The accessory navicular is an extra bone on the medial side of the navicular that can cause pain due to pressure on the lump from footwear (especially things like ice skates) and also be a factor in flat or overpronated feet due to changes in the pull of the tendon from the muscle that is the main supporter of the arch of the foot.
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The accessory navicular (AN) is a common anatomical variation of the foot that can cause discomfort and pain in some individuals. It is an extra bone or piece of cartilage located on the inner side of the foot, near the arch.
What is an Accessory Navicular?
The accessory navicular is a congenital condition, meaning it is present at birth. It is estimated that around 10-15% of the general population has an AN, although not all individuals with this condition will experience symptoms. The AN can be classified into three types:
- Type 1: A small, rounded ossicle (bone) within the posterior tibial tendon.
- Type 2: A larger, triangular-shaped bone connected to the navicular bone by a synchondrosis (cartilaginous joint).
- Type 3: A bony prominence that is fused to the navicular bone.
Symptoms of Accessory Navicular
While many individuals with an accessory navicular do not experience symptoms, others may develop pain and discomfort due to various factors, such as:
- Overuse or repetitive strain: Activities that involve repetitive stress on the foot, such as running or dancing, can cause irritation and inflammation.
- Poor foot mechanics: Abnormal foot pronation or supination can put additional stress on the AN, leading to pain and discomfort.
- Trauma: A direct blow to the foot or a sudden injury can cause pain and inflammation in the AN.
Common symptoms of accessory navicular include:
- Pain or tenderness: On the inner side of the foot, near the arch.
- Swelling or redness: Around the AN.
- Limited mobility: Stiffness or limited range of motion in the foot or ankle.
- Difficulty walking: Pain or discomfort while walking or engaging in activities.
Diagnosis and Treatment
Diagnosis of accessory navicular typically involves a combination of:
- Physical examination: A healthcare professional will assess the foot and ankle for pain, tenderness, and range of motion.
- Imaging studies: X-rays, CT scans, or MRI scans may be used to confirm the presence of an AN.
Treatment for accessory navicular depends on the severity of symptoms and may include:
- Conservative management: Rest, ice, compression, and elevation (RICE) can help alleviate pain and inflammation.
- Orthotics and shoe modifications: Custom orthotics or shoe inserts can help redistribute pressure and reduce stress on the AN.
- Physical therapy: Stretching and strengthening exercises can help improve foot mechanics and reduce pain.
- Surgery: In some cases, surgical removal of the AN or repair of the posterior tibial tendon may be necessary.
Prevention and Management
While it is not possible to prevent an accessory navicular, there are steps that can be taken to reduce the risk of symptoms:
- Wear supportive shoes: Choose shoes with good arch support and cushioning.
- Use orthotics: Custom orthotics can help redistribute pressure and reduce stress on the AN.
- Stretch and strengthen: Regular stretching and strengthening exercises can help improve foot mechanics and reduce pain.
Most Useful Resources:
Accessory Navicular (PodiaPaedia)
Surgery for accessory navicular (Podiatry Arena)
Accessory navicular (Podiatry Arena)
Classification of the Accessory Navicular (Podiatry Ninja)
Accessory Navicular (Foot Health Forum)
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