Running with Sesamoiditis

Running with Sesamoiditis: Ultimate Guide

Running with sesamoiditis can be one of the worst experience for runners or cross-trainers.Running with Sesamoiditis It’s usually associated with overuse which results to inflammation of the tendons attached to the two sesamoid bones situated at the ball of the foot.

Sesamoids act as a pulley which enables tendons to move the big toe allowing it to push off whenever you run or walk. Since they are placed in the metatarsal, sesamoids also help the ball of the foot to bear weight during high impact activities.

Intense activities such as dancing, running, walking or jumping may sometimes lead to increased pressure at the ball of your foot. This in turn causes injuries to the tendons, bones or even the tissue adjacent to the joint.

Also Read: Best Running Shoes for Capsulitis of the Second Toe

Symptoms of Sesamoiditis

  • The first indicator of sesamoiditis is pain under your big toe. Normally, the pain develops gradually.
  • The big toe feels stiff and painful when bending or straightening.
  • Sometimes it may be associated with bruising or inflammation

Sesamoiditis can sometimes be confused with the fracture of sesamoid bones. But while symptoms of fracture are felt almost immediately, pain from sesamoiditis occurs gradually.

As the symptoms progress, the affected person my start to limb as they try to shift their body weight to the unaffected foot.

Causes of Sesamoiditis in Runners

Overuse: You’re at a higher risk of suffering sesamoiditis if you are frequently engaged in activities that exert excessive pressure on the ball of the foot. Such activities may include running, ballet dance, jumping, basketball and so on.

Foot Type: If you have high foot arches, you put excessive pressure on the balls of your feet especially during high impact activities. Thus, you’re more likely suffer sesamoiditis than individuals with flat or medium foot arches.

Also at risk are bony people because their bodies lack enough fat to shield the sesamoids.


Your doctor will physically touch the ball of the foot to check for any signs of tenderness. The flexibility and the intensity of pain on the big toe might be used to diagnose the possibility of sesamoiditis.

If the physical examination is positive, an X-ray will be used to differentiate sesamoiditis from fracture. In case of fracture, the sesamoids appear to have jagged edges. However, in the absence fracture, sesamoids are usually smooth. Taking X-rays of both feet will help in comparing the condition of your sesamoids.

Greater details of the condition can be provided through a bone scan. An MRI or ultrasound can be used to check for any injuries in the tendons or soft tissue.

Related: Best Shoe Inserts for Capsulitis

Treatment Options for Sesamoiditis

Usually, treatment for sesamoiditis is focused on relieving pain and inflammation. Thus, surgical interventions are very rare. Below are some of the methods commonly used in the treatment of sesamoiditis.


The first intervention for sesamoiditis is to try to halt any activities or motions that exert pressure on the ball of the foot. For instance, you can use crutches to avoid putting pressure on the affected foot. Resting and icing may also help reduce pain.

If your footwear such as high-heeled shoes are causing excessive pressure on the sesamoids, replace with supportive and comfortable shoes. Consider wearing low-heeled shoes that have a soft midsole.


Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can be administered to ease pain. In addition, cortisone injections may be administered to reduce the inflammation.

Shoe Therapy

Most Podiatrists will recommend shoe therapy as one of the most efficient remedy for sesamoiditis. The best running shoes for sesamoiditis should have the following features:

  • Zero drop or minimalist configuration to keep the ball of the foot at the same level with the heel. This minimises the pressure exerted by the weight of the foot on the ball of the foot.
  • Sufficient arch support also helps alleviate excessive pressure on the ball of the foot.
  • Shoes with wide toe box allows the big toe as well as other toes to splay thus relieving them of pressure. This enables the toes to have proper alignment.
  • They should have sufficient cushioning especially at the forefoot to shield the ball of the foot for unwanted impacts.

Best Running Shoes for Sesamoiditis

1. Orthofeet 672 Athletic Shoe

As its name depicts, orthofeet is designed with an orthotic foot bed to protect runners from common foot injuries. If you suffer from sesamoiditis, plantar fasciitis, back pain, knee pain among others, this is the right running shoe to wear.

Orthofeet 672 Athletic Shoe

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One of the notable feature in this shoe is the arch support which adapts to the anatomy of your foot. The lightweight cushioning at its midsole gives you a soft and energetic landing to propel you forward.

The lacing system enables you to wear and remove the shoe without tying or untying the laces. Plus there’s a heel strap for securing the foot inside the shoe without accidental slippage.

  • Orthotic foot bed
  • Heel strap secures the foot
  • Breathable upper
  • No tying or untying laces
  • Runs small

2. Hoka One One Bondi 5

This is a trusted brand when it comes to arch support and comfort. With its ortholite insole the arch is well supported which alleviates pressure at the ball of the foot.

Hoka One One Bondi 5

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It midsole features an EVA cushioning which runs full-length. Thus your under-foot is fully protected from any harsh ground impacts. The outsole is made of high quality rubber to enhance good traction and add to the durability of the shoe.

The upper unit has a breathable mesh which is also responsible for the comfortable support of the foot.

  • Ortholite insole is good for arch support
  • Well-cushioned foot-bed
  • Breathable
  • Comfortable
  • Roomier toe-box
  • Expensive

3. Brooks Ghost 12

Designed for neutral pronation, this running shoe comes in handy for people suffering from sesamoiditis. Two types of technology are utilized in its midsole to give it excellent cushioning that will protect your underfoot from harsh impacts.

Brooks Ghost 12

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Blown rubber makes the outsole because of its durability and good traction on surfaces. With the heel detached from the forefoot and midfoot, ground impact is concentrated at the heel. This alleviates pressure on the ball of the foot thus protecting the sesamoids from injury.

The engineered mesh on its upper unit promotes good breathability while supporting the foot with a comfortable wrap. This mesh is reinforced with synthetic overlays to boast its structure and protect it from wear and tear.

The inner lining, padded tongue and collar enhances your overall comfort while the lacing system ensures a secure fit.

  • Comfortable
  • Supportive
  • Promotes smooth transition
  • Breathable
  • Toe box is a bit narrow


Orthotic insoles can be worn with most of your running shoes to provide extra cushioning and arch support. They are especially very helpful for individuals with high foot arches. High foot arches lack the ability to absorb shock which heightens the pressure on your sesamoid bones.

However, you can get either over-the-counter or customized orthotic insoles to support your arches and prevent sesamoiditis injuries or fractures. Metatarsal pads are the most ideal insoles for sesamoiditis.

Best Insoles for Sesamoiditis

Dr. Frederick’s Metatarsal Pads – Best For Sesamoiditis

Dr. Frederick’s Metatarsal Pads - Best For Sesamoiditis

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Hyjinx Re-Usable Metatarsal Cushions – Great for Sesamoiditis

Hyjinx Re-Usable Metatarsal Cushions - Great for Sesamoiditis

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Natracure Gel Metatarsal Pads – For Sesamoiditis

Natracure Gel Metatarsal Pads – For Sesamoiditis

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Pedag Drop Metatarsal Pads

Pedag Drop Metatarsal Pads

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Soft Gel Metatarsal Pads – For Men and Women

Soft Gel Metatarsal Pads – For Men and Women

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Sesamoiditis can side-line or completely hinder you from your running or cross-training activities. However, with proper treatment, the condition should go out in a short period. Much of the interventions focus on reducing pressure on the ball of the foot. Thus, with the best running shoes for sesamoiditis it is possible to alleviate the pain and prevent future injuries.

In addition, customized orthotic insoles or metatarsal pads can be used to prevent sesamoiditis injuries or fractures.

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