Sesamoiditis is a condition commonly seen in dancers that leads to pain in the forefoot specifically under the big toe joint. The sesamoids are two small bones located inside the tendon that runs under the big toe. They function as a pulley increasing the leverage of this tendon. The sesamoids can sometimes become inflamed and in some cases fractured or necrotic due to the excessive pressure placed on them through demi pointe work.

  • High arched foot type – less area of contact with the foot and the ground increases the pressure placed on the sesamoids
  • Pronation (rolling in of the feet) – causes the sesamoids to rotate leading to irritation over time
  • Boney foot type – with minimal fatty padding for cushioning
  • Shoes with reduced padding
  • Increased load in activity levels
Sesamoiditis - Highett Podiatry


  • Gradual onset – the pain usually begins as a mild ache and increases gradually as the aggravating activity is continued
  • Limited skin changes – rarely see redness or bruising
  • Reduced dorsiflexion of toe
  • Pain when rising onto the ball of the foot


  • Taping and padding of the area to reduce pressure on impact
  • Altering training and technique re training to alleviate the load placed on the sesamoids whilst they recover
  • Footwear modifications
  • Orthotics
  • In more severe cases surgery may be required to remove the sesamoid bones

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The information in this resource is general in nature and is only intended to provide a summary of the subject matter covered. It is not a substitute for medical advice and you should always consult a trained professional practising in the area of medicine in relation to any injury or condition. You use or rely on information in this resource at your own risk and no party involved in the production of this resource accepts any responsibility for the information contained within it or your use of that information.