Sesamoid Injuries of the Great Toe Joint

Spring is upon us, and choices of shoe gear change, as well as increased levels of outdoor weight-bearing activities, which can set us up for sesamoid injuries of the great toe joint.  Sesamoid injuries are common, but often overlooked injuries to the great toe joint.  Proper diagnosis and early treatment intervention is essential.   Most people experience pain in their underlying great toe joint made worse with weight-bearing activity. So what exactly are sesamoids? Sesamoids are accessory bones found throughout the body.  They are found embedded in tendons and act as pulleys to increase the power and efficiency of those tendons and their neighboring joints. The kneecap is the largest sesamoid bone in the body and increases the strength of the quadriceps tendon during knee extension, enabling us to walk, jump and climb with greater power. In the foot, there are two sesamoid bones present in the flexor tendon beneath the great toe joint.  They are about the size and shape of peanuts. Their job is provide us with greater propulsion when walking, running and jumping. Certain activities and biomechanical factors can contribute to sesamoid injuries.
  • High arches place more force on the heels and sesamoid bones.
  • Bunions change the weight bearing distribution on the sesamoid bones.
  • High heeled shoes.
  • Sports such as running, basketball, ballet, football and tennis.
What types of sesamoid injuries do we typically see?
  • Sesamoiditis:  This is an overuse injury of the sesamoid bones, caused by a repetitive bruising of the bones. The symptoms will quickly improve if the pressures on the sesamoids can be reduced.  
  • Fracture:  The fracture is often from a memorable event, but sometimes can result from prolonged overuse.  Unlike most bones, the sesamoid bones of the foot have poor blood supply leading to prolonging or non-healing.
  • Avascular necrosis:  Blood supply to the sesamoid bone is lost leading to degeneration and chronic pain.
  • Turf toe:  This is an acute hyperextension injury of the great toe joint seen in high energy sports such as football.  The ligaments and tendons around the sesamoids are strained.
Minor injuries, such as sesamoiditis may be managed simply with changes in shoe gear or custom orthotics, however, more serious injuries may require immobilization or even surgical intervention. As with most injuries, proper and early diagnosis is essential. - Lee Firestone, DPM Dr. Firestone practices in the K Street NW (202-223-4616) and Chevy Chase (301-913-5225) locations. The information on this site is provided for your assistance only; this site does not provide podiatric advice.  You should never diagnose or treat yourself for a podiatric condition based on the information provided herein, and the information is not provided for that purpose.  Likewise, you should never determine that treatment is unnecessary based on this information.  The information contained herein is not a substitute for podiatric care provided by a licensed podiatric professional.  The information provided herein is not podiatric, medical or professional advice.  This site does not create a doctor-patient relationship. Doctor Firestone and Foot and Ankle Specialists of the Mid-Atlantic, LLC expressly disclaims all warranties of any kind, whether express or implied, related to any products offered for sale on this web site.  Doctor Firestone and Foot and Ankle Specialists of the Mid-Atlantic, LLC further expressly disclaims any product warranties of effectiveness or fitness for any particular purpose or use.  You are solely responsible for your use of, or reliance on, any products offered for sale herein, and any consequences arising out of such use or reliance.  In no event will Doctor Firestone and Foot and Ankle Specialists of the Mid-Atlantic, LLC be liable for any damages resulting from use of or reliance on any such products, whether based on warranty, contract, tort or any other legal theory.   This Website, and the information contained herein, is provided to you as a service for use at your sole risk.   If you are feeling ill, please call your primary care physician, or other healthcare provider.  In the case of an emergency, please go to the nearest hospital.  

Dr. Kyle Scholnick Featured in PM Magazine

Foot and Ankle Specialists of the Mid-Atlantic, LLC (“FASMA”) podiatrist Kyle Scholnick, DPM, was recently published in the January and February 2016 editions of Podiatry Management Magazine. Dr. Scholnick's articles, "Anterior Ankle Impingement Syndrome" and “The Effects of Renal Disease on Wound Healing” were chosen as featured articles for the magazine's continuing medical education (CME) program. Dr. Scholnick completed his three-year foot and ankle surgical residency at Yale-New Haven Hospital in New Haven, Connecticut, where he served as Chief Resident. His areas of interest include forefoot and rearfoot reconstructive surgery, diabetic limb salvage, sports medicine, and trauma. As a published author, he has written about osteomyelitis, wound healing, chronic venous insufficiency, tarsal tunnel syndrome, ankle impingement, and plantar fasciitis. Dr. Scholnick practices at the Kensington and Columbia offices with staff privileges at MedStar Montgomery Medical Center and Howard County General Hospital. Foot and Ankle Specialists of the Mid-Atlantic, LLC, has 22 locations in DC, Maryland, Pennsylvania, and Virginia.  To find a location near you, and to request an appointment online, please visit our website at

