r/AccessoryNavicular

Some context: I've had custom orthotics for flat feet since I was a kid. also have EDS so my feet ligaments are wonky. I have a right-only type 2 AN (6mm with edema as of April 2025). I had an injury early 2025 that caused what we now know was an AN flare which led me to need a boot and brace for several months. I did the arch strengthening PT. I was no longer bracing by Aug but was still doing PT. I finally built up to biking again around Jan 2026 and continued my balancing exercises. Overall I'm have been very aware of my arch when standing without insoles.

At the end of March, the pain returned. Some mornings I woke up (esp if my medial foot was flat on the bed) w/ excruciating pain and tenderness, unable to walk. It often improved during the day, but overall I ended up mostly walking on the outside of my foot to avoid pain. I figured it was an overuse injury from changing from winter boots to running shoes. I wanted to keep wearing my winter boots for support but I couldn't bc they press on my navicular and malleolus. I saw the podiatrist on Apr 20, who said it was probably an overuse injury from the shoes + increase in activity. Made a little adjustment in my orthotic. He reminded me the PT protocol, said to come back if it got worse.

On May 1, I suddenly woke up being unable to walk or bear weight. Pain + tenderness at both the navicular and the medial malleolus. I kinda freaked out bc I couldn't even put my foot on the floor and booked a bunch of appointments to get in to whoever would see me first.

I saw the DPM again on May 5. He did an ultrasound and found: "Partial tear of the spring ligament. Accessory navicular syndrome and medial column instability of the right foot." He said to wear the boot for at least another 2 weeks but if it takes longer, don't rush it. Come back in a month.

I had an appt w an ortho doc today for a 2nd opinion (and after learning about the Kidner on this sub I wanted to hear his thoughts). I explained the injury/pain and briefly told him about the suspected ligament damage. Offered the ultrasound results but he didn't read it. He said that I have adult onset flat foot disorder, so follow the Alvarez protocol (ideally ASAP, but after I can bear weight) and get orthotics. I told him I've had flat feet all my life and I wear custom orthotics but have not had arch issues until last year with the injury. I then commented ab the navicular. He said that ANs are common and it's rare that they cause pain. He said if we determine the AN is the culprit and all non-op things fail then we can consider surgery but we aren't anywhere near that at this time. I should continue to wear the boot until the 1 month mark and start PT when possible.

I also got a 3rd opinion at a sports medicine place last week thanks to my frenzy. Said I have to strengthen (fair) and that the pain is out of proportion to the injury so it's probably CRPS (lol??).

I am relieved that ortho doesn't think I need surgery but also am worried bc I am starting an intense program at school in the fall and I can't afford to have this recur or have a surgery after school starts. I'm feeling uneasy not bc of his non-operative recs (PT has truly saved my life) but bc I don't really feel like he actually listened or "got it"? Like the DPM thinks it's ANS and frankly I agree, but the ortho doesn't. This is my 3rd recurrence of a flare in that area, and it's by far the worst. I still cannot bear much weight. The DPM said on the ultrasound the interior muscles seem hypertrophied so he's not worried about strength, rather he thinks the muscle bulk might be compressing the area.

I have had bad injuries in the past that have had a similar initial prognosis but ultimately didn't heal, requiring procedures after way too much suffering (hello proximal tib-fib instability). I really want to avoid that again.

Has anyone had success with PT in cases like these? Any other recs?

I live in rural NZ and the local medical system is thin on the ground.... only one foot and ankle surgeon in our area. I was told, as a child, that I had flat feet and an extra bone. I've had symptoms consistent with AN for almost 20 years, ie inflammation of the PTT. However it hasn't shown up in X-rays. Unfortunately, I haven't been able to get anyone to review X-rays to see if the this is real, or a product of wrong viewing angle or inattentiveness on the part of the radiologist. After much fussing I got an appointment with the local foot and ankle surgeon. He didn't even look at X-rays and ultrasound, but did look at my foot and gait and had me do a one foot heel raise (which I can do). He recommended reconstructive surgery for adult acquired flat foot (I've had flat feet all my life and still have some arch) and glossed over the AN question, saying "if I find one I'll probably remove it". He brushed away my question about Kinder procedure.

I would really like to be without foot pain. But there are enough stories about failed surgery, and the recovery is so demanding, I am not willing to commit.

Hi guys, I've been looking at different options for shoes to wear at home since ANS diagnosis - and wow there's a lot of options and mix reviews.

Big brand names that I often come across are the Oofos, Hokas Ora's, Archie's slides.

Wondering if anyone owns these and are they worth it? Open to consider other brands as well!