Foot and Ankle Problems By Dr. Richard Blake: Navicular and Posterior Tibial Injury: Email Advice

Tuesday, August 9, 2016

Navicular and Posterior Tibial Injury: Email Advice

Hi Dr. Blake:

I am a 64-year old woman. Like many, I have a navicular bone on my right arch which is somehow intertwined with the neighboring tendon. About 10 years ago, I somehow tweaked the tendon which resulted in a lot of pain. I was relegated to a boot for 6 weeks and did not have any problems until about one year ago when it started acting up again.

It has been intermittent with months of pain free days but recently I had a foot massage and the well-meaning masseuse worked on my feet (much to my delight) only to awaken this pain yet again. I have gone back into the boot but am not convinced that the boot is doing the best job. I like being in my new balance tennis shoes with my orthotics because of the arch support from the orthotics which the boot does not have. I looked on your website today and have also ordered the tape from supporthefoot.com to see if that will help. There doesn’t seem to be any swelling and I have not had an MRI because the pain is so intermittent. My concern is that I seem to get better and then fall back time and again… I would like to get this quieted down once and for all. Any suggestions you can provide on the best course of action will be appreciated.

Thank you.

Dr Blake's comment: You seem right now to be doing everything right in the short term, but addressing the overall strength of that tendon, and the surrounding tendons/muscles, could be crucial. I typically try to get patients 3 times stronger than you are now. You should also learn the leukotape version of posterior tibial taping. I have a video on that and also the main exercises. You should without pain gradually spend the next year getting stronger. The classic exercises are metatarsal doming, single leg balancing, 2 positional toe raises, and theraband posterior tibial and peroneus longus strengthening. Good luck!