FASMA Participates in Local Health Fair

Foot and Ankle Specialists of the Mid-Atlantic, LLC (“FASMA”) podiatrists Caitlin Madden, DPM and Adam Spector, DPM attended the Health & Wellness Fair at Wheaton Mall, hosted by Holy Cross Hospital,  in January to answer questions about common foot ailments and promote general foot health. Drs. Spector and Madden are very active in the community and participate in a variety of health fairs and events throughout the area. Dr. Adam Spector received his Doctorate in Podiatric Medicine from Temple University of Podiatric Medicine, PA, in 1989. He then completed a surgical residency at Roseland Surgery Center and St. Michael’s Medical Center in New Jersey. He is Board Certified by the American Board of Foot and Ankle Surgery (ABFAS) in foot and ankle surgery and is a fellow and founding member of the American Society of Podiatric Surgeons. Current, Dr. Spector is the chief of podiatric surgery at Holy Cross Hospital, and director of the only in-office JCAHO-certified ambulatory surgery center in the DC/MD/VA area. Dr. Caitlin Madden received her Doctorate of Podiatric Medicine from Temple University School of Podiatric Medicine in 2011. She completed 4 years of residency at Penn Presbyterian Medical Center;extensive forefoot, rearfoot and ankle surgical experience, including acute foot and ankle trauma, reconstructive principles, diabetic limb salvage and wound care, along with multiple non-podiatric medical and surgical rotations. Dr. Madden is an Associate of the American College of Foot and Ankle Surgeons and a member of the American Podiatric Medical Association and the Maryland Podiatric Medical Association. She graduated from the University of Notre Dame in 2007 with a Bachelor of Science degree. She is a native of southern New Jersey, and grew up learning about podiatry from her father, a well-respected podiatrist, professor and administrator. To make an appointment with Drs. Spector or Madden, call the Wheaton office at 301-949-3668 or the Shady Grove office at 240-268-7450, or use our online appointment request form.

Dr. Mo Esmaili Board Certified by American Board of Podiatric Medicine

Foot and Ankle Specialists of the Mid-Atlantic, LLC (“FASMA”) is proud to announce that podiatrist Mo Esmaili, DPM, is now Board Certified by the American Board of Podiatric  Medicine. Dr. Esmaili practices in the Kensington office. Dr. Esmaili received his Doctorate of Podiatric Medicine from Temple University School of Podiatric Medicine in 2009. He then completed three years’ post-graduate training in podiatric medicine and surgery, at Virtua West Jersey Hospital in Voorhees, New Jersey where he was Chief Resident.  As Chief Resident, Dr. Esmaili was selected to participate in a surgical mission trip to El Salvador, where he used his training in residency to surgically treat children with congenital deformities, such as flat foot, club foot, and cavus foot-type deformities. He has held expertise in Reconstructive Foot and Ankle Surgery, Trauma, Diabetic Foot Care, Limb Salvage, Sports Medicine, Acute and Chronic Tendon Rupture. Dr. Esmaili enjoys traveling, playing tennis, and spending time with his family. Dr. Esmaili is fluent in Farsi and English.  He enjoys giving back to the community and is involved with Catholic Charities to provide care to the less fortunate. Congratulations, Dr Esmaili, on your Board Certification! To schedule an appointment with Dr. Esmaili, call the Kensington office at 301-949-2000 or request an appointment online.

Mid-Atlantic Podiatry Supergroup Adds a New Podiatrist

Foot and Ankle Specialists of the Mid-Atlantic, LLC (“FASMA”) welcomes Stacia Jones, DPM, to its Greenbelt and Annapolis Divisions on April 1, 2016. Dr. Jones received her doctorate from Temple University School of Podiatric Medicine.  She completed 3 years of extensive surgical training in foot and ankle reconstructive surgery in New York City.  During her senior year, Dr. Jones had the distinction of being named Chief Resident. Upon graduating from the residency program, Dr. Jones moved to Harrisburg, PA, where she spent 3 years providing podiatric medical and surgical services to patients in Central Pennsylvania.  Dr. Jones relocated to Maryland to be closer to her family and friends. Her areas of expertise include management of diabetic wound care, forefoot reconstructive surgery, pediatrics, and sports medicine injuries. Dr. Stacia Jones is a diplomate of the American Board of Podiatric Medicine. To schedule an appointment with Dr. Jones, call the Greenbelt office at 301-577-4464 or the Annapolis office at 410-266-7575, or use our online appointment request form.