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Advanced Podiatric Procedures & Services in Los Angeles, CA


The front portion of your foot is constantly in motion when you are walking or standings. It helps you to maintain balance and stability. It's also the portion of the foot that pushes off each time you take a step. The sesamoid bones are located in the ball of your foot and bear much of the pressure and force as you take each step. Sesamoiditis is a common condition that can occur in athletes and other individuals who are extremely active.

What Is Sesamoiditis?

The two sesamoid bones are extremely small and are located next to the tendons that run from the ball of the foot to the big toe. They function in much the same fashion as the patella or kneecap. The kneecap's purpose is to allow the tendons to extend further, providing leverage that makes it possible for the joint to function properly. The sesamoid bones serve the same purpose. Sesamoiditis occurs when the tendons that encase the two small bones become inflamed. The inflammation restricts regular joint movement, making it difficult to bend the big toe or walk without extreme pain or discomfort. Even though the sesamoid bones are not connected to another bone, they can be broken and damaged much like the others.

Common Causes

Sesamoiditis is a form of tendonitis that affects the two small sesamoid bones that lie under the joint of the big toe. It is often associated with overuse and placing excessive amounts of pressure on the ball of the foot for long periods of time. Wearing shoes that fit poorly or provide very little support to the feet can also cause the inflammation to occur. The constant stress that is placed on the balls of the feet during certain types of activities can also lead to chronic inflammation and tendonitis of the sesamoid bones. If the condition is left untreated, the inflammation may become chronic requiring long-term treatment.

Signs and Symptoms

The symptoms associated with sesamoiditis often come and go with the amount of movement the foot experiences. Depending on the cause, the pain may be intermittent or chronic. In most cases, wearing shoes that have some type of insert or support will help to alleviate some of the pain while you are walking or moving about. Because the condition is a form of tendonitis, the pain is similar to that of a wrist or elbow injury.

The longer you continue to ignore the signs, the more inflamed the tendons will become. People often associate pain in the arch or along the bottom of the foot with plantar fasciitis. Sesamoiditis occurs near the ball of the foot, not along the arch like fasciitis. It is also more intense when constant pressure is applied to the area. With fasciitis, the pain is more constant, especially when the tendons are stretched.


In order for Dr. Fihman to diagnose sesamoiditis, a thorough clinical evaluation must be performed to determine if any other problems are also present. A sharp blow to the ball of the foot can actually fracture the small sesamoid bones. If the healing goes well, you may not experience any further pain. If the bones are intact and the tendons are inflamed or irritated, sesamoiditis may be the cause. An x-ray or MRI may be used to diagnose a break or a dislocation. If the entire circumference of the ball of the foot is inflamed or affected in any way, arthrocentesis may be used to make the diagnosis.

Treatment Options

Both shoes and activities may be the cause of the sesamoiditis. Once a diagnosis has been made, Dr. Fihman will also be able to determine the cause of the problem. If the cause has to do with a specific type of shoes, simply changing your shoes or using orthotics may help relieve the pressure and allow the inflammation to dissipate.

If a certain activity is suspected, you may need to purchase a set of shoes that better support your feet while you are participating. If the problem becomes too severe, you may have to forego the activity altogether. You may be able to extend the amount of time simply by using R.I.C.E. (rest, ice, compression, and elevate) after each competition or activity. When it comes to any type of tendonitis or inflammation of the tendons, rest offers the greatest benefits when it comes to speeding up the healing process.

When chronic sesamoiditis is diagnosed and there are no specific triggers, orthotics may provide the support your feet need. People who live extremely active lives can't afford to let foot pain come between themselves and their jobs or the things they love to do. Seeking treatment at the first sign of pain is extremely important if you want to maintain your current level of activity without experiencing pain and discomfort.

Orthotics are a simple form of treatment that offers a wide variety of benefits. They help to restore balance throughout the body as you walk and also reduce the amount of pressure your feet must accommodate with each step. Orthotics are designed to provide support while remaining your foot to be fully flexible. They are manufactured using an exact model of the bottom of your foot so they fit comfortably and securely when you walk or run.

Aftercare and Prevention

As with most forms of tendonitis, surgery is normally not an option for sesamoiditis. Physical therapy, stretching exercises, and orthotics are often the primary forms of treatment. Pain medications and anti-inflammatory medications may be used to help reduce the discomfort associated with the inflammation of the tendons. Therapeutic foot baths can relax the muscles in the feet relieving tension and pressure that often builds within the foot after a long day.

Massage therapy may also be beneficial because it improves circulation to the affected area and helps to break down the inflamed tissues. It can also help you to maintain flexibility and range of motion. In addition to stretching and manipulating the soft tissues of the foot, it works the tendons and ligaments as well without placing any additional stress or pressure on them.

Once the condition is brought back under control, the key is to prevent it from recurring. Learn what type of shoes cause the pain and discomfort and avoid them. If you participate in activities that tend to irritate the tendons and fascia along the bottom of the foot, look into having custom-made orthotics created that fit inside your shoes and provide your feet with the support they need. Orthotics will fit into most types of shoes and will cushion the ball and heel of your foot so that you can walk comfortably.

It's also important to visit your podiatrist once a year for a complete evaluation of your feet. Dr. Fihman makes this an easy practice keep with her convenient concierge service. She can come to you, anywhere in the Los Angeles/Beverly Hills area. At your annual exam, she will perform a clinical evaluation that allows her to detect any potential problems that may lead to bigger health issues in the future. If minor issues exist, she can take the steps to correct them immediately. Sesamoiditis does not have to be a major concern and it shouldn't be a reason that you give up doing the things you love.

Getting to Know Dr. Fihman

Dr. Leonora Fihman is a board-certified podiatrist who serves the residents of Southern California. With her unique concierge service, she can treat almost any condition in your home or while you are at work. When you are diagnosed with sesamoiditis, it can be extremely painful to walk from one place to another. Joggers, dancers, and athletes are often very active and don't want to deal with the stress and frustration of having pain in their feet. Dr. Fihman can treat their sesamoiditis effectively whether they come to her office or she goes to their home.

With sesamoiditis, even the simple act of walking can be painful. Since the condition can happen to almost anyone, it's important that there be treatment options that fit everyone's schedule as well. Dr. Fihman uses diagnostic tools and treatment options that are both safe and effective. Her goal is to provide the treatment you need without the excessive use of medications or surgical procedures that can increase your risk of potential re-injury. With sesamoiditis, resting your foot as often as possible and physical therapy are common treatment options she uses to help get you back on your feet as quickly as possible.

If you are experiencing any type of foot pain or discomfort, contact Dr. Fihman today and schedule your clinical evaluation. She can treat your sesamoiditis and get you back on your feet in a short period of time while allowing you to remain as active and productive as possible.



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