Pain Under Your Big Toe When Walking, Running or Pushing Off? 

Pain beneath the big toe can make every step uncomfortable.  Whether you've recently increased your activity, enjoy running or spend long hours on your feet, discomfort in this area can quickly begin to affect your walking, exercise and everyday life.

At Callen Olive, we don't just treat the painful area.

We identify why the sesamoid bones have become overloaded, helping reduce pain whilst improving the way your foot functions to reduce the likelihood of symptoms returning.

Book your Biomechanical Assessment today.

Could it be Sesamoiditis?

Common symptoms include:

• Pain beneath the big toe joint
• Pain underneath the ball of the foot
• Tenderness when pushing off
• Pain during walking or running
• Swelling around the joint
• Pain in thinner footwear
• Difficulty with sport
• Feeling like you're walking on a pebble
• Symptoms that improve with rest before returning again

What is Sesamoiditis?

The sesamoid bones are two small bones beneath the big toe joint.

Although small, they absorb enormous forces every time you walk, run, jump or climb stairs.

Repeated loading can irritate these bones and the surrounding tissues, resulting in inflammation and pain beneath the big toe.

Why does Sesamoiditis develop?

It is rarely caused by one thing alone.

Common contributing factors include:

• Running and jumping sports
• Sudden increases in training
• Prolonged walking
• High arches
• Restricted big toe movement
• Foot biomechanics
• Unsupportive footwear
• Occupations involving prolonged standing

Understanding these factors is often the key to long-term recovery.

Could it be something else?

Pain beneath the big toe isn't always Sesamoiditis.

Other conditions that can produce similar symptoms include:

• Sesamoid stress fractures
• Turf toe
• Hallux Rigidus
• Metatarsalgia
• Gout
• Arthritis
• Flexor tendon injuries
• Plantar plate injuries

Accurate diagnosis is important because treatment differs significantly.

How we assess Sesamoiditis

We begin by understanding:

• your symptoms
• activity levels
• footwear
• previous injuries
• sporting demands

Your assessment may include:

• Clinical examination
• Big toe joint assessment
• Foot posture assessment
• Biomechanical assessment
• OptoGait gait analysis
• Footwear assessment
• Strength and flexibility testing

Where appropriate, imaging such as X-ray, ultrasound or MRI may be recommended.

Your personalised treatment plan

Every treatment plan is tailored to your symptoms, lifestyle and goals.

Treatment may include:

Biomechanical Assessment

Understanding how your foot moves often explains why excessive pressure is occurring beneath the sesamoid bones.

Custom Foot Orthotics

Where appropriate, custom orthotics help redistribute pressure away from the painful area whilst improving foot function.

Footwear Advice

Simple footwear changes can dramatically reduce loading beneath the big toe.

Padding & Offloading

Protective padding may provide immediate relief whilst irritated tissues recover.

Rehabilitation

Targeted exercises help improve strength, mobility and the foot's ability to tolerate load.

Activity Modification

Rather than stopping all activity, we'll advise how to remain active whilst allowing the tissues to settle.

Our aim is not simply to reduce today's pain.

Our aim is to help you return to walking, running and everyday life with comfort and confidence.

Pricing

Every treatment begins with a comprehensive assessment so we can understand why your symptoms have developed and recommend the most appropriate treatment.

Book your appointment

Persistent pain beneath your big toe doesn't have to stop you doing the things you love.

Whether you've recently developed symptoms or they've been troubling you for months, we're here to help.

Book your Biomechanical Assessment today and take the first step towards moving with comfort, confidence and ease.

Frequently Asked Questions

Can Sesamoiditis heal on its own?

Some mild cases may improve with rest and a temporary reduction in activity.

However, persistent pain should be professionally assessed to identify the underlying cause and reduce the risk of ongoing symptoms or an undiagnosed stress fracture.

How long does Sesamoiditis take to heal?

Recovery varies depending on the severity of the condition, how long symptoms have been present and the factors contributing to excessive pressure beneath the big toe.

Many people begin to notice improvement within several weeks once the area is effectively offloaded and the contributing factors are addressed. More persistent cases may take longer.

Can I still exercise?

In many cases, yes.

You may need to temporarily reduce or modify high-impact activities while the area recovers. Your podiatrist will advise you on suitable alternatives and help plan a gradual, safe return to your usual activity.

Will I need Custom Foot Orthotics?

