Forefoot Pain in Runners, Dancers and Others Might be Sesamoiditis

Forefoot Pain in Runners, Dancers and Others Might be Sesamoiditis

A Monthly Foot Fact from

Runners, dancers and anyone whose physical activity puts continuous pressure on the forefoot should be aware of a common ailment called sesamoiditis, which causes pain in the ball-of-the-foot.
According to Dr. Suzanne Belyea, medical director of, the term “sesamoiditis” describes any irritation of the sesamoids, tiny bones located within the tendons that are attached to the big toe.

“The sesamoids function as a pulley, like the kneecap, increasing the leverage of the tendons controlling the toe. Every time you push off against the toe, the sesamoids are involved, and with heavy activity they can eventually become irritated, even fractured,” Dr. Belyea says.

The most common symptom of sesamoiditis is pain in the ball-of-the-foot, especially on the medial, or inner, side. The condition can typically be distinguished from other forefoot conditions by its gradual onset. Pain usually begins as a mild ache and increases gradually as the aggravating activity is continued.

“The pain can build up to an intense throbbing,” Dr. Belyea says. “In most cases, though, there is little or no bruising or redness.”
Increased activity is one of the major causes of sesamoiditis. People with bony feet or with high arches also tend to be more susceptible because of the added pressure on the forefoot.

Minor cases of sesamoiditis call for a strict period of rest, along with the use of a modified shoe or foot orthotic to reduce pressure on the affected area. A metatarsal pad placed away from the joint can redistribute weight-bearing pressure to other parts of the forefoot.
The big toe can also be bound with tape or athletic strapping to immobilize the joint as much as possible and allow for healing to occur. Decreasing or stopping activity for a while will give sesamoids time to heal.

If the patient does continue to work out, Dr. Belyea recommends applying ice to the area for 10 to 15 minutes after exercise, or after any activity that aggravates the area.
It’s always a good idea to see a doctor for a correct diagnosis, especially if home remedies do not work.

For more information on sesamoiditis and other foot conditions, visit

last update: July 2008

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