Sesamoiditis in cyclists

Two pea-shaped bones, called the sesamoid bones, lie under the ball of the big toe. Even though they are very small, they play an important role in walking. If the sesamoid bones become damaged/irritated, they can cause a lot of pain and discomfort.

ANATOMY

Under the joint between the big toe and the
forefoot (ball of the foot) there are two small bones: the sesamoid bones.
The muscle that moves the big toe down
passes under this joint and then passes over the elevation formed by the sesamoid bones. This elevation serves as a pivot point for the said muscle, allowing it to function better. The sesamoid bones also contribute to better pressure absorption under the foot when walking and standing. In addition, they facilitate friction in the soft tissues below the joint when the big toe moves.

WHAT ARE THE CAUSES?

Overload of the sesamoid bones can arise in different ways. When the tissue around the sesamoid bones becomes inflamed, it is called sesamoiditis.

Overexertion, repeatedly performing the same movement as is done, for example, with running and dancing.
Fracture of the sesamoid bone, which can occur after a fall or hard landing on the forefoot. A fracture can also be the result of prolonged overload.
Hollow feet, which puts a lot of pressure on the sesamoid bones.
Overpronation, because the foot sinks in too much while walking, causing an overload on the ball of the big toe.
'Stiff big toe', when the big toe can no longer move upwards properly, the push-off will put a lot of pressure on the ball of the big toe while walking.

WHAT ARE THE (PAIN) COMPLAINTS?

People with an irritation of the sesamoid bones usually feel a vague pain under the ball of the big toe.
The sesamoid bones are sensitive/painful to the touch.
The movements of the big toe are often limited. The upward movement, such as when taking off the foot while walking, is often painful.
There may be numbness in the big toe and the adjacent toe.

WHAT CAN WE MEAN FOR YOU?

If the (sports) podiatric examination shows that there is a cause in the foot position and/or the walking pattern, we have the following treatment options: