Sesamoids are small bones that connect only to tendon or muscle rather than to other bones. The kneecap is the largest sesamoid, but several more are found in the foot: two near the great toe, one in the middle, and one at the side of the foot. The sesamoids of the foot help with weight-bearing and lifting the great toe. They can undergo two types of injury: fracture and inflammation of the tendons surrounding the sesamoid. This second type of injury is called sesamoiditis. Symptoms: Pain localized to the ball of the foot. Pain in sesamoiditis usually has a gradual onset, while pain with a fracture has a rapid onset. Pain and impaired movement of the great toe. There may be swelling and bruising Physical examination of the foot in the region of the sesamoids and examination of the movements of the great toe are important in diagnosis. Your physician may also obtain X-rays or a bone scan to check for fractures and to examine bone structure. Treatment primarily consists of rest, ice, anti-inflammatory drugs, and cushioning of the forefoot. Taping and braces may help in severe cases or with fractures. If these measures fail, surgery may be necessary.