The sesamoids are two small bones underneath the ‘ball’ of the big toe. They lie within the flexor hallucis brevis tendon and act as pulleys rather like the kneecap does with the quadriceps. They form part of the big toe metatarsophalangeal joint.
Problems with these bones usually cause pain directly in this region, under the big toe. They are usually caused by overuse or a traumatic event.
Most patients can be treated without surgery, with rest and modifying activity, combined with off-loading insoles. Rarely surgery is required