Why does it hurt right above my heel?

Recovery Time After Accessory Navicular Surgery


Overview
The accessory navicular (os navicularum or os tibiale externum) is an extra bone or piece of cartilage located on the inner side of the foot just above the arch. It is incorporated within the posterior tibial tendon, which attaches in this area. An accessory navicular is congenital (present at birth). It is not part of normal bone structure and therefore is not present in most people. People who have an accessory navicular often are unaware of the condition if it causes no problems. However, some people with this extra bone develop a painful condition known as accessory navicular syndrome when the bone and/or posterior tibial tendon are aggravated. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.

Accessory Navicular

Causes
This can result from any of the following. Trauma, as in a foot or ankle sprain. Chronic irritation from shoes or other footwear rubbing against the extra bone. Excessive activity or overuse. Many people with accessory navicular syndrome also have flat feet (fallen arches). Having a flat foot puts more strain on the posterior tibial tendon, which can produce inflammation or irritation of the accessory navicular.

Symptoms
A visible bony lump on the inner part of the foot, towards the middle, just above the arch of the foot. Redness, swelling, and sensitivity of the bony prominence. Pain or throbbing in the middle of the foot and the arch. Difficulty with foot movement and activity. Possible skin callous or skin irritation caused by footwear rubbing over the lump. Not everyone who has an accessory navicular will develop these problems. When problems do occur, they may begin in early adolescence. The obvious indication is a painful bump on the inside of the foot, which hurts to touch, and causes problems that gradually become worse, and which are aggravated by activity, walking, etc., leading to all the problems discussed here. Pain may be worse towards the end of the day, and continue into the night.

Diagnosis
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or s welling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated. X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluate the condition.

Non Surgical Treatment
The goal of non-surgical treatment for accessory navicular syndrome is to relieve the symptoms. The following may be used. Immobilization. Placing the How does Achilles tendonitis occur? foot in a cast or removable walking boot allows the affected area to rest and decreases the inflammation. Ice. To reduce swelling, a bag of ice covered with a thin towel is applied to the affected area. Do not put ice directly on the skin. Medications. Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be prescribed. In some cases, oral or injected steroid medications may be used in combination with immobilization to reduce pain and inflammation. Physical therapy. Physical therapy may be prescribed, including exercises and treatments to strengthen the muscles and decrease inflammation. The exercises may also help prevent recurrence of the symptoms. Orthotic devices. Custom orthotic devices that fit into the shoe provide support for the arch, and may play a role in preventing future symptoms. Even after successful treatment, the symptoms of accessory navicular syndrome sometimes reappear. When this happens, non-surgical approaches are usually repeated.

Accessory Navicular Syndrome

Surgical Treatment
Once the navicular inflammation has lessened it is not necessary to perform surgery unless the foot becomes progressively flatter or continues to be painful. For these children, surgery can completely correct the problem by removing the accessory navicular bone and tightening up the posterior tibial tendon that attaches to the navicular bone. The strength of this tendon is integral to the success of this surgery as well as the arch of the foot. Following surgery the child is able to begin walking on the foot (in a cast) at approximately two weeks. The cast is worn for an additional four weeks. A small soft ankle support brace is then put into the shoe and worn with activities and exercise for a further two months.

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برچسب: How do you treat a sore Achilles tendon?، What is the Ilizarov method?، How long will it take for my Achilles tendon to heal?،
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Accessory Tarsal Navicular Pain


Overview
The navicular bone is located on the top of the foot near the arch. People who have this extra bone can feel a bump or bony protuberance on the top of the foot above the arch. While the bone itself does not cause pain, accessory navicular syndrome can develop when the bone and/or nearby tendon is irritated. The navicular bone is attached to muscles, ligaments and the posterior tibial tendon. Since ligaments and tendons have poor blood supply and don?t heal easily, any irritation to the surrounding structures can develop into a painful condition.

Accessory Navicular Syndrome

Causes
It is commonly believed that the posterior tibial tendon loses its vector of pull to heighten the arch. As the posterior muscle contracts, the tendon is no longer pulling straight up on the navicular but must course around the prominence of bone and first pull medially before pulling upward. In addition, the enlarged bones may irritate and damage the insertional area of the posterior tibial tendon, making it less functional. Therefore, the presence of the accessory navicular bone does contribute to posterior tibial dysfunction.

Symptoms
Many people with an accessory navicular do not experience symptoms, however some may notice a bump and/or swelling on the inside of the foot just above the arch. They may also experience pain in the middle of the foot, particularly with physical activity.

Diagnosis
To diagnose accessory navicular syndrome, the foot and ankle surgeon will ask about symptoms and examine the foot, looking for skin irritation or s welling. The doctor may press on the bony prominence to assess the area for discomfort. Foot structure, muscle strength, joint motion, and the way the patient walks may also be evaluated. X-rays are usually ordered to confirm the diagnosis. If there is ongoing pain or inflammation, an MRI or other advanced imaging tests may be used to further evaluate the condition.

Non Surgical Treatment
Patients with a painful accessory navicular may benefit with four to six physical therapy treatments. Your therapist may design a series of stretching exercises to try and ease tension on the posterior tibial tendon. A shoe insert, or orthotic, may be used to support the arch and protect the sore area. This approach may allow you to resume normal walking immediately, but you should probably cut back on more vigorous activities for several weeks to allow the inflammation and pain to subside. Treatments directed to the painful area help control pain and swelling. Examples include ultrasound, moist heat, and soft-tissue masغير مجاز مي باشدe. Therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area.

Accessory Navicular Syndrome

Surgical Treatment
rolotherapy Strengthens the ligaments, tendons and muscle attachments affected by ANS. Prolotherapy is an injection technique that works to strengthen these ligament, tendon, and muscle attachments by causing a mild anti-inflammatory response in the tissues. Prolotherapy supports the body’s normal healing response to injury. The solution directed at the injured and weakened tissue will cause an influx of blood supply and regenerative cells to come to the area. As part of this healing cascade, collagen cells will also be deposited at the injured site. The tissue, which What is distraction osteogenesis? made mostly of collagen, will become stronger and tighter as these new collagen cells mature. The injured tissue becomes healthy again. When the weakness or injury in these structures is resolved, often times the symptoms with ANS are resolved and the patient no longer suffers from chronic foot pain. In our experience, patients typically feel better soon after treatment. However, if the person desires to run again or continue to be very active, it may take 3-5 treatments to fully resolve the condition. Activity is increased during treatment as symptoms resolve.

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برچسب: How do you prevent Achilles tendonitis?، What is a heel lift?، How can we increase our height?،
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