I have been suffering from glut. med. pain for over 30 years and one time I was diagnosed by ultrasound imaging of having glut. med. tendinopathy. Running has been difficult. I read this article in 2013 with interest, and it was of great help. Including massage by a professional therapist twice monthly with emphasis on the hips and exercises as described in this link http:///gluteus- I now do 100 km per month without much hip problems. In fact, nowadays I experience other issues, such as beginning compartment syndrome etc. The amount of suffering seems constant! :=)
Keep Running The Distance
This patient has a painful accessory navicular that has failed conservative treatment. Excision of the medial prominence of the navicular is indicated as a second line of treatment.
The accessory navicular is a normal variant seen in up to 12% of the population. Repetitive microtrauma at the level of the synchondrosis may lead to medial foot pain. If non-operative management fails, excision of the accessory navicular is indicated. Often, advancement of the posterior tibial tendon is completed with accessory navicular excision (Kidner procedure). The theory is that this helps restore the pull of the tendon and prevents medial arch sag.
Kopp et al. retrospectively reviewed symptomatic patients treated with accessory navicular excision and anatomic repair of the posterior tibialis tendon. Thirteen of 14 patients were pain-free. No patients had activity limitations and all were satisfied with the outcome.
Bennett et al. retrospectively reviewed symptomatic patients treated with accessory navicular excision and anatomic repair of the posterior tibialis tendon. Good and excellent results were obtained in 90% of patients.
Figure A shows an AP radiograph of the foot that demonstrates an accessory os of the navicular.
Answers 1, 2: Given that this patient has exhausted conservative measures, surgical intervention is the next best step.
Answers 4, 5: This is not a navicular fracture.
Spent couple of months bed ridden due to instant weakness of my leg. I could only pull my leg forward by inching my toes forward. Finally I went to a low cost/free hospital/clinic to get help because I had no insurance. It took months to receive the help I needed and by then, I was already starting to feel better.
Physical therapy got me to walking again but remember feeling a weird feeling in my knee but ignored it. I remember mild inflammation in foot and ankle but it was so mild and would come and go that I figured it was irritation from my leg and not having walked on it for months and months. The pain in my hip had nearly gone away but not quite.