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Sunday, December 27, 2015

Accessory Navicular: Email Advice

Hi Dr Blake!

I'm a young adult with flat feet, extreme high arch and accessory navicular.
It all started 6 years ago when I had pain right at the extra bone. I did ballet at the time and soon after, the pain was unbearable to the point of sharp pain at the bone every step I took. At that time, my treatment was icing, taping, ankle guards, orthotics and pain killers everyday. I even had 3 sessions of physiotherapy every week for 2 years. I experienced numerous ankle sprains through walking in a day where my feet either sprains inwards or outwards (even while wearing ankle guards and orthotics) and was literally unable to run. I even tried chinese healing to reduce the swelling. It got to the point where I'm  so used to the pain because I experience it with  every step i took. I saw an orthopedic surgeon who failed to pick up the accessory navicular problem and thus did nothing with it.
Dr Blake's comment: High Arch feet when unstable can be extremely difficult to treat and need an expert in making podiatric custom orthotic devices. 

I stopped ballet 2 years ago and the pain at the bone got better. I stopped wearing ankle guards a year ago. I've been on orthotics and very expensive arch support shoes for 5 years (24/7) but I notice that my ankle still severely slops/falls inward when walking. There is also some pain involved. So I'm  wondering if it's  time to consider surgery if this is a problem that may continue for the next 40 to 50 years.
Dr Blake's comment: Glad you are feeling better. Yes, surgery to remove the accessory navicular should be an option to give you a stronger arch. But, it is complicated, and requires that you find several surgeons and get their opinions on whether it will help you. I am hopeful you are doing a daily home strengthening program for your arch, especially the posterior tibial tendon. Also, if you have a complication with the surgery, is that a risk you are willing to take? 

Lastly, Sorry for the long question and i appreciate  your time taken to read and answer my question.
Thanks and Regards,

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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.