Sesamoiditis is a painful condition of the plantar aspect of the 1st metatarsal head. The two pea sized sesamoid bones are located under the 1st metatarsal head. These bones assist the first metatarsal shaft and the great toe in the propulsive phase of gait.
Each sesamoid bone bears one sixth of the forefoot weight. Tenderness can be on one or both of these bones. Impact and overuse are generally the causative factor. Malaligned foot biomechanics may place more stress on the sesamoid bones. Custom molded orthotics to balance the biomechanics of the foot, loading the medial longitudinal arch and transverse metatarsal arch provide relief. As with any forefoot condition, a slow gentle calf muscle stretching program should be started several times a day as soon as possible.