Sesamoiditis is a forefoot condition often found in active people who practice dancing or running. The most common symptom is pain under the big toe or ball of the foot, specifically at the sesamoid bones. These two pea-shaped bones are actually embedded in a tendon located in the ball of the foot. Simply stated, the role of the sesamoid bones is to absorb the weight placed on the ball of the foot when you walk, run and jump. Problems arise when these bones become irritated or even fracture. Since they are inside a tendon, you subsequently develop a tendonitis. Sesamoiditis pain appears gradually at first, increasing with aggravating factors such as physical activity. People typically experience a dull or sharp pain under the big toe or ball of the foot, generally with little swelling or reddening. Running and other aerobic activities are the primary instigators. Individuals with thin or boney bone feet are more at risk, as they lack sufficient fat tissue to “cushion the impact” for the sesamoid bones. Sometimes, a trauma can initiate the symptoms. The size of the sesamoid bones, patient weight, foot structure, activity level and type of shoe are all potential factors contributing to sesamoiditis.