Medical Disclaimer
The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
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Sesamoid Fractures (Broken Bones Under Big Toe)
Sesamoid fractures are breaks in two tiny pea-sized bones embedded in the tendon under the big toe joint - they can occur from acute injury (stubbing toe, landing from jump) or as stress fractures in dancers and athletes who repetitively load the forefoot, causing pain and tenderness under the ball of the foot that worsens with push-off, with treatment usually involving 6-8 weeks of offloading in a walking boot achieving 70-80% healing, but some require surgical removal if conservative treatment fails.
đWhat is Sesamoid Fractures (Broken Bones Under Big Toe)?
Sesamoid fractures are breaks in two tiny pea-sized bones embedded in the tendon under the big toe joint - they can occur from acute injury (stubbing toe, landing from jump) or as stress fractures in dancers and athletes who repetitively load the forefoot, causing pain and tenderness under the ball of the foot that worsens with push-off, with treatment usually involving 6-8 weeks of offloading in a walking boot achieving 70-80% healing, but some require surgical removal if conservative treatment fails.
đŦWhat Causes It?
- Acute trauma (stubbing toe, landing from jump, direct blow to ball of foot)
- Stress fracture from repetitive loading (ballet dancers, sprinters, basketball players)
- Sudden forceful push-off causing flexor hallucis brevis (FHB) tendon to avulse sesamoid bone
- High-impact activities on hard surfaces (running on concrete, court sports)
â ī¸Risk Factors
You may be at higher risk if:
- Ballet dancing or activities requiring repeated push-off on toes (en pointe)
- High-impact sports (basketball, volleyball, running, tennis)
- High-heeled shoe wear (increases forefoot loading)
- Foot biomechanics (high arch, cavus foot increases sesamoid pressure)
- Previous sesamoid injury or sesamoiditis
đĄī¸Prevention
- âWear appropriate cushioned footwear for high-impact activities (avoid thin-soled shoes)
- âUse metatarsal pads or dancer's pads if participating in forefoot-loading activities (ballet, running)
- âGradual progression of training volume (avoid sudden increases in mileage or jump training)
- âCross-training to reduce repetitive forefoot loading (alternate running with cycling, swimming)
- âAddress foot biomechanics (orthotic arch supports if cavus foot increasing sesamoid pressure)