How long for sesamoid fracture to heal

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There is one sesamoid bone on each side of the base of the big toe. The muscles that bend the big toe down the toe flexors pass underneath the main joint of the big toe, crossing over the bump formed by the sesamoid bones.

This bump acts as a fulcrum point for the toe flexors, giving these muscles extra leverage and power. The sesamoids also help absorb pressure under the foot during standing and walking, and they ease friction in the soft tissues under the toe joint when the big toe moves. Sesamoid pain can develop a number of different ways. When the tissues around the sesamoid bones become inflamed, doctors call the condition sesamoiditis.

Sesamoiditis is often caused by doing the same types of toe movements over and over again, which happens in activities like running and dancing. Fractures can also cause pain in the sesamoids. Fractures can occur when a person falls and lands bluntly on the ball of the foot. Stress fractures can also occur in the sesamoid bones. Stress fractures are usually caused by the strain of overworking the soft tissues.

Athletes most often suffer stress fractures of the sesamoids because of the heavy and repeated demands that training places on the soft tissues of the foot and big toe. Arthritis can develop where the sesamoids glide under the bone of the big toe.

The sesamoid bones create a joint where they move against the bone of the big toe. Like other joints in the body, this joint can also develop arthritis. Arthritis is more likely to be a problem in people who have high arches in their feet. The high arch causes the main joint of the big toe to become rigid. This focuses strain and pressure on the sesamoids. In some cases, blood supply to the sesamoid bone is decreased.

This condition is called osteochondritis. Osteochondritis causes a piece of the bone to actually die. The body's attempts to heal the area may build up extra calcium around the dead spot. Sometimes sesamoid pain comes from extra tissue under the big toe joint, similar to a corn. Doctors call this extra tissue an intractable plantar keratosis. People with sesamoid problems usually feel vague pain under the main joint of the big toe. The sesamoids typically feel tender when touched.

Movement of the big toe is often limited. People tend to notice pain mostly when their big toe is stretched upward , which can happen when the back foot pushes off for the next step. Occasionally the joint catches or pops. The catching or popping is often followed by increased pain, which usually eases after resting.

Some people report feelings of numbness in the web of the first two toes. Your doctor will ask many questions about your medical history. You will be asked about your current symptoms and whether you've had other foot and joint problems in the past. Your doctor will then examine your painful toe by feeling it and moving it. This may hurt, but it is important that your doctor locates the source of the pain and determines how well the toe is moving.

You may also be asked to walk back and forth. Your doctor will probably order an X-ray. The axial view gives doctors a good idea whether there are problems in the sesamoids. To get an axial view, the X-ray is angled to show the space between the sesamoids and the bottom part of the big toe joint. The X-ray image may show a sesamoid bone that looks like it is divided into two or more separate bones, as though it were fractured.

This is normal in about 10 percent of people. If the small space between the bone pieces is smooth, it's probably okay. If the space is jagged, there could be a fracture. Your cast may be removed after two weeks and you may be put into a removable cam walker if you need continued support as you begin walking. If the pain goes away and your physician sees signs of healing after six weeks, you typically can return to normal shoe wear. When you can tolerate the pain, a period of relative rest begins, which lasts until your foot can withstand the stress of the activity that caused the sesamoid disorder.

Relative rest means that you need to keep your activity level below your level prior to injury. Though the pain has gone away from your foot, you are still at risk for reinjury if you return to the same activity that led to overuse and caused the injury.

In some cases, your pain may continue for a prolonged period of time. After four to six months of conservative treatment without results, you may become a candidate for surgery to remove the injured sesamoid. Formal physical therapy may not be necessary after a sesamoid disorder.

Many patients can adequately restore motion and strength in their big toe with a regular cardiovascular exercise program. Most patients can return to sports and activities within two or three months after the injury. Begin exercising with short walks and increase the duration and intensity as pain allows.

You may be able to use stationary cycles or swim without causing much pain in your foot about two weeks after the injury, except when you are wearing a cast. When your pain is gone, start with low impact exercises. Progress to light jogging before sprinting, jumping, and cutting. More vigorous running and exercise typically can begin within eight weeks after treatment begins.

Gradually return to activities with pain as your guide. Increase your workouts slowly, and if pain returns, decrease the intensity and duration of your walks, runs, or other physical activities. The best way to prevent reinjury in your sesamoid is to be sure that your big toe is flexible and strong before you begin repetitive running, jumping, and cutting motions.

The risk of reinjuring your sesamoid is small if it heals properly. Returning to activities before your pain has gone away and increasing your activity level too quickly may cause pain and symptoms to flare up again.

Proper footwear, designed for your particular sport or activity, can help protect your foot against abnormal strain in your big toe joint.