Morning folks,

Just wondering if anyone's had a positive outcome with sesamoiditis?

I started feeling pain under my big toe joint at the end of March. Initially it was sore after a run and felt like I had a stone in my shine from then on which had me cutting runs short. Doc diagnosed osteoarthritis after a quick jiggle of the joint. Said there was nothing that could be done as it's wear and tear. Get some cushioned insoles and take it easy.

I the spoke with the osteopath that I see occasionally and she didn't think the joint was arthritic. She tested it with a tuning fork for stress fracture (but did point out that you rarely get a false positive, would be a very unscientific test) and it was fine. Had acupuncture which did seem to help ease it as by then I was experiencing pain all around the big toe and off I went on a walking holiday.

Walking felt relatively good - big, heavy soled boots with sorbathane insoles and although uncomfortable in the evenings it wasn't unbearable. Walked 10 miles a day on average in the Lakes (Wainwrights). Returned home, ran 5k on two consecutive days, the pain kicked in and lasted another two days before fading a little. 

I decided to rest at that point and am now coming up to 3 weeks off. I saw the physio last week who has diagnosed Sesamoiditis as it's now a very specific sore point. I feel pain when I get up, it eases after a bit of time on my feet, and returns as the day progresses.

Last night I walked to the local pub, and from other short walks it appears about 10-15 mins in my limit before it gets sore. It'd driving me mad not being able to run. Hence wondering if anyone has had a positive outcome? 

Currently using self massage and rolling with a frozen water bottle. Back to physiology next week to see how we're getting on.  

Off to parkrun soon. The only good thing is that I can volunteer even more! 


  • I sympathise.

    The short answer is that yes, I have had a positive outcome, but it has been a long and emotional road.  On the plus side you will be told, and will read, will say that most cases of sesamoiditis resolve relatively simply.  Mine was not simple but I would say that every professional I have seen has been surprised at how difficult mine has been to treat.  You should be encouraged by that - stubborn cases genuinely are rare, though they do happen.

    I started having problems in autumn 2012, stopped running completely in spring 2013 and could not run again until January 2014 and then spent 8 months building up in tiny increments.  I had a break for other reasons from November 2014 but now, with a lot of caution and listening to my body, I can run.  I was told I would never run again as everything had been unsuccessful.  Cycling is for me still a problem.

    I'd be happy to give you more information about my story but in short(ish), the treatments I had included:

    Physiotherapy (lots of), MRI (simply to rule anything else out given how stubborn it was being in resolving), ECSWT treatment, podiatry including orthotics, 3 months in an air walker boot.

    In my case (and every case is different) I think what worked/didn't work:

    • massaging my foot did not help, and possibly exacerbated things, especially if I went over/around the sesamoid area.
    • The air boot made little if any difference.
    • Realising that the fact the pain is delayed (e.g. will occur 36 hours after running) made it very difficult to know when you are doing too much - it's too late by then.  Being super cautious was the only way I got back.  Doing too much just puts you back to nearly square one each time.
    • Stretching my hamstrings, calves, Achilles and plantar fascia (all very tight in me) was probably one of the two single things that helped the most.  I suspect all this tightness pulling on the sesamoid hindered the healing, so addressing that, in my case, was key.  If I keep on top of stretching now I can keep things at bay - slip up on this slightly and I feel it come back immediately. 
    • Swimming made it worse (probably the kicking off the wall, but possibly also having foot in pointed position didn't help - for me even lying in bed on my front, with my foot pointed would cause pain).  Cycling made it worse, despite everyone saying it shouldn't.  Cleats were the worst, even after a professional fit to set these as far back in my feet as possible.  I can only cycle now if I do it in trainers and pedal with my heel.  I don't tell you this to say don't do either - I was advised they would be fine.  I just say this to remind you that everyone is different and you need to listen to your own body about what does/does not help/hinder.
    • This may not apply (but may help someone else): but high heels and ballet pumps were killers.  I rarely wore heels or pointy shoes, but I lived in flat ballet pumps.  I now wear undignified wide toed, wide fitting, granny-type shoes for work.  At all other times I wear trainers.  I'm quite uncompromising on this - for me protecting my feet trumps other people's ideas of what I should be wearing.
    • I said above that stretching was one of two things that helped the most.  So, what was the final thing?  I cannot, CANNOT, C-A-N-N-O-T tell you what a total running life-saver my hoka shoes have been.  For me, they have literally been a miracle.  There is differing advice about whether to have lots of cushioning, whether hard soled shoes are best, whether a rocker style shoe help.  Again, I think the message is that you have to find what works for you.  Personally I think that the combination of low he
  • lost the end of that...

    Personally I think that the combination of low heel drop, maximal cushioning that hokas have makes sense for sesamoiditis (low heel drop means not placing pressure forwards, cushioning for obvious reasons).  However of course, lots of people have recovered from sesamoiditis continuing to run in their normal shoes.

    I really hope you have a quick recovery - for a small bone it can cause a disproportionate amount of pain!  Good luck, and hope it helps that even in the most stubborn of cases I got through it eventually.


