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Old 06-21-2012, 08:17 AM   #1
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Painful Accessory Navicular in a 10-yo gymnast

My 10 year old daughter-gymnast-dancer rolled her foot inward mid-April 2012and has had nothing but pain in her foot ever since. We had her foot x-rayed at the pediatricians office a few days later. Result was negative for any broken bone, so we began relative rest/ice/ibuprofen. 2 weeks later she heard a "pop" at the end of gymnastics while landing a front HS. Back to the ped. where it was re-xrayed and we were once again told to rest, etc. It was so painful at this point that I got her crutches. After 5 days of continued pain, we visited an ortho. who pulled up the same film and immediately diagnosed an accessory navicular fracture. She was put in a walking cast for 3 weeks (and continued to notice the pain while in the cast), and has been in a boot for the last 3 weeks following removal of the cast. All along she has maintained little to no improvement. When we visited a foot/ankle specialist last week, he scheduled an MRI which was negative, but did comfirm the AN in her foot. The specialist recommended a cortisone injection which the pediatrician cautioned against and advised us to reconsult the ortho. before scheduling that. The ortho. quickly dismissed the idea of the injection for now and prescribed PT for "iontophoresis desensitization" which looks to me like a way to "inject" an anti-inflamatory using an electro-stimulation method (and NO needle). Telling us to check in after 4 weeks or so, at which time we'll decide that either things are "good enough" or that surgery is needed. I am in NO HURRY for my 10 year old to have a surgery (and one with a long recovery period at that-at least that's the way it sounds to me), but I also don't want her fighting this for several years until we can get something done. I'm not really opposed to the cortisone injection (although she wants to avoid it all cost), but just don't know that it's going to fix the problem (it does seem like it might be worth a try though). Really wondering if anyone else has had experience with this in a younger kid. Most of what I've read pertains to adolescent or older children. EXTREMELY frustrating as not only can she not do what she loves (tumbling--still doing bars w/ heavy spotting & upper body conditioning), but other normal summer time activities are on hold as well (zoo, amusement park, etc.) because it's painful for her to be on it (even in the boot) for very long. Thanks for taking the time to read this and offering any advice or experience you may have.

 
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Old 09-09-2012, 01:33 PM   #2
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Re: Painful Accessory Navicular in a 10-yo gymnast

So, she had surgery to remove the extra bone on August 3. Woke up in a pink cast and in a lot of pain when the meds wore off the next day. Used crutches for the 1st 4-5 days, then able to bear weight in the walking cast. Cast came off August 24 and she hobbled out of the Dr. office in a boot. Pretty painful for a couple of days after that cast came off. Started PT the week after though. The 1st day of PT was painful, but w/in a week of that 1st PT session she had big improvement and w/in 10 days became interested in getting out of the boot. Today's Sept. 9 and she'll go back to gymnastics for bars/upper body conditioning today. The foot feels a LOT better. Wish we could have done the surgery earlier on and not wasted so much time. My only fear now is that because it feels so much better she'll be tempted to use it too much too soon. Caught her doing back flips on the trampoline a couple of days ago. Hopefully the tendon has successfully reattached and she won't do anything to disrupt the healing!!

My advice to (especially younger) people with this condition would be to have the surgery. We waited what felt like a very long time (about 3 months from the time we figured out what was causing the pain) before getting the surgery. During that time, she could only marginally participate in her sports (gymnastics and dance). She has had about 5 weeks completely out of the gym since the surgery and will have tons of hard work ahead of her in order to be competetive this season (and will miss the 1st 2-3 meets), but this seems like a WAY better path than the one we were on.

 
Old 09-09-2012, 01:54 PM   #3
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Re: Painful Accessory Navicular in a 10-yo gymnast

I agree. My daughter had an inflamed AN when she was about 9 and it hurt without response to all conservative measures for almost a year. Her surgery went fine and she was back to normal in a few weeks. Once these bones get inflamed, they just don't do well and are better off coming out.

 
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