condition is caused by damage to a sesamoid bone or a surrounding tendon.

What increases the risk?

This condition is more likely to develop in people who:

• Dance ballet.
• Run.
• Play sports.
• Are active on artificial turf.
• Wear high heels.

What are the signs or symptoms?

Symptoms of this condition include:

• Pain under the big toe.
• Pain when you try to straighten your big toe.
• A popping sound that happens at the time of injury.
• Swelling.
• Bruising.

How is this diagnosed?

This condition is diagnosed with:

• A physical exam.
• Observation of your movement while you walk.
• An X-ray.
• Bone scans.

How is this treated?

Treatment for this condition depends on the location, type, and severity of the injury. Treatment may involve:

• Resting the affected area.
• Applying ice to the affected area.
• Taking over-the-counter pain medicine.
• Placing a cushioned pad in the shoe.
• Avoiding activities that are causing injury.
• Taping your toe to prevent movement.
• Getting steroid injections.
• Wearing a cast, brace, or orthotic shoe.
• Physical therapy.
• Surgery.

Follow these instructions at home:

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
• Do not put pressure on any part of the cast until it is fully hardened. This may take several hours.
• Do not let your cast get wet if it is not waterproof.
• Keep the cast clean.

If you have a brace:

• Wear the brace as told by your health care provider. Remove it only as told by your health care provider.
• Loosen the brace if your toes become numb and tingle, or if they turn cold and blue.
• Do not let your brace get wet if it is not waterproof.
• Keep the brace clean.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you can take showers. You may only be allowed to take sponge baths for bathing.
• If your cast or brace is not waterproof, cover it with a watertight plastic bag when you take a bath or shower.

Managing pain, stiffness, and swelling

• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

Driving

• Do not drive or operate heavy machinery while taking certain prescription pain medicines.
• Ask your health care provider when it is safe to drive if you have a cast, brace, or orthotic shoe on a foot that you use for driving.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider or physical therapist.

Safety

• Do not use the injured limb to support your body weight until your health care provider says that you can. Use crutches as told by your health care provider.

General instructions

• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay bone healing. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• Pain and swelling continue even with treatment.
• Pain and swelling return after you get back to your normal activities.
• You cannot put pressure on your foot.

Get help right away if:

• You lose sensation in your foot.
• Your toes turn cold and blue.