Running with Accessory Navicular Syndrome

In early summer of 2018, I was sitting with me legs out, rubbing me feet and ankles. While doing so, I noticed there was a hard bump (like from a bone) on the inside of my left foot above the arch. Upon Googling , I learned it is called an accessory navicular. It most commonly forms in youth, when bones are growing. I had never before noticed it, so I have no idea if I’ve had it for ages, or if it happened in adulthood.

Accessory Navicular prominently on the left, some people have it on both feet

The discovery explained some foot pain and the trouble I was having finding a shoe that provided the support and cushion necessary for long runs. Some can go their whole lives with an accessory navicular and it doesn’t bother them. If it does bother you, it’s called Accessory Navicular Syndrome (ANS).

Since the beginning of my running days, the muscle on the inside of my foot/ankle gets sore easily. The accessory navicular is part of the posterior tibial tendon-that exact area that would get easily aggravated. It also gives you flat arches, which tells why I couldn’t seem to find shoes that had the arch support I needed. I tried a variety of shoes, but none seemed to make the cut. I thought stability shoes were the answer, but me feet don’t dramatically overpronate so they didn’t solve the problem (I still wear some stability shoes, along with neutral shoes).

Last year I found a site that talked about ANS, saying that Foot Chair Insoles are best option. I put them in almost all my running shoes. Despite being a bit stiff, they work great. When my husband saw them he said it was the most intense arch support insole he’d seen! I would still like to find a shoe that can last through a marathon without having to use the Foot Chair (here’s what I found to be the best running shoes for flat feet), but for now I’m grateful I at least have the insole.

Another way to ease arch soreness is to will roll your foot on a tennis ball or trigger point ball. Most runners with normal feet do this as well. If you’ve never tried it you really should!

It was nice to discover the reason for the easily irritated tendon on my foot, and why my arches would get sore. I know now what the problem is, and how to deal with it. Since using the proper insole and compression gear, I have able to run many 20+ mile runs, including marathons. The good news is that after a marathon I really don’t notice pain in my foot, I’m almost always more sore in my legs themselves.

When I wear casual shoes, or running shoes that don’t have the foot chair insole, I will wear arch supports. These have helped a lot, especially since we’ve lived in cities where we do a lot of walking. In warm weather and around the house I wear recovery sandals. Oofoos is a popular brand, I also use the Hoka One One recovery sandals. A lot of running shoes offer their own version, but those are the only two brands that I have worn. The Oofoos are much softer than the Hoka’s, but some days I prefer that stiffness of Hoka.

Wearing Oofoos, they also have flip flops

For some, surgery may be the best option if accessory navicular pain is severe and can’t seem to be relieved. They would remove that small bone (which isn’t needed at all) and reshape the posterior tibial tendon. Of course I’m hoping I will never need that surgery. For now, the insoles, compression ankle sleeves, and ice seem to do the trick.

If you have Accessory Navicular Syndrome, you certainly don’t need to think that running is out of the question. Even running a marathon isn’t out of the question! You just need to be mindful to take the right precautions ahead of time. Here are some other massage tools that could help with various foot and leg pain/soreness.

~~Just a random thing I’m adding to this post-Last night Shalane Flanagan posted on her Instagram about the two surgeries she’s had. Turns out she had ANS and surgery to have the accessory bone removed. This only occurs in 4-14% of the population, so I find it interesting that she happened to have it as well.

Have you ever heard of ANS? Do you have it? What shoes/shoe products have helped?

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6 comments

  1. Hi Laura! Thank you so much for this post. I have severe ANS. I’ve had it since high school but luckily, my dad is a track coach and longtime runner so I have had access to physical therapy and other resources. I’ve also been steered away from surgery by many people. Anyways, I get pain often after runs. I didn’t educate myself about all the shoe options until pain presented itself more these past few years. I am wondering what types of shoes you wear? I have had some luck with certain models of Hoka One One paired with SOLE customizable insoles. Ironically, I found out about the shoe/insert combo from a fellow ANS sufferer on Shalane Flanagan’s Instagram post earlier this year!

    1. I wear a variety of shoes, you can read about them in this section of the blog https://262.run/category/run-gear/
      For longer runs I always wear shoes with an insole. Even shoes that claim that have good arch support, it’s just never enough! For shorter runs I’m not as picky. If I have a shorter run, and am using shoes without an insole, I wear an arch sleeve (like these https://www.amazon.com/s?k=arch+sleeve&ref=nb_sb_noss) and that has helped a lot! I’ve worn Hoka One One Ahari and it has good arch support, but again, for a run longer than 15 miles I don’t think it’s enough.

      1. Thank you for your response! I am having trouble finding a consistent daily trainer- what is your current go to? I looked at your other posts and noticed you wear some New Balances for longer distances. I recently hit a wall after trying out some Mizuno Wave Horizons and Hoka Cliftons. I am feeling a little lost, shoe-wise. I would like to run a marathon at some point and I’ve always held back for fear that nothing will support me long enough, but I do like to walk in New Balance 860s. I find that, at times, NB’s are not quite cushiony enough even though the support is there. Whereas, my Hoka Cliftons are certainly cushiony enough but don’t have enough support. I am just in this loooong, ongoing process of testing out shoes. The ANS makes it harder!

        1. Yeah for every marathon I’ve worn New Balance with the foot chair insole. Not the most cushiony, but my feet feel great! The Mizuno’s I have are really comfy, but they don’t provide enough arch support on their own. I’ve heard cliftons are good for ANS but I still haven’t tried those particular Hoka’s. It does feel like a never ending search!

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