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Saturday, August 24, 2019

Accessory Navicular: Email Advice

Dr. Blake,

I happened upon your blog and found some very useful information about Accessory Navicular.  I have a unique case according to my podiatrist and wanted to share and get your opinion. 

I am a 40 year old teacher.  I only discovered anything about accessory navicular around 3 years ago.  I have always had intense pain tolerance and can remember in college after waiting tables I would curl my feet and walk on just the outside heels and toes to relieve the pain. 

I have Accessory Navicular in both feet.  It was never discovered as a child or young adult.  I played athletics and did pointe ballet for many years.  The problem increased as I got older until the pain was constant and it did not matter what I did to alleviate the pain , stretching, ice, rest it was always there. 

3 years ago I made the decision to go to the podiatrist and they made this discovery I was quickly fitted with a Richie Orthotic on both feet.   It immediately changed my pain level.  Was it still painful yes but I could now walk again and for long distances and could stand for long amounts of time again, it was wonderful. 
Dr. Blake's comment: This is a ankle foot orthotic device.

Recently I have had a change in pain in association with the Accessory Navicular on both feet.  It has come back and it is intense.  It seems as though my Richie braces while still providing some support are now not doing all it was doing even 6 months ago. 

I have been told I am a candidate for the surgery but it puts me out for quite a while and with having this condition in both feet the concern is favoring the non surgery foot and intensifying the already agitated condition.  

Do you have any suggestions?
Dr. Blake's comment: Sometimes you just have to rest the area for a while to get it to calm down again, while you are gradually strengthening the posterior tibial tendon. Flareups should not be construed as reasons to do surgery. See the videos below on a gradual posterior tibial strengthening program (6 months) and the taping technique (also 6 months). Icing 3 times a day to decrease the overall inflammation for 10 minutes a session. Below the knee boot for 4 hours per day to rest the area per foot, alternating back and forth. You have to have a EvenUp on the other side to balance. You should know if this is starting to calm it down over the next month while you continue to be the teacher of the year!!. I hope this helps you start going in the right direction. Rich

Thank you for your time and consideration


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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.