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Sesamoiditis refers to the inflammation of the tissue surrounding the two little bones called the sesamoids, which are located directly under the ball of the foot.

I experienced what was the beginning of this injury when I first gave myself turf toe playing soccer. If you’re thinking,

‘Wasn’t that article written way earlier this year?’

Yes, you’re correct. That is the same injury I am talking about.

I was competing for a ball while playing soccer and I essentially bent my toes back while my force was moving forward, hyperextending them to an uncomfortable position. I could feel almost immediately that there was going to be a problem after that.

This gave my big toe some problems for a while, but I ignored it and played through it for months. Then as the pain moved from my big toe down to the ball of my foot / plantar surface, I knew it was time to stop playing again.

Huge sigh. I can’t stand getting hurt.

Regular rest did not help much because I was intertwining too much movement and activity into my life while “resting” by avoiding running, jumping, or playing soccer. This has not been enough though, especially since my job requires me to be on my feet all day.

I have had to take the measures much further because I am officially tired of being like this, I want it over-with. Here’s what I have been doing lately that’s been giving me success:

Stop Bending the Toes

Stop bending the toes back at all costs. This is what most likely caused the injury anyway so it’s best to not repeat that motion when the area is still inflamed.

You should probably even be careful bending the toes the other way, although I like to with caution to give mine a bit of a stretch. 

Stay Off the Foot

Stay off the foot as much as possible. The more walking and pressure you’re putting onto that area, the less chance it has of healing quickly. This is a very tough injury to heal because obviously you have to walk often.

Retain Ankle Mobility

Keep the ankles mobile so that when you walk, your toes do not have to bend as much.

There is a reason that ankle mobility is so vitally important, and that’s because when your ankles bend at full range of motion, it takes pressure off the ball of your foot and toes from having to absorb so much pressure and make all the push-off force.

This is one reason why doing myofascial release exercises to improve ankle dorsiflexion can be so important. 

Force the Foot to Stay Flat

Get in some shoes or a walking boot that keeps your foot flat. When I say flat, I don’t mean just avoiding bending, I mean the toes, ball of the foot, and heel are all as close to level with each other as possible.

This is incredibly hard to find in today’s world as you hear me talk about often. What I would recommend is a pair of good minimalist shoes like Vivobarefoot’s but you probably want to be wearing a thicker sole while your foot is tender.

If you can tolerate the thin sole or are usually on softer ground, these may be the best option for you. Otherwise, I would recommend some kind of walking boot or “post-operation” shoe that will let your foot sit in there unimpeded and allow you to walk while it heals.

I recently picked up this exact boot which has been great for me. I wear it all day at work and am able to walk normally without issues. 

No Elevated Heels

Avoid shoes with elevated heels. Really, you should always avoid these anyway, but with sesamoiditis, it’s especially the case.

The problem here is that an elevated heel is going to push your weight more onto the ball of your foot than if you were standing on level ground. This is a problem when you’re already struggling with inflammation in that area and in some pain. Avoid heels at all costs for the time being until you sort this problem out. 

Wide Toe Box

Wear footwear that has a wide toe box. You’re going to need a lot of room for your toes to spread when you’re trying to heal.

A huge reason why is because when you look at an X-ray of someone who has sesamoiditis, you can usually see from over the top of the foot that one of the sesamoids is way out of place. This indicates that the big toe has been pushed out of proper alignment and too far inward.

The patterns with most healing really are similar as you might’ve noticed from some of my other posts. Restore the toes to their proper positions, lose the elevated heels, and overall stop impeding the foot’s natural functions.

Like I mentioned earlier, the boot I just bought has an excellent toe box that is actually square-shaped to provide extra room inside the boot for any kind of bandaging or padding you might be wearing.

I put a thinly padded insole into mine because I do so much walking on hard floors and I also will wear toe spacers inside it sometimes just to keep training my toes to spread out again.

The boot also doesn’t wrap around the ankle, it’s more like a shoe. This is great because that allows the ankle to bend at full range which takes some of the pressure off the forefoot when you’re walking.

Metatarsal Pads

One more idea that you can try is to place metatarsal pads into your boots or shoes. These pads are good for stable cushioning and making sure the fat pad on the bottom of your foot stays in it’s position under the ball of the foot. Many times, this fat pad can get displaced and lead to pain.

Other than these safety precautions, there’s not a lot you can do unfortunately because the area simply needs time to recover.

I still do myofascial release work on my legs and feet but at least for me, it hasn’t had a ton of influence on the way I feel. I should mention that one night, when I was very fed up with my condition, I used a golf ball and dug in around the ball of my foot and between my toes very hard and I noticed some improvement right away.

Only try this if you feel it’s necessary. I always feel that there’s more knotted up tissue and adhesions to break up so I like to exercise this option. I went between the metatarsal heads and between my toes on the top and bottom of my feet and it did help. But since then, I have not been able to make any noticeable improvement like that. 

Unfortunately, this is an injury that needs time and rest to heal. That is very much not my style to accept those things because I like to be proactive so I can exercise and play sports again.

But the truth is, I prolonged my recovery process by trying to play through it for a couple months after and walking on it so much and bending the toes like normal. The area got traumatized by being hyperextended and since we have to use our feet to move, the ball of the foot and sesamoids see a lot of action.

If you’re struggling with this problem, try the things I mentioned above as they will speed the process up and give your feet some genuine rest.