Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Township, MI
Last reviewed: May 2026
Sesamoiditis near Farmington Hills often hides a sesamoid stress fracture that looks like a normal bipartite sesamoid on X-ray — and treating a fracture as inflammation delays healing by months. An MRI is the only way to tell them apart before committing to a treatment plan. Call (810) 206-1402 — sesamoid evaluation and treatment in Farmington Hills.
Medically Reviewed by: Dr. Tom Biernacki DPM · Board-Certified Podiatrist · Balance Foot & Ankle PLLC · Updated 2026
Sesamoiditis Treatment Near Farmington Hills, MI
Sesamoiditis treatment near Farmington Hills, MI is available at Balance Foot & Ankle in Bloomfield Township. Dr. Biernacki DPM provides sesamoid offloading orthotics, corticosteroid injections, and when needed, surgical sesamoidectomy. Don’t keep pushing through big toe pain. Call (810) 206-1402.
What Is Sesamoiditis?
The sesamoids are two small bones embedded in the flexor hallucis brevis tendon beneath the first metatarsal head — they function like kneecaps for the big toe, providing a mechanical advantage for push-off and absorbing the weight-bearing forces of the forefoot. Sesamoiditis is inflammation of the sesamoid bones and surrounding soft tissue from repetitive stress. It produces a dull aching pain under the ball of the foot at the base of the big toe, which worsens with activities that load the forefoot — running, dancing, wearing high heels, or even walking barefoot on hard surfaces. In our Farmington Hills-area patients, sesamoiditis is most common in ballet dancers, runners, and athletes in forefoot-dominant sports.
Key Takeaway: Sesamoiditis vs. sesamoid fracture vs. avascular necrosis all look similar clinically — proper imaging (X-ray + MRI or bone scan) is essential before treatment, because the approach differs significantly between diagnoses.
Diagnosis and Treatment
We distinguish sesamoiditis from sesamoid fracture using weight-bearing X-rays and MRI when needed. Many patients have a bipartite sesamoid (naturally split into two pieces) that mimics a fracture on X-ray — MRI clarifies this. Sesamoiditis treatment is primarily about reducing load on the sesamoids: custom orthotics with a sesamoid dancer’s pad cutout (a J-pad that offloads the sesamoid while cushioning around it), stiff-soled shoes that limit first MTP joint dorsiflexion, and activity modification. Corticosteroid injection around the sesamoid provides significant pain relief for acute flares. Complete sesamoid fractures with avascular necrosis that fail prolonged conservative care are treated with sesamoidectomy — surgical removal of the damaged sesamoid.
Recovery Timeline and Return to Activity
Sesamoiditis is one of the slower-healing foot conditions — the sesamoids receive relatively poor blood supply and the forces on them during normal walking are substantial. Mild-to-moderate sesamoiditis typically responds to 6–12 weeks of conservative care. Sesamoid stress fractures require 3–4 months of protected weight-bearing. Dancers and athletes should expect a gradual, supervised return to full activity. In our experience, patients who rush back before symptoms fully resolve almost always relapse.
⚠️ See a Podiatrist If:
- Persistent pain under the big toe ball that worsens with activity
- Big toe is painful and stiff, especially during push-off phase of walking
- You’ve had multiple “turf toe” injuries
- Pain persists despite rest and shoe changes for more than 3–4 weeks
- You’re a dancer or runner with forefoot pain that limits performance
Plantar Plate Tear Recovery Products
Conservative management of plantar plate tears focuses on offloading the injured metatarsophalangeal joint and reducing extension forces on the toe:
Pedag Metatarsal Pad — Joint Offloading
A metatarsal pad placed proximal to the injured MTP joint transfers pressure away from the plantar plate during push-off. This is the single most important conservative intervention for plantar plate tears — it dramatically reduces the load on the injured ligament with every step. Placement is precise: it must sit just behind the metatarsal head, not under it. We demonstrate correct placement at every appointment.
