The most frequent inflammation in runners, athletes and dancers, sesamoiditis, is the inflammation of sesamoids, i.e. the small bones at the base of the big toe, caused by continuous microtrauma from excessive physical activity – explains Dr. Lara Castagnetti, osteopath and specialist in Physical Medicine and Rehabilitation at Humanitas. In addition to athletes, sesamoid inflammation can also affect people who do not practice intense sports and women used to wearing high-heeled shoes that overload their forefoot.
The pain is not violent, but appears gradually, slowly, until the person cannot walk, run or do sport. This is because the sesamoids and tendon structures of the big toe flexor that wrap around the bones at the base of the first toe of the foot, are functional to the dynamics of the step and the pain is localized just near the metatarsophalangeal joint of the big toe. This is the point where leverage occurs when we walk or run that allows the foot to rest on the phalanges and move the step. The most frequent symptoms are pain only at the foot and not at rest, swelling and redness at the base of the big toe and in nearby structures. Generally, those who have a very thin and bony foot, or a hollow foot, i.e. with a very accentuated foot arch, may be more susceptible to inflammation of these structures. When symptoms occur, it is important to rest, i.e. avoid overloading your foot with sports activities or the use of heels, prefer footwear with a soft foot bed, and use ice on the area. Finally, consult your doctor, who will prescribe specific diagnostic examinations such as X-ray and/or MRI, to establish physiotherapy.