Pain Under the Big Toe? It Could Be Sesamoiditis

If you’re experiencing pain under the ball of your foot — especially beneath your big toe — you might be dealing with sesamoiditis. This condition can be particularly troublesome for runners, dancers, and anyone who spends a lot of time on their feet.

At Move4 Physiotherapy & Podiatry, we’re experts in diagnosing and treating sesamoiditis through a comprehensive, personalised approach involving both our physiotherapists and podiatrist. Together, we’ll help you relieve pain, restore function and stay active.

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What Is Sesamoiditis?

Sesamoiditis is inflammation of the sesamoid bones — two small, pea-shaped bones located beneath the big toe joint (1st metatarsophalangeal joint). These bones sit within a tendon and act like pulleys, helping the big toe move efficiently during walking, running and pushing off.

When the area is irritated or overloaded, it can cause local pain and swelling, particularly during weight-bearing activities.

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Symptoms of Sesamoiditis

• Pain beneath the base of the big toe, especially when walking or running
• Swelling or bruising under the toe
• Difficulty pushing off during walking or sport
• Increased pain when barefoot or in flexible shoes
• Tenderness to touch under the toe joint

Symptoms often come on gradually but can be worsened by continued loading or poor footwear.

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What Causes It?

Sesamoiditis is usually caused by repetitive stress on the forefoot, but contributing factors can include:

• High-impact activities like running or dancing
• High-arched or rigid feet (which increase pressure under the big toe)
• Poor foot biomechanics or gait patterns
• Inappropriate or unsupportive footwear
• Footwear with minimal cushioning or high heels
• Sudden increases in activity or training load
• Occupations requiring prolonged standing or kneeling

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Our Combined Physio & Podiatry Approach

At Move4, we take a joined-up approach to foot pain. Our physiotherapists and podiatrist work together to get to the root cause of your sesamoiditis, ease symptoms, and stop it coming back.

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Podiatry for Sesamoiditis

Our podiatrist will assess:

• Pressure distribution and gait mechanics
• Foot posture and loading through the forefoot
• Shoe wear patterns and support level
• Activity demands and aggravating factors

You may benefit from:

• Orthotic insoles to redistribute pressure away from the sesamoids
• Footwear advice to improve cushioning and reduce overload
• Taping or padding techniques to offload the big toe
• Advice on modifying activity while still keeping you moving

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Physiotherapy for Sesamoiditis

Our physios focus on restoring movement and strength through:

• Detailed assessment of the foot, ankle, and lower limb
• Strength and mobility exercises for foot and toe muscles
• Manual therapy or soft tissue release (if required)
• Progressive loading programmes to build tolerance
• Gait retraining and functional rehab to improve foot mechanics
• Return-to-sport or activity planning

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Who Is Sesamoiditis Common In?

We commonly see sesamoiditis in:

• Runners and dancers, due to repeated forefoot loading
• People with high arches, who naturally bear more weight under the big toe
• Those returning to sport after a break or sudden increase in training
• Workers on their feet, especially on hard floors
• People wearing minimalist shoes without adequate cushioning

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How Long Does Recovery Take?

Recovery varies depending on severity and how early you seek treatment. With proper support, most people improve significantly within a few weeks. Chronic cases may take longer but respond well to a structured plan.

Our aim is always to keep you moving where possible, not rest indefinitely.

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Move4 Clinic Locations

Get expert sesamoiditis treatment at either of our Northampton clinics:

📍 Riverside Clinic – inside The Chamber Gym
📍 Courteenhall Clinic – free parking and accessible location

Both offer on-site podiatry and physiotherapy, so you can get everything you need in one place.

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Take the Next Step — Without the Pain

Foot pain under your big toe doesn’t have to stop you in your tracks. Whether it’s been niggling for weeks or flared up suddenly, we can help.

📞 Call: 01604 935 678
📧 Email: info@move4physio.com
🌐 Book Online Now

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Move4 Physiotherapy & Podiatry
Step into expert care — and out of pain.

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