You have 2 sesamoid bones in your foot. These are small pieces of bone embedded in tendon, and they function like pulleys (kinda similar to your kneecap) for your big toe joint, by providing a smooth surface over which the tendons slide.
Your sesamoids help to absorb the weight placed on the ball of the foot when walking, running and jumping.
Complete recovery after sesamoidectomy is known to be quite variable – ranging from months to a year. This is due to factors such as:
- Whether you followed your doctor’s post-op instructions carefully, including rest, wound care, rehabilitation, proper footwear, etc.
- Lifestyle habits, including nature of your job, amount of exercise, running habits etc.
It’s for these reasons that your surgeon is the best person to ask about how long the swelling will take to recover completely.
Your foot has a dense sensory innervation, so it’s not uncommon for patients who’ve had their sesamoid bone removed to continue experiencing some pain and swelling in the ball of the foot for several months. This swelling should be isolated to the ball of your foot.
Generally speaking however:
- The initial healing after sesamoidectomy takes weeks.
- It takes about 3 months for all the soft tissues in your foot to settle after surgery – most of your improvement should be seen in the first three months.
- It generally takes 6 months or more for the swelling to fully subside, and by this point you should be able to resume most of your normal activities.
- By the 1 year mark, most people would have put the surgery behind them. Thus, you can continue to expect improved pain and function up to 1 year.
- Obviously any issues after the surgery, including swelling, needs to be followed up, because a disproportionate amount of pain and swelling could be due to other factors that warrant investigation. I imagine you will still be on follow-up by the surgeon who operated on you.
The fact that the swelling is ONLY brought by heavy duty work or exercise, and returns to normal after rest, makes it less likely to be worrying. Amongst other reasons, this type of swelling could be due to overuse, foot imbalance, or improper footwear and placing too much stress on the toe joint.
My suggestion, if I were you, would be to discuss these issues regarding swelling and recovery with your surgeon, for 2 main reasons:
- He can check for any other potential problems related to the surgery, such as infection
- He can link you up with appropriate professionals for further care, be it a podiatrist to assess and prescribe you correct footware, or a physiotherapist/sport medicine doctor to plan rehabilitation of your foot.
In the interim, whenever your toe is swollen, you could rest, ice and elevate it – simple things to do to reduce the swelling more quickly. If the pain or swelling is bad, taking an NSAID like ibuprofen can help as well.
