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Accessory navicular bone and tendonitis

Printed From: CyberPT - Your Online Physical Therapy Resource
Category: Patient Forum
Forum Name: Lower Leg, Ankle & Foot Injuries/Conditions
Forum Description: Patients can post questions and experiences about lower leg, ankle & foot injuries/conditions.
URL: http://www.cyberpt.com/ptforum/forum_posts.asp?TID=794
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Topic: Accessory navicular bone and tendonitis
Posted By: shocktrauma2011
Subject: Accessory navicular bone and tendonitis
Date Posted: Jan 21 2011 at 11:30am
Hi everyone! I am a 27 year old female with bilateral accessory navicular bones. The left is much worse than the right. After seeing a podiatrist in May of 2010, my feet were feeling pretty good. He made me orthotics, and we figured out that a night splint was key to my left foot feeling good. 
 
On October 13, 2010, I injured my left foot. In sneakers, with my orthotics, my left foot landed on the edge of a rock right under the navicular. Went to ER and the Dr wasn't sure if it was broken. Went to a new podiatrist (moved since first) who put me in a soft cast thing and a walking boot and said it wasn't broken. I was told to wear the boot or sneaker as tolerated. I wore the boot for a few weeks, and continued to use my night splint. 
 
At the 12 week mark, I went to another podiatrist since the one I was seeing didn't seem to have a plan. New Dr sent me for an MRI that showed no fracture, just a large accessory navicular and tendonitis. New Drs plan is to stretch for 3 weeks, try wearing my original orthotics, and he gave me a medrol dose pack.
 
Now here I am at 14 weeks post injury with no relief in sight. I put the orthotic back my shoes yesterday, and today I can barely walk. I still use the night splint, stretch everyday, and only exercise at a low level of tolerance. In other words, I only walk on the treadmill for a few minutes instead of pushing for longer. I know that I will be able to push past any pain, but will have to RICE my foot for double whatever time I exercise.
 
Please, please give me some advice! Do I wear the walking boot for a certain number of weeks regardless of who well I'm feeling? Do I need a hard cast? Any ideas for me?
 
Thanks! 


Replies:
Posted By: Ask a PT
Date Posted: Jan 24 2011 at 8:24am

Have you participated in physical therapy yet? A physical therapist can evaluate you and analyze your gait pattern and recommend the best type of support for your foot. It is quite common for individuals with an accessory navicular to have flat feet. Proper foot support including shoes and/or custom orthotics are key. The tendon most affected as a result of the accessory navicular structure is the posterior tibialis tendon. Stretching can be performed a well as exercises and to strengthen the muscles at the ankle and foot. These exercises may also help prevent recurrence of the symptoms. Modalities such as phonophoresis/ultrasound or iontophoresis could be utilized as well to assist with decreasing the inflammation. As far as what to utilize, walking boot or hard cast, it would be best to address this with your doctor or therapist as he or she will be most familiar with your specific condition and give you the best recommendation.



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