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Saturday, October 17, 2015

Accessory Navicular: Email Advice

Dear Dr Blake:

I strained my accessory naviular syndosmosis 8 months ago. MRI showed no PTT tears and very minimal bone oedema. I am in orthotics and some days are pain free but some days I get an ache around the area or more proximally up the PTT, pain 1-2/10 max. I can cross train, row and cycle but am doing no impact activity. My orthopaedic surgeon told me that if it was going to settle it would have done by now and that the next step to consider is surgery (he recommended a Kinder procedure). Given how much better it has got and fairly positive MRI results I would like to think that conservative treatment could work for me but lack guidance as to how to go about it. Should I be considering surgery at this point? Can delaying surgery affect how successful the outcome is? Many thanks in advance. 

Dr Blake's response:

     Doing surgery now is like recommending preventative surgery. I have not heard you talk about strengthening exercises. You need to gradually, and pain free, strengthen the PT tendon, and other tendons/muscles that support your arch. You need to maximize the amount of arch support you get from your othotic devices. You need to do posterior tibial taping for all your athletic activities. Hope this helps. Rich 

http://www.drblakeshealingsole.com/2012/11/posterior-tibial-tendon-dysfunction.html

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Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.