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The ball of the foot, what is it and what can go wrong?

The “ball of the foot” is a common term referencing the prominent area on the bottom of the foot just before the big toe joint. As well as a few other structures, there are 2 small bones under your big toe joint called sesamoids. Their job is to absorb pressure when walking and running, help raise and move the big toe and decrease friction forces.

A common injury to this area is called sesamoiditis.

As the ‘itis’ part of sesamoiditis suggests, these bones can become inflamed and injured due to high amounts of pressure and impact. They may become very achy, swollen and redness might appear. If this is not managed the bones can fail (fracture).

Who is more at risk?

- People doing high impact sports

- A sudden increase in activity

- High arch foot types

- Extended periods of running

- High heels

- Wearing shoes that lack cushioning

Some things to try at home:

Initial treatment is aimed around reducing pain and inflammation, give the following a try:

- Rest. As annoying as it is, many of these suggestions will aim to reduce the pressure, and rest is an easy way to do this. Try swimming to keep fit in the mean time.

- Wear cushioned, supportive runners for a couple of weeks. Try and use them at all times. Think of it like the sling you might use for your sore shoulder or arm.

- Ice

- Anti-inflammatories can be discussed with your podiatrist, pharmacist or GP

We understand treatment can be frustrating, however injuries are part of life for most of us. If you don't look after injuries in the early stages, they can become bigger problems and may require more time consuming and costly care.

Things your podiatrist can do:

Your podiatrist will ensure correct diagnosis and be able to help reduce you pain effectively. They will be also looking in to why the issue occurred in the first place and how to avoid it in the future.

They may do any or all of the following:

- Offload the area with padding and/or orthotics

- Provide footwear advice and modification

- Assess your foot posture and mechanics to see whether there is anything stressing the sesamoids out more than they can manage

- Refer for radiological imaging (x-ray, ultrasound or MRI)

On the occasion that the injury is non-responsive, or people do not follow treatment advice, the sesamoids can eventually fracture. In many cases, a moonboot (CAM walker) can be used with or without orthotics or padding. The injury will need to be monitored by your podiatrist. On occasion, people may require input from an orthopaedic (bone) surgeon.

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