Do you suffer from pain and discomfort under the big toe?

You might suffer from irritation or injury of the sesamoid bones. At FASA we have developed a specialised technique to treat these injuries non surgically and have the experience to provide expert surgical advice and treatment if necessary.


The sesamoid bones are two pea-like shaped bones found on the ball of the foot, underneath the big toe.

Sesamoid bones assist with the natural movement of the big toe and provides extra assistance when the big toe pushes off during walking and running.

In many ways they function like a knee cap.



Like a knee and its kneecap, the big toe joint and its sesamoid bones can be injured suffering problems like fractures, cartilage damage and ligament tears. Such injuries can occur in association with any activity especially with repeated stress to the big toe joint, for example, basketball, ballet, football, running and tennis.

We commonly see these injuries in teenagers.

HINT: Wearing high heels can also be a contributing factor.


To be successful will depend on an accurate and early diagnosis! A range of treatments are used and often in combination including:

  • Offloading pressure to the area to relieve any inflammation. We provide guidance on footwear, strapping and appropriate types of insoles.
  • Immobilization is often required. At FASA we use a specific form of immobilisation developed by Mark Gilheany to address sesamoid pathology. This will be in conjunction with a rehabilitation program once weight bearing is allowed.
  • Medications can be prescribed. At FASA we can prescribe the appropriate medications for managing the pain and inflammation associated with such injuries and can also use stimulatory injections to assist healing where indicated.


Occasionally the sesamoid injury will not respond to conservative care. In these cases, surgical removal of the sesamoid is considered and discussed with you. Like all operations there are relative risks and precautions we need to be aware of but using minimally invasive dissection techniques and repair of the soft tissues about the sesamoid region, patients generally return to full function including elite performance after a recovery period.

Other operations have been proposed for sesamoid pain, but these can be complicated and have a high failure rate. At FASA we suggest you obtain an opinion from us if you have been recommended to undergo an operation for sesamoid pain. Especially if the suggested operation is anything other than sesamoid removal.

Call (03) 9639 4644 to make an appointment or