  • ClagClag ✭✭✭

    image Thanks Princess Leah for such detailed information. I definitely need to do more stretching. I go to Pilates and have found that painful afterwards but need to stretch more as I am tight in the Achilles, calf, hamstring! Glad to hear you've recovered, albeit from a long road and perseverance. 

  • It turned into a bit of an essay!

    If you are tight in those areas I find this helps with stretching...

    I found doing heel stretches/lifts using stairs put too much pressure on my forefoot, but this gadget seemed to get a real stretch without as much pressure in that area.

    I think I may have recovered quickly if I had been on top of the stretching earlier, so I really hope doing that can help you.
  • Sorry to hear that you're suffering Clag. It seems that Princess Leah has a lot of experience that could be helpful. I would suggest also seeing a podiatrist with a view to maybe getting some orthotics that take the pressure off the affected area.

    If you think you can or you think you can't you're probably right.
  • ClagClag ✭✭✭

    Thanks LM.H, how are you? When did you earn the .? image

  • I'm doing ok thanks. 2008 image

    If you think you can or you think you can't you're probably right.
  • ClagClag ✭✭✭
    Aaaargh! I've now had 5 weeks off running. Been going to Physio, having acupuncture and ultrasound. I've not walked more than 20-30 mins at a time (until yesterday when I walked about 3 miles). Felt like I had a stone in my shoe and foot's been sore since.

    Physio today recommended an X-ray as they're not doing much for me other than trying to find ways to ease the pain. Worried that maybe the doc was right about OA!!! A little scared of what might be found. Really missing running (& walking)!
  • Cal JonesCal Jones ✭✭✭

    There are a few things it could be. I thought I had sesamoiditis when I woke up with a searing pain in the ball of my foot (did some hill sprints the previous day) back in 2011. X-Ray revealed nothing, but then, when I was massaging my foot, I found a lump that turned out to be a cyst. It took about a year for the NHS to get around to removing it but I've not had any pain since. The pain itself actually went away on its own after about a month, though I decided to get the op anyway in case it came back.

    First thing I did, on getting the pain, was switch to zero drop shoes (I'm a PE teacher, so on my feet all day) to keep my weight back on my heel, but that proved to be a mistake as I ended up with a nasty chase of Achilles tendonitis despite not running. Just be warned!

  • Really sorry to hear you haven't had any relief.

    Have you considered seeing a podiatrist? When I first saw one they initially created some padding for me that protected my sesamoid by offloading the area. It was a bit like a ring doughnut with the hole below the sesamoid thus protecting the area. I think you can buy them, but my podiatrist just made one for me temporarily out of a bit of padding stuff so that it was in exactly the right place. Might be worth discussing with physio if the x-ray does not show anything.

    Hope you get good news soon.
  • ClagClag ✭✭✭

    I'm in the fortunate position of having private healthcare through my husband's work so have held off on podiatry in the hope that I'll be referred if need be. I've got some padding for my shoes. Now got an appointment to consult further by phone tomorrow and will hopefully get X-rays sorted out sooner rather than later.

    Cal, I too teach (thankfully not PE) and have found my other leg achilles niggling as I'm in trainers just now all day. It often niggles though so am trying to treat it well in the hope that it doesn't get any worse! 

  • Hi Clag, was just wondering how you are doing? Hope things are going well.
  • ClagClag ✭✭✭

    Just noticed your reply Princess Leah!

    Having been referred to a consultant he advised bypassing x-ray and getting an MRI. After a long wait, I have the results and it is an 'inflamed swollen intermetatarsal bursa between the 1st and 2nd MTP joints'. He said the best way to describe it is like housemaid's knee in the foot.

    Hoping to get prescription anti-inflammatories from a phone consultation today as I can't see a GP for a fortnight due to my practice changing the way they work. Used to be that you phoned on the day and were pretty much guaranteed an appointment; however, due to patient feedback they're now making most appointments pre-book able so you can wait ages! image

    Anyway, delighted to know that it is fixable, there's no degeneration in my foot at all - yeah! image Worst case scenario it continues after 4 weeks of meds, I've got an appointment in 6 weeks time for a cortisone injection if required. I hope it wont be!

  • Sorry, completely missed your reply!  I'm so glad you had good news and that it is something fixable.  I think 'knowing' what you have for sure is also a big help psychologically.  Hope treatment is going well and are all back on track image

  • ClagClag ✭✭✭

    Back to the drawing board ... Ended up getting a cortisone injection that worked wonders for the bursitis, but since restarting running in October I've developed Sesamoiditis again. Seems to have been triggered/flared up more by wearing heels for a night out!

    Saw the podiatrist yesterday and he's made me a pad for my trainers. Said to try it for three weeks and hopefully it'll ease the pressure/redistribute the weight. Ultimately though the issue is with having a strong forefoot strike and he's said unless I change this the problem will continue. Not sure where to go next, so many conflicting opinions out there and so many different specialists. 

