Sesamoiditis & Sesamoid Fracture Treatment in Los Angeles
Pain under the ball of the big toe is often a sesamoid problem. Dr. Alexis Dixon, MD, FAAOS, a board-certified orthopaedic foot & ankle surgeon in Marina Del Rey, diagnoses and treats sesamoiditis and sesamoid fractures.
Forefoot Conditions
What Are the Sesamoids?
The sesamoids are two small, pea-sized bones under the ball of the big toe. They help you push off when you walk and run, and because they take so much force, they’re prone to inflammation and fracture.
Two common problems affect them. Sesamoiditis is inflammation of the sesamoids and surrounding tendons from overuse or repetitive pressure. A sesamoid fracture is a break in one of the bones, from either a sudden injury or chronic stress. Both cause pain under the big-toe joint that worsens with activity, and because they can look similar, telling them apart (and distinguishing a true fracture from a naturally two-part “bipartite” sesamoid) takes an experienced eye.
If you have persistent pain under the ball of your foot near the big toe, it should be evaluated by a foot and ankle surgeon.
Know the Signs
Symptoms & Causes
- Pain under the ball of the foot, beneath the big toe
- Pain that worsens with walking, running, or pushing off
- Swelling and tenderness in the area
- Difficulty bending or straightening the big toe
- Pain when wearing heels or thin-soled shoes
Common causes include running, dancing, high-impact sports, high-arched feet, and footwear that loads the forefoot. Sudden trauma can cause an acute fracture; repetitive stress can cause a stress fracture or sesamoiditis.
Getting It Right
Diagnosis
Accurate diagnosis is key, because sesamoiditis, a true fracture, and a normal bipartite sesamoid can all look alike. Dr. Dixon combines a focused exam with X-rays, and MRI or a bone scan when needed, to distinguish inflammation from a fracture and to confirm whether a two-part sesamoid is broken or simply a normal variant. Getting this right determines the correct treatment.
Conservative First
Treatment Options
Step 1
Rest & Offloading
Activity modification, stiff-soled shoes or a boot, padding and orthotics to take pressure off the sesamoids, and anti-inflammatories.
Step 2
Immobilization
For fractures, a period of immobilization and protected weight-bearing to allow the bone to heal.
Step 3
Surgery
For fractures that won’t heal or chronic pain that doesn’t respond, surgery addresses or removes the affected sesamoid.
Why See a Board-Certified Orthopaedic Surgeon (MD)?
Sesamoid problems are easy to misdiagnose: a normal two-part sesamoid is often mistaken for a fracture, and vice versa. A board-certified orthopaedic foot & ankle surgeon has the imaging expertise to get the diagnosis right and protect the big-toe joint that powers every step.
Recovery
What Recovery Looks Like
Weeks 1–2
Offload the sesamoids, stiff-soled shoe or boot, padding, and activity modification.
Weeks 2–6
Continued protection; fractures may need immobilization to heal.
Weeks 6–12
Gradual return to activity with orthotics to prevent recurrence.
If surgery
A structured, supervised recovery and return-to-sport plan.
What Patients Say
Patient Reviews
Patient Questions
Sesamoid FAQs
About Your Surgeon
Alexis E. Dixon, MD, FAAOS
Dr. Dixon is a board-certified orthopaedic foot & ankle surgeon practicing in Marina Del Rey, California. USC-trained and named an LA Magazine Top Doctor since 2017, she combines surgical expertise with a conservative-first philosophy, treating the underlying joint and tendon, not just the symptom. She treats ganglion cysts, bunions, Achilles injuries, plantar fasciitis, fractures, and the full range of foot and ankle conditions.
Meet Dr. Dixon →Pain Under the Ball of Your Foot?
Get an accurate diagnosis and a clear plan from a board-certified orthopaedic foot & ankle surgeon in Marina Del Rey.