I’ve got a mild pain in the ball of my foot behind my big toe. Kinda hurts to walk/run. The pain is by no means intense but I know it is there. I’m on a self prescribed break from running for a while and am taking some Vitamin I (ibuprofen). Any experience out there with this before I call my podiatrist?
Very common problem. As always, need to get a good diagnosis first (and you have obviously done some research). Off loading of the sesamoids (there are 2 in most people) is your first and main treatment. Second is to make sure you don’t have a stress fx or fx of the sesamoid. The pain with these is not usually intense, but there and annoying with any pressure at all (even just pushing on them). Any swelling there? Also, many people have bipartite sesamoids (it is in 2 pieces) and that does 2 things: makes a fracture diagnosis more difficult (esp if not seeing a specialist) and it also pre-disposes to sesamoiditis since you now have “2” pieces moving around/articulating with the plantar aspect of the great toe joint.
Good luck!
Be careful and definitely don’t ignore like I did! One of mine, the one on the inside ended up in lots of pieces by the time I went to the doc. He ended up doing surgery and removing it. Now I have a ton of scar tissue and other issues due to the surgery which was SEVEN years ago! 
I don’t really have any swelling. My big toe has not lost any flexibility. There is pain when I push on it with my fingers but it is not more/less that just walking…which really is minimal. Got an appt with the podiatrist next thursday. Does biking aggrivate it? I haven’t noticed that it does but would like to keep biking if I could.
You should be OK biking if you don’t feel any pain. If you do, hold up until your visit
I had it two years ago. My physician is USA Speedskating team doc, and he suggested cutting a donut out of an unused running shop footbed and taping it too my foot. I did so for running and biking. I survived the rest of the season without further inflamation and with a period of rest over the winter, it healed up and I have no probs…
I had a sesamoidectomy back in 1992 . I trained/raced for a year prior…did IM Canada 1991 on it. It hurt more to walk than run. It took me a year to come back after surgery. Your running/walking will never be the SAME, but it will be pain free and you can compete at the same level.
Seek out a good doc for this. Don’t be shy about going to both podiatrists and/or orthopods w/ FOOT subspecialization. Our DPM colleagues truly have more experience in sesamoid surgery, but try to find one w/ a sports practice or academic affiliation. My surgery was done by an MD orthopod who had done a foot/ankle fellowship…but in hindsight(now after going to residency myself…) I realize that a well trained DPM would have had more cases under his/her belt.
Cheers,
HC
My wife had problems with her sesamoid bones and was diagnosed twice with a stress fracture of the sesamoid. After 2 years of struggling with the problem she has finally gotten rid of it with two steps:
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a cast for 5 weeks. Just the normal walking was enough to never allowing it to heal properly. Got a light fiberglass cast with gore-tex insert that allowed her to swim with a pull buoy and to bike on the indoor trainer. Completely unloading the weight for 5 weeks allowed it to heal.
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insoles to relieve the stress on the sesamoid bone
She has done 4 Ironman and one marathon since.
Assuming that you were diagnosed properly, you have to first let it heal, and secondly, then you have to figure out what caused the problem. Is it wrong shoes, too much mileage or increase in mileage, or your biomechanics ?
Letting it heal will not help in the long term unless you figure out and correct what caused it in the first place.
Good luck,
Francois in Montreal
Thanks everyone. My podiatrist was able to squeeze me in this morning. Sesamoiditis it is. X-rays didn’t show anything bad in his eyes. He recommended no running for a month, ibuprofen and ice. He said biking was ok as long as it is pain free…same advice as rroof. thanks again. Looks like I’m on a bike focus month…I need it anyway.
This really works and is very cheap–
Get some Spenco insoles–the green kind with the black closed cell foam bottom. Put your foot down on the insole and mark where to big toe joint rests. Now, cut out a 1 to 1 1/4" sized hole there. This takes direct pressure off of the sesamoid. If need be, you can even build up around the hole with some molefoam to relieve more pressure. When you stand on the insole, it should feel that your sesamoid is sitting in a hole. Wear this as much as possible. Do not go barefoot if at all possible. Keep using this insloe even after the pain subsides.
I have done this and I have recommended this to others and it has worked for all.