Sesamoiditis is inflammation under the ball of the big toe. It is perhaps only the anatomists who know that there are two small jelly bean like bones under the big toe joint called the sesamoids. These are embedded in the large tendon that runs under the big toe, from the muscles the Long Toe Flexor or Flexor Hallucis Longus (FHL) and the shorter tendon, Flexor Hallucis Brevis. They act as a fulcrum point as you push off giving extra leverage and power.

Red flag Signs. If there has been a sudden onset of sharp symptoms in the toe there is likely to be a fracture, especially if you can point to when it came on.

If there is a constant feeling of burning or nerve like pain – there is potential nerve damage and this needs to be assessed by your physio.

The ball of the foot is very tender to walk and weight bear upon. It feels like you have something in your shoe. To bend the toe up causes a sore and even sharp feeling with a tight tugging felt through the toe and into the sole of the foot.

Treatment involves restoring the normal function to the sesamoid movement and look at why you have overloaded the toes to begin with. Local treatment to reduce inflammation as well as off loading the area are effective in the short term with longer term solutions being found in improving the bio-mechanics.