Sesamoid Injuries

Sesamoids are two small bones that are beneath the great toe joint, 1st MPJ, of every foot. They exist inside the flexor tendon to the great toe (hallux), and they function much like the knee cap does to produce a mechanical advantage around the joint. The difference between sesamoid bones and the knee cap, is sesamoid bones are under constant pressure from walking, and even increased impact from sports activities, such as running or jumping.

Sesamoid Injuries Include:

  • Turf Toe - Traumatic Injury to the ligaments around the 1st MPJ. This usually occurs during high impact sports. The hallux can become dislocated leading to intense pain, and sometimes the sesamoid can become fractured. If left untreated, instability of the joint may occur, causing lingering pain during high demand activities.
  • Sesamoiditis - This is a condition of inflammation around the sesamoid bones. This is more of an overuse injury that may be caused by improper shoes or foot structure. Tightness in the Achilles tendon also places more pressure on the ball of the foot, including the sesamoids.
  • Fracture - High energy injuries, such as a fall or turf toe injury can cause the sesamoid bone to break. Also, repetitive impact from endurance exercise can lead to a stress fracture, which can be more difficult to diagnose.



Clinical history and physical exam are important to identifying sesamoid injuries. X-rays are standard, to help rule out fractures and identify foot structure. Diagnostic Ultrasound and MRI can be useful in identifying more subtle injuries.

Turf Toe Injury of Sesamoid bone in foot

Non-Surgical Treatment of Sesamoid Injuries:

  • Padding, Taping, or Strapping
  • Oral or Topical Anti-Inflammatory Medication
  • Steroid Injection
  • Physical Therapy
  • Custom Orthotics


Sesamoid injuries are commonly treated without need for surgery. When surgery is necessary, post-operative physical therapy is important to rehabilitate and strengthen the ligaments and tendons around the joint.

If you think you may have a Sesamoid Injury, Call us at 512-593-2949 or CLICK HERE to Schedule an Appointment.