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Sunday, October 18, 2015

Accessory Navicular: Email Advice

Hi Dr. Blake

I have a son with accessory navicular and somewhat flat feet.  He is a 6 ft 8th grade, power forward and has been playing for many years.  Last year he had a hairline fracture of his fifth metatarsal and this past spring he rolled his ankle again and was in instant pain and we discovered it was related to an injury to his accessory navicular.  That foots accessory navicular five months later is slightly larger on the foot that was injured and was recently kicked in a game inflaming it slightly.  He dropped running cross country as he plays both aau and school basketball.  He uses voltaren diclofenac gel topically when it was acute.  He originally five months ago was in a boot for 5 weeks.
Dr Blake's comment: Due to the vulnerability of that bone to have flareups, make sure he is using taping when he plays, and ices daily for 20 minutes each evening every day religiously. 

He was told by a sports orthopedist to use Superfeet inserts which he played in today and they were fine.  He wears Adidas high tops which are good for people with flat feet.
Dr Blake's comment: Sounds great---good stability shoes, taping, arch support!!

Questions: are there other things that can be done for accessory navicular issues/syndrome?
Dr Blake's comment: Based on the extent of reflare, you can increase or decrease the mechanical support and anti-inflammatory measures. I always love accessory navicular patients to do posterior tibial strengthening as long as it is non painful. Sure, you can go to custom orthotic orthotics if the Superfeet are not enough support. You would have to see if he is walking and running whether he is still pronating. You can improve the taping by going to a good Posterior Tibial J Strap. You can get a Stromgren Ankle Brace and only use the inside strap (I have my patients actually cut off the outside strap that would pronate them. 

   Are Superfeet inserts what is best for this?   I say your wish list I. Ur blog and in always after him to not walk barefoot around the house and wear slippers.  He has been playing competitive basketball since 4th grade and this discovery/injury of this accessory navicular was just discovered in June of this year.

Any suggestions would be much appreciated.  He is a very good player, will be the captain of this 8th grade team, and would like to potentially play in college.   I would like to do everything I can for him to realize that.
Dr Blake's comment: Please comment on this post where he is now in regards to his injury. As long he is not limping, he can play. I hope this helps somewhat. Rich 

Thank you in advance for ur help Dr. Blake!

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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.