Brooks Ghost 16 — Stiff-Soled Shoe for Plantar Plate Recovery
A shoe with a firm, relatively inflexible forefoot is essential for plantar plate tear rehabilitation — it prevents the excessive toe dorsiflexion during push-off that stresses the injured ligament. The Ghost 16’s firm DNA LOFT midsole resists forefoot bending effectively. Combined with the metatarsal pad, this combination significantly reduces pain during walking and allows the plantar plate to heal without repeated re-injury.
Getting to Our Office From Farmington Hills
Our Bloomfield Township office at 43494 Woodward Ave #208 is about 15–20 minutes from Farmington Hills via I-696 E to Woodward Ave. We accept most major insurance. Call (810) 206-1402 or book online.
Stop Pushing Through Sesamoid Pain
Balance Foot & Ankle · Serving Farmington Hills & Michigan
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📋 Dr. Tom Biernacki, DPM, FACFAS answers:
Sesamoiditis near Farmington Hills is inflammation of the sesamoid bones located under the big toe joint, causing pain with walking and push-off activities. Our podiatrist serving Farmington Hills differentiates sesamoiditis from sesamoid stress fracture using X-ray and bone scan or MRI when needed, as treatment differs significantly. Conservative care for sesamoiditis includes offloading padding under the ball of the foot, a dancer’s pad, stiff-soled footwear, and custom orthotics with a sesamoid cutout. Activity modification and anti-inflammatory medications reduce acute inflammation. Corticosteroid injections provide targeted relief for persistent cases. For confirmed sesamoid stress fractures, non-weight-bearing immobilization for six to eight weeks is required. Patients near Farmington Hills who do not respond to conservative care after four to six months may require surgical sesamoidectomy, which has excellent outcomes when properly indicated.
What is sesamoiditis and what causes forefoot pain under the big toe?
Sesamoiditis is inflammation of the sesamoid bones — two small bones embedded in the flexor hallucis brevis tendon beneath the first metatarsal head — caused by repetitive stress or acute overloading. Ballet dancers, runners, and people with high arches are most susceptible. Our podiatrists in Farmington Hills distinguish sesamoiditis from sesamoid fracture using X-rays and MRI, since management differs significantly between the two conditions.
How is sesamoiditis treated?
Treatment focuses on offloading the sesamoids: dancer’s pads, custom orthotics with sesamoid cutouts, stiff-soled footwear, and activity modification away from high-impact loading. NSAIDs and corticosteroid injections reduce acute inflammation. Non-weight-bearing casting is used for sesamoid stress fractures. Most inflammatory sesamoiditis resolves within 6–12 weeks of consistent conservative care.
When is surgery considered for sesamoid problems?
Surgery is reserved for avascular necrosis, displaced fractures failing conservative care, or chronic pain unresponsive to 6+ months of treatment. Sesamoidectomy reliably relieves pain, though partial removal is preferred to preserve hallux flexion strength. Full return to sport typically requires 3–4 months after surgical recovery.
Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.
More questions patients ask
How long does sesamoiditis take to heal?
Sesamoiditis healing time ranges from 6 weeks for mild cases to 6 months or longer for severe cases, especially when a sesamoid stress fracture is present. Bipartite sesamoids (naturally split bones) complicate diagnosis because they look like fractures on X-ray. MRI is the gold standard for confirming a true sesamoid injury and guiding realistic recovery timelines.
What is the difference between sesamoiditis and a sesamoid fracture?
Sesamoiditis is inflammation of the sesamoid bones and surrounding tendons without a true break. A sesamoid fracture is an actual crack in the bone, which requires longer immobilization and sometimes surgical removal if it fails to heal. MRI distinguishes between the two — plain X-rays often cannot, especially when a bipartite sesamoid (congenital split) is present.
Can you walk on sesamoiditis?
Walking with sesamoiditis is possible but aggravates the condition if footwear isn't modified. A stiff-soled shoe with a dancer's pad (padding that offloads the ball of the foot under the big toe) significantly reduces pain during walking. Complete non-weight-bearing with a walking boot is prescribed for sesamoid stress fractures or severely inflamed cases that don't respond to padding alone.
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