Sesamoid Pain (Pain Under the Big Toe) Treatment in Mineola, NY

MULLIGAN CONCEPT

Sesamoid Pain

The sesamoids are two small bones under the big toe joint that help it push off. Irritation, called sesamoiditis, or a turf toe sprain causes pain under the big toe when walking, running or rising onto your toes. At Enhanced Physical Therapy in Mineola, we offload the area, then use Mulligan big toe mobilization and taping to restore comfortable movement.

Certified Mulligan Practitioner Over 10 Years of Experience

Our clinics director is a Certified Mulligan Practitioner (CMP) with over a decade
of experience using this evidence-based approach. Each treatment is customized to
your specific diagnosis and movement limitations to achieve optimal outcomes.

Common signs of sesamoid pain

Pain under the big toe joint
Pain pushing off or rising onto your toes
Pain in heels or thin-soled shoes
Swelling under the big toe
Pain after a big toe was bent back in sport (turf toe)

What causes it

Repeated load on the ball of the foot from running, dance, court sports, high heels and a high-arched foot can irritate the sesamoids. Turf toe happens when the big toe is forced back.

How we examine it

Before any hands-on treatment, we ask about your health and screen for anything that needs a doctor first. We check for fractures and stress injuries of the sesamoids, which may need imaging, and test the big toe joint, ankle and how you push off. We test whether taping or a glide eases walking.

Mulligan techniques we use

First MTP MWM. A gentle glide of the big toe joint during movement, used once the joint is ready.
Sesamoid and turf toe taping. Tape that limits painful bending.
Offloading pads. Pads or insoles that take pressure off the sesamoids.

What the research says

There is little research on Mulligan techniques for sesamoid pain, beyond a single turf toe case report. Offloading and footwear are the main treatment. We use Mulligan techniques to restore movement once pain has settled.

What else is in your treatment plan

Your plan includes offloading, taping, footwear advice, foot and calf strengthening and a staged return to activity.

How long recovery takes

Mild sesamoid irritation often settles in 4 to 8 weeks. Fractures and severe turf toe take longer.

When to see a doctor first

Call your doctor, or get urgent care, if you have any of the following:

Pain after a fall or jump with swelling (possible fracture)
Unable to bear weight
Severe bruising under the big toe
A hot, red, swollen joint (possible gout)
A wound or callus that breaks down, especially with diabetes

Sesamoid pain treatment near Mineola

Enhanced Physical Therapy is at 137 Willis Ave, Suite 100, Mineola, NY 11501, a short walk from NYU Langone Hospital-Long Island. We see patients from Mineola, Garden City, Williston Park, New Hyde Park, Carle Place, Westbury, Albertson and Manhasset, and across central Nassau County.

Frequently asked questions

What are the sesamoids?

Two small bones under the big toe joint that help it push off.

What is turf toe?

A sprain of the big toe joint from the toe being bent back, common in field and court sports.

Do I need an X-ray?

If pain follows an injury, or doesn't settle with offloading, imaging may be needed.

What shoes help?

A stiffer sole and a lower heel usually help. A pad can offload the area.

Written and clinically reviewed by Jacob Kurian, PT, MSPT, CMP, DPT, Certified Mulligan Practitioner, Enhanced Physical Therapy, Mineola NY. Last updated October 14, 2026.

Move Better, Feel Better

If this is limiting your work, sleep or activity, call Enhanced Physical Therapy at (516) 833-5880 to book an evaluation with Jacob Kurian, Certified Mulligan Practitioner. Mulligan treatment may help reduce pain and improve movement, and we will tell you honestly what to expect.