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What’s That Pain in the Ball of My Foot?


At Paul S. DeMarco, DPM, we often find that patients who are experiencing pain or swelling and bruising in the ball of the foot, particularly if it is close to the big toe joint, have an injury to the sesamoids. The sesamoids are two small bones (about the size of corn kernels) that are embedded in the tendons on either side of the base of the big toe. Under normal conditions, the sesamoids act as a pulley system for the tendons, providing a smooth surface for them to move over which gives your foot leverage during activities where you push off with your big toe. The sesamoids also help absorb weight and stress placed on the ball of the foot during high impact activities like running, jumping and dancing.

Types of Sesamoid Injuries

Sesamoid injuries often occur as a result of activities that put excess pressure on the ball of the foot such as basketball, tennis, ballet and football. Patients with high arches and those who spend long periods of time wearing high heels are more prone to sesamoid problems. Sesamoid injuries can also involve the bones, tendons and tissue of the big toe joint.

There are three primary kinds of injuries:

  1. Sesamoiditis—this is an inflammation of the sesamoid bones and tendons they are associated with. The pain is usually chronic and may feel like a dull ache. Pain usually increases during activities that put pressure on the sesamoids or when wearing certain shoes.
  2. Fracture—just like any other bones, sesamoids can break. You may experience an acute fracture due to a trauma such as a direct blow or impact to the foot. In addition to severe pain, you will have swelling at the site of the break. A chronic fracture is comparable to a stress fracture. It comes about over time and the pain may come and go based on activity.
  3. Turf Toe—when the big toe is hyper-extended beyond its normal range, either due to a sudden injury or repetitive action the soft tissues surrounding the big toe joint is damaged. You may feel a sharp pain or even feel a “pop” at the moment of injury.

Treatment of a sesamoid problem will depend on the specific injury and severity of the damage. If you have injured the big toe joint of your foot or are just experiencing chronic pain and discomfort in this area, contact our Somers Point office so our board certified podiatrist, Dr. Paul S. DeMarco can diagnose and treat your condition.