Pain-free Tennis (finally)
Just wanted to share my sesamoid story to offer a bit of optimism to others out there who are frustrated.
I first injured my foot in 2024 when warming up for a social doubles match on a slightly frozen court. Thought nothing of it at the time, assuming that I'd stubbed my toe, and stupidly played on for a few hours. The next days and weeks were painful to walk, and when things weren't improving I went to the physio. It initially got misdiagnosed as a medial toe ligament sprain, which wasn't improving despite months of rehab exercises. Eventually got referred for an MRI which confirmed sesamoiditis. Rather than go down the route of steroid injections (which sounded unlikely to fully resolve the issue) or surgery, I decided to attempt to self-manage a gradual return to sports.
Things that I have tried over three past 12 months that haven't really helped:
- Taping to help with toe alignment
- Anti inflammatory medication
- Strengthening exercises, stretching, balance work
- A variety of different insoles, including some specifically for ball of foot pain
Things that have somewhat helped:
- I switched my work shoes and started wearing HOKA Bondi 9s pretty much all the time. It was only when I did this that I realized how much my normal work shoes were aggravating my sesamoiditis.
- I changed tennis shoes from Adidas Barricades (my go to for ~20 years) to K-Swiss Hypercourts, based on positive reviews from elderly players and reading about the increased foam depth on the forefoot.
But the main thing which has almost fully resolved my pain is using a carbon fibre Morton Extension plate underneath my insole (both work and sports footwear). I sort of stumbled across this while mid deep dive into insoles research, but I can't believe how much of a difference it has made. The plate is very thin so still reasonably flexible, but takes a lot of the pressure off your MTP joint during flexion. I also experimented with full foot carbon fibre plates, but this was giving me pain in my outer toes, which the Morton Extension version isn't. They were pretty inexpensive on Amazon, I got a pack of 2 for about £40, and use them underneath Superfeet insoles.
I can now play hours of tennis again with only minimal discomfort, and no more waking up the following day with a throbbing foot.
So good luck to anyone out there who is struggling in their own sesamoid journey, and just know that there is light at the end of the tunnel!