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What Are the Sesamoids?

The sesamoids are two small bones under the big toe joint. They act like pulleys, helping you push off when walking, running, or jumping.

When these bones or the surrounding tendons become irritated, inflamed, or injured, the result is sesamoiditis — a painful condition common in athletes and active adults.

A more severe injury, turf toe, occurs when the big toe is forcefully bent upward, damaging the ligaments around the joint.

Common Symptoms

• Pain under the big toe joint

• Swelling or tenderness in the forefoot

• Pain when pushing off the foot

• Difficulty running or jumping

• Stiffness in the big toe

• Sharp pain with toe extension (turf toe)

• Trouble wearing certain shoes

Why Sesamoiditis & Turf Toe Happen

These injuries often develop due to:

• Running or jumping sports

• Dancing

• Barefoot activity

• High‑impact exercise

• Wearing flexible or minimalist shoes

• Sudden hyperextension of the big toe (turf toe)

• Repetitive forefoot pressure

Without treatment, pain can become chronic and limit activity.

When Sesamoiditis Becomes a Problem

You should be seen if you experience:

• Persistent big‑toe pain

• Pain that worsens with push‑off

• Swelling under the big toe

• Difficulty running or exercising

• Pain that interferes with work or sports

• A popping sensation (possible turf‑toe sprain)

If your forefoot pain is accompanied by arch collapse, it may be related to Adult Flatfoot or PTTD.

Treatment Options

At Orthopedic Foot & Ankle Institute, our team — Dr. Savage, Dr. Sibel, Dr. Samant, and Dr. Solomon — offers:

• Custom Orthotics

• Offloading pads

• Anti‑inflammatory treatments

• Shockwave therapy (Coming Soon)

• Physical therapy

• Immobilization for turf‑toe sprains

• PRP injections for chronic tendon or ligament injury 

For advanced cases, learn more about surgical options on our Reconstructive Surgery page.

Do Sesamoid Injuries Require Surgery?

Not always. Many patients improve with conservative care. However, surgery may be recommended if:

• Pain persists despite treatment

• A fracture is present

• Turf‑toe ligament damage is severe

• Daily activities are limited

Our specialists offer modern sesamoid and ligament repair techniques designed for long‑term relief.

Schedule Your Appointment Today

Call Our Office at 702.997.9833

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Author

Roman Sibel, MD Dr. Roman Sibel, MD is an orthopedic surgeon practicing at Orthopedic Foot & Ankle Institute in Henderson, Nevada. Dr. Sibel specializes in a variety of cutting-edge foot and ankle treatments, including reconstructive surgery, sports medicine, trauma surgery, diabetic care, and laser treatments for removing nail fungus. Dr. Sibel retains active affiliations with numerous Las Vegas hospitals, including Southern Hills Hospital and Medical Center, and St. Rose Dominican Hospital’s multiple campuses throughout Nevada. He also works with several local surgical centers, such as Parkway Surgery Center, Sunset Ridge Surgery Center, and Coronado Surgery Center. Graduating from Pennsylvania State University in University Park, Pennsylvania, Dr. Sibel went on to earn his medical degree from MCP-Hahnemann School of Medicine in Philadelphia. He completed both his internship and residency in orthopedic surgery at Ohio State University in Columbus, Ohio, and finished his foot and ankle fellowship training at the Hospital