Friday, March 30, 2018

It's Complicated...

Again, I am not a medical professional in any way, and am not giving medical advice.

As I have been following the recommended treatment for PTT (Posterior Tibial Tendonitis), I have noticed that the protruding area below my medial malleolus, which I had assumed was my inflamed tendon, was quite hard and bony. That always seemed very strange, so I decided to research it further...

What I found is that approximately 10% of the population has the same protrusion just above their arch, and it is called an "Accessory Navicular Bone" -- lucky me. It's basically an extra chunk of bone that has been present since birth, but is only now deciding to cause trouble for me. Once it does start to cause trouble, it they call it Accessory Navicular Syndrome -- here's a good article discussing this: Accessory Navicular Syndrome

Here's what the article has to say: "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." 

The article also states that the "accessory" can start to present problems due to "excessive activity or overuse". Yep, that would probably be the cause.

Here is a photo of what a protruding accessory navicular bone looks like (not my feet).



As shown in the photo, the accessory navicular on my left side protrudes further than my medial malleolus, especially when I bear weight on that foot, and my arch drops to the floor. I also have the accessory on the right foot, but it is not as pronounced as the left, and that arch has not fallen to quite the same degree.

Much of the information out there on the web suggests that surgery is the best way to take care of this condition, but some of that info also suggests that it can be a very complicated surgery with a long recovery time, as there is often tendon attached to the area slated for removal. I did find one YouTube video from a podiatrist who suggests that surgery is over-prescribed, although I don't know if he is taking distance running into account. Here is the video:



I have been trying to keep a stubborn, bullheaded, attitude about running, and even got 5.5 miles in yesterday afternoon; but this really does present complications to my overall plan. The current plan is to tough it out and complete half marathon #10 in 27 days, but after that; my plan will likely involve visits to my doctor, and likely a podiatrist and/or physical therapist. 

At this point, if I could back my mileage off and only run 10K races, I would be thrilled. Until I have a doctor tell me that I need to stop running, I'm rolling with my theme song for the next 3 weeks: Marchin On by OneRepublic



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