Not everyone with Sesamoiditis requires orthotics.

However, if foot mechanics or excessive pressure beneath the big toe are contributing to your symptoms, Custom Foot Orthotics may help redistribute pressure away from the sesamoid bones and form an important part of your treatment plan.

Is Sesamoiditis the same as a stress fracture?

No.

Sesamoiditis involves irritation of the sesamoid bones or surrounding tissues, whereas a stress fracture is a small crack within the bone itself.

The symptoms can feel very similar, which is why professional assessment—and imaging where appropriate—may be required to establish the correct diagnosis.

Can footwear make Sesamoiditis worse?

Yes.

Shoes with limited cushioning, thin soles, high heels or designs that increase pressure beneath the big toe joint may aggravate symptoms.

Your podiatrist can advise which footwear features may help reduce pressure and improve comfort.

Why Patients Choose Callen Olive

Your feet deserve more than treatment.

At Callen Olive, we believe exceptional podiatry is about far more than relieving pain.

It's about understanding how your feet affect your comfort, confidence and the way you move through life.

Every person who walks through our doors has different goals, which is why every treatment plan is tailored to your individual needs, lifestyle and ambitions.

Because no two people — or feet — are the same.

Expert Care. Personally Delivered.

We combine specialist clinical expertise, advanced technology and genuinely personalised care to help you achieve the best possible outcome.

From your first appointment, you'll understand what's causing your symptoms, the treatment options available and how we'll support you every step of the way.

Why Patients Choose Callen Olive

• Specialist podiatry team
• Personalised treatment plans
• Advanced technology
• Evidence-based care
• Award-winning patient experience
• Trusted by thousands of patients every year

More Than A Podiatry Appointment

Exceptional care isn't just about clinical expertise.

It's about feeling listened to, understood and supported from the moment you arrive until long after your treatment has finished.

Because that's what great care should feel like.

We Care.

It's more than our promise.

It's how we listen, how we explain, how we treat and how we support every patient who places their trust in us.

Because helping you move with comfort, confidence and ease is why Callen Olive exists.

Healthy Feet. Healthy Body. Healthy Mind.

 

Further information

Every step places pressure beneath your big toe

The sesamoid bones act as small shock absorbers beneath the big toe joint.

During walking, running and jumping, they help:

• Support the big toe joint

• Absorb impact forces

• Improve leverage during push-off

• Protect the surrounding tendons

• Support balance and stability

When the pressure passing through this area exceeds what the tissues can comfortably tolerate, irritation and pain may develop.

Understanding why this pressure has increased is often the key to successful long-term treatment.

Why early assessment matters

Many people continue walking or exercising with pain beneath the big toe for weeks or months before seeking advice.

Without addressing the underlying cause, symptoms may repeatedly return when activity resumes.

Early assessment may help:

• Reduce pain

• Offload the affected area

• Support tissue recovery

• Maintain activity levels

• Reduce compensation through other parts of the foot

• Identify or exclude a stress fracture

• Reduce the likelihood of recurring symptoms

Is it Sesamoiditis or something else?

Pain beneath the big toe can have several possible causes.

Conditions with similar symptoms include:

• Sesamoid stress fracture

• Turf toe

• Hallux Limitus

• Hallux Rigidus

• Metatarsalgia

• Flexor tendon injury

• Bursitis

• Gout

• Plantar Plate Injury

Accurate diagnosis is important because these conditions may require different treatment approaches.

When should you seek professional advice?

We recommend arranging an assessment if:

• Pain lasts longer than a few days

• Walking becomes uncomfortable

• Exercise is becoming difficult

• Symptoms repeatedly return

• You notice swelling beneath the joint

• Rest no longer improves the pain

• You are struggling to wear your usual footwear

• Pain developed following a sudden increase in activity

• You are concerned about a possible stress fracture

Earlier diagnosis often supports a quicker recovery and helps reduce the risk of ongoing problems.

Related conditions

• Metatarsalgia

• Plantar Plate Injuries

• Hallux Limitus

• Hallux Rigidus

• Stress Fractures

• Turf Toe

• Morton's Neuroma

• Foot Pain

Related treatments

• Biomechanical Assessment

• OptoGait Gait Analysis

• Custom Foot Orthotics

• Footwear Assessment

• Rehabilitation Programmes

• Shockwave Therapy, where clinically appropriate

• Podiatric Acupuncture