Sesamoiditis: Pain Under the Ball of Your Big Toe Explained
If you’ve ever felt a sharp or achy pain under the ball of your big toe, you may be dealing with sesamoiditis. This is a common injury we see at Melbourne Podiatry Clinic, particularly in runners, dancers, and athletes who spend a lot of time on the balls of their feet.
Our podiatrist Tess explains what sesamoiditis is, what causes it, and how it can be treated effectively.
What Are Sesamoid Bones?
Sesamoid bones are small, round bones embedded within tendons. They act like pulleys, helping
tendons glide smoothly and improving leverage during movement.
In the foot, the sesamoids sit at the base of the big toe joint. These tiny, sesame-seed-shaped bones play a big role in allowing effective toe-off during walking and running.
What Is Sesamoiditis?
Sesamoiditis is the inflammation of one or both sesamoid bones and the surrounding tissues under the big toe joint. While pain can also be caused by arthritis, reduced blood flow, or even fracture, the most common cause is inflammation due to overloading the area.
Causes and Risk Factors
Several factors can contribute to sesamoiditis, including:
Excessive loading or pressure under the big toe joint
Sports that keep you on the ball of your foot (e.g., dancers, sprinters, footballers)
The position or shape of your big toe compared to the others
Training overload — too much exercise too soon
Low bone density
Excessive body weight
Age (more common in teens and young adults)
Symptoms of Sesamoiditis
Typical signs include:
Dull, aching pain under the big toe joint
Sharp pain when standing or walking
Pain when pressing directly under the big toe joint
Discomfort when extending the big toe
Diagnosis
A podiatrist can usually diagnose sesamoiditis during a physical assessment of your feet. In some cases, additional imaging such as an x-ray, ultrasound, or MRI may be recommended, particularly if symptoms don’t improve or a fracture is suspected.
Treatment Options
The goal of treatment is to reduce pain, inflammation, and excessive loading on the big toe joint. Treatment may include:
Ice and anti-inflammatories in the early stages
Footwear changes, padding, or taping to reduce pressure on the sesamoids
Custom orthotics to redistribute load and protect the area
Strengthening exercises for the surrounding muscles and tendons
👉 Patients who seek assessment early often return to sport and activity much faster than those who delay treatment.
Get Expert Help for Sesamoiditis
If you’re experiencing pain under your big toe, don’t ignore it — sesamoiditis can become a long-term problem if left untreated. At Melbourne Podiatry Clinic, our experienced podiatrists will perform a thorough assessment, provide targeted treatment, and guide you back to pain-free movement.