  • I'm gutted for you.

    I'm not sure I understand what is meant by not having a strong forefoot strike - do you land on your forefoot?  I heel strike and was told never to risk transitioning to forefoot striking.  That doesn't help you with your point about conflicting opinions!

    Does your podiatrist suggest how to improve your forefoot strike?  Does he/she have an interest in sports/running?

    Keep us updated with how you're getting on, and sorry you have had this set back.

  • ClagClag ✭✭✭
    Yes, he said I land on my toes. Suggested trying for a more mid foot strike & when I asked how to do this he suggested just making a more conscious effort not to land on my toes. I think the pad he's given us maybe helping with this as it's lifting my toe. Will try it for a few weeks and may see someone else that's been recommended if need be.

    On the upside, it does seem to be having a positive effect on the other niggles I've been having.
  • ClagClag ✭✭✭

    Well, I've now gone down the orthotics route and picked them up yesterday. The podiatrist reckons that the bursitis is back and will continue to be an irritation until the load is taken off the sesamoids.

    Initial frustration is that they don't fit in everyday shoes (too big)! Podiatrist suggested my every day shoes must be too small (6.5 to 7 on occasion) as my trainers are 7.5, but I'd be wandering around in shoes like boats if I went that big!  

    Hopefully I'll see the benefits when I start wearing them and breaking them in as right now I'm beginning to regret paying out such a lot for them! 

  • ClagClag ✭✭✭

    Well, the saga continues. Have now developed an achilles niggle in the other leg and have been told by the physio (& am feeling the same) that the orthotics are doing nothing for me. She says my gait is neutral, which is what the consultant also said initially when he advised me not to bother wasting money on orthotics! However, I didn't want to keep getting injections and thought it worth a try.

    The upshot is a return to the consultant this week for further advice. I now find that just being on my feet all day is painful. Any sort of restrictive footwear makes it worse with the compression, and I'm not convinced that running or long distance walking worsens it as it's just niggly all the time. Here's hoping we can get it resolved this time.  

  • This is an old thread I know, but I wanted to make an account to post on here. Looking up sesamoditis can be very depressing on the internet, but having just played 2 hours of seven a side football last week having recovered twice from sesamoiditis I wanted to provide some home.

    I had had it first last May. Swelling was very stubborn and eventually had a steroid injection. I reacted quite badly but it did the job eventually and I returned to football in September, having been walking throughout August (including a 7 hour walk up 1700m in the Alps). 

    Then it flared up up again in February. Was depressing I admit, but what I learnt from before was to be conservative with it. That meant I drove to the gym and swam to maintain fitness. I gradually reintroduced walking after about 3/4 weeks of only walking when necessary (around 3000 steps per day max.). 

    Again, I was walking more regularly in around April, though overdid it on holiday and took it easy until May. Now in May and June I averaged around 7000 steps a day and as I mentioned before returned to football last week. 

    So, it’s a frustrating process and gets depressing especially when reading stuff on the internet. However, be conservative, get orthotics from a podiatrist, see a specialist, have a cortisone shot if needed and rest. It is possible to recover, you just don’t see those who have recovered posting about it on the internet. 

    On that note orthotics have really helped me as an overpronator and I thing that stopping using them contributed to my flare-up, as well as playing squash three times in one week! 

    One other thing which which helped me recently is OSMO patch. Looks like BS, but it genuinely seems to have worked for me. It didn’t help with the pain or healing, but I had some residual swelling and it helped take that away and free up the movement in the joint. 

    If if you’re reading this I’m sorry you’re going through sesamoiditis, but focus on recovering and have faith that your body can heal this. 
  • * I wanted to provide some hope! (I should really have proof read before I clicked the post comment button)
  • I should also have mentioned Hokas. They really helped me as I was limping and scared to push off the toes of my left foot. The rocker sole helped normalise my gait and the huge amount of cushioning makes my Adidas ultra boosts feel like wooden clogs. Definitely worth the price to get a pair of them. Note that not all have the rocker sole. Make sure you buy their running shoes with the meta - rocker. 
  • Hey Clag,
    I did a research on sesamoiditis injury actually it is an overuse injury that involves inflammation and it is caused by the increased pressure on the sesamoids bones which is located in the ball of the foot behind the big toe.

    This kind of injury occurs with the activities that require a lot of pressure on the ball of the foot like football, basketball, tennis, running, and ballet.

    I would like to add some points which will help you to recover fast:
    1.) Don't apply ice directly to the skin but use an ice pack or wrap the ice in a towel.
    2.) Tape the great toe so that it remains bent slightly downward (plantar flexion).
    3.) Maybe your podiatrists recommend an injection of a steroid medication to reduce swelling.
    4.) Stop the activity causing the pain.
    5.) Last point is, kindly wear proper shoes which can provide you good forefoot cushioning and should be wide from the toe as it allows the foot to spread which will help to reduce the pressure from the forefoot and can save you from a lot of pain.

    Hope so that these all points will help you :) Get well soon
Sign In or Register to comment.