Sesamoiditis is an inflammation of the sesamoid bones, two small bones located beneath the big toe joint. These bones are embedded within tendons and absorb shock and stress during weight-bearing activities like walking. When irritated or inflamed, they can cause pain in the ball of the foot. This article provides practical guidance on how to walk more comfortably and reduce pain with sesamoiditis.
Choosing the Right Footwear and Support
Selecting appropriate footwear is a primary step in managing sesamoiditis, as certain shoe features can significantly reduce pressure on the affected area. Shoes with stiff soles limit the natural bending of the big toe joint, which helps reduce stress on the sesamoid bones. Rocker bottom shoes are also beneficial; their curved sole design propels the foot forward, taking pressure away from the forefoot during walking. A wide toe box prevents toe compression, allowing them to spread naturally and easing pressure on the sesamoids.
Low heels lessen the force on the sesamoid bones, while generous cushioning and shock absorption in the sole further reduce impact. Brands such as Hoka (particularly the Bondi series), Saucony Endorphin, and Skechers Performance Go Walk are often recommended for their cushioning and support.
Beyond footwear design, supportive devices can provide targeted relief. Orthotic insoles, whether custom-made or over-the-counter, help by distributing body weight more evenly across the foot and reducing direct pressure on the sesamoids. These inserts can absorb impact and offer arch support, contributing to proper foot alignment.
Metatarsal pads offload pressure from the ball of the foot, including the sesamoid area. Specialized padding, such as dancer’s pads, can create a cutout around the sesamoid bones, effectively redistributing weight and cushioning the area. Conversely, high heels, flat shoes with minimal support, narrow shoes, or those with very flexible soles should be avoided, as they can exacerbate pain by increasing pressure or restricting natural foot movement.
Adjusting Your Walking Technique
Modifying your walking technique can significantly reduce stress on the sesamoid bones and alleviate pain. One effective strategy involves altering your foot strike to minimize the push-off phase involving the big toe. Instead of forcefully pushing off the toes, focus on a smoother heel-to-toe roll that de-emphasizes the final big toe propulsion. Shortening your stride length can also help, as it reduces the force and leverage placed on the forefoot with each step.
Consciously shifting your weight distribution during walking is another important technique. Try to place more weight on the outer edge of your foot or towards the heel, diverting pressure away from the sensitive area under the big toe. Maintaining good overall body alignment contributes to proper foot mechanics and can indirectly reduce undue pressure on the forefoot. When starting or resuming walking, it is beneficial to begin with shorter distances and durations. Gradually increase the length and intensity of your walks as your comfort level improves and pain subsides.
Managing Pain While Active
Managing pain during and after activity is an important part of living with sesamoiditis. Applying the RICE principle can help alleviate discomfort and inflammation. Resting the affected foot from aggravating activities is often the first step to allow inflamed tissues to calm down. Applying ice packs to the ball of the foot for about 10-minute intervals can help reduce localized inflammation and pain.
Taping techniques can provide support and limit the movement of the big toe joint, which can reduce direct pressure on the sesamoids. A common method involves creating a “donut” shaped pad to offload the painful area, or taping the toe in a neutral position to immobilize the joint. Over-the-counter pain relievers, such as ibuprofen, naproxen, or acetaminophen, can offer temporary relief from pain and inflammation. Performing gentle warm-up exercises before walking and cool-down stretches afterward can prepare the foot for activity and aid in recovery.
Activities to Limit or Avoid
Certain activities can significantly aggravate sesamoiditis and should be limited or avoided to promote healing and prevent further irritation. High-impact activities place excessive pressure and repetitive stress on the sesamoid bones. This includes running, jumping, and dancing, particularly ballet, which involve forceful push-offs from the toes. Sports that require sudden stops, starts, or quick changes in direction, such as basketball or soccer, can also worsen the condition.
Walking barefoot, especially on hard surfaces, can be particularly detrimental for individuals with sesamoiditis. Without the cushioning and support of shoes, the sesamoid bones bear the full impact of each step directly. Activities that involve deep squatting or crouching can put direct and intense pressure on the sesamoids, leading to increased pain. Any movement or activity that causes excessive or repetitive bending of the big toe should be minimized, as this motion can strain the affected area.