A sesamoid stress fracture is a fracture of one of the tiny sesamoid bones located under the big toe. This condition is usually related to repetitive stress like increasing running speed too quickly. These tiny fractures are hard to diagnose because they cannot be seen on an X-ray.
Sesamoid bones are bones that are embedded within a tendon. There are two sesamoid bones in the foot. These tiny bones are about the size of a bean and located under the big toe. When you walk, a large percentage of your body weight is transferred to the sesamoid bones.
Sesamoid Stress Fracture Symptoms
While there are many conditions that cause foot pain, there are some notable symptoms of sesamoid fractures. You may have one or more of the following symptoms.
- Pain – Pain from a sesamoid fracture is located in the ball of the foot and the big toe joint.
- Swelling – Swelling is often limited to the big toe and the area surrounding the big toe joint.
- Bruising – Bruising is often present in the affected area, and it will likely be tender to the touch.
- Limited mobility – The range of motion in the big toe is often limited.
A sesamoid stress fracture may be caused by an injury like jumping from a high platform to a hard surface or a sports impact injury. More often, they are caused by repeated stress injuries often found in athletes and runners.
Sesamoid Stress Fracture Diagnosis
Sesamoid fractures are difficult to diagnose. These tiny fractures are often not visible until they begin to heal. It is important to diagnose sesamoid fractures quickly to avoid further damage. Podiatrists use different tests to diagnose sesamoid fractures.
- Self-diagnosis – If you suspect a sesamoid fracture, you may be able to determine the problem by yourself. Lightly press the bottom of the big toe joint with one finger until you locate the tiny sesamoid bones. If one is notably more tender than the other, you might have a fracture. If the entire area is painful, the diagnosis is more likely to be a form of tendinitis. If you suspect a fracture, see your doctor.
- History – It is important for your podiatrist to hear how your injury began. Specific types of injury and stress are what cause sesamoid damage.
- Physical exam – Your doctor will provide a visual exam to look for swelling and other symptoms. Pressure will be applied to the sesamoids to determine if a fracture is likely.
- Imaging – Your podiatrist may order imaging such as x-rays, magnetic resonance imaging (MRI), or computed tomography (CT) scan. These tests are usually to confirm the diagnosis suggested by the history and physical exam.
Sesamoid Stress Fracture Treatments
Sesamoid injuries can be difficult to heal. The most important thing you can do to speed recovery is to take the injury seriously. Follow your podiatrist’s directions and rest your injury.
- Conservative treatment – There are several conservative treatments to speed the healing process. Stop the activity that caused the injury. Immobilize the joint with a plaster cast or stiff-soled shoes. Ice the affected area and keep the foot elevated. In some cases, a bone stimulator may be used. Sesamoid fractures take 6 – 8 weeks to heal properly through non-surgical treatments.
- Surgery – If results are not experienced within 4 – 6 weeks, surgery might be necessary. Surgery is usually avoided when possible since the sesamoid bone is partially or completely removed.
Sesamoid stress fractures are notoriously slow to heal, which is particularly frustrating to athletes, runners, or anyone particularly active. It is important to properly diagnose the condition and allow full healing time. Continuing to add pressure to any sesamoid injury can lead to additional damage. It is crucial to take this tiny injury seriously for a complete recovery. To schedule a consultation with our office for a complete diagnosis contact us today.