Supernumerary Bones

According to the etymology of the word, supernumerary bones are simply one or more extra bones. In fact, they’re small bones that have not fused with the main bone. They’re called accessory bones. This condition, often invisible and painless, is present since birth in a small number of individuals and remains mostly unsuspected. At least, until chance decides otherwise, usually following a wrong movement or an injury.

Since the foot is the most common place where these extra ossicles are found, it’s more likely for an athlete to suffer from a syndrome involving an accessory bone. Indeed, their presence can lead to complications, especially in people who repeatedly flex and point their feet, such as ballet dancers and soccer players. The pain is also often mistakenly associated with a sprain. 

How to Know if You Have an Accessory Navicular Bone Syndrome

Although quite rare, three supernumerary bones located in the foot are known to be problematic:

*The trigone bone, located at the back of the talus (the bone that articulates with the ankle mortise and is responsible for the pain associated with pointing the foot and jumping).

*The accessory navicular bone adjacent to the navicular bone or accessory navicular syndrome (often found in flat foot conditions).

*The peroneal bone embedded in the tendon of the long fibular muscle (which causes pain mistaken for a sprain).

Incompletely fused to the normal bones and retained by a thin joint, these three intruders are usually discovered by accident. Intensive sports activity resulting in a conflict between these ossicles and the surrounding tendons is usually the reason for the revelation of a supernumerary bone. Sometimes, their existence is only learned if a direct impact causes a fracture, such as kicking a ball.

The pain brought on by the accessory navicular bone syndrome is frequently localized on the inside of the foot, while the peroneal bone involves the outside of the foot. Sometimes both a hard ball and swelling appear at these locations. The pain and inflammation, both of which are aggravated by repeated pulling or twisting of the ankle, will probably lead you to seek medical attention. With the help of an ultrasound, the podiatrist will explore potential avenues that could explain the causes of your symptoms or the small extra bone will be visible through x-rays taken from the side or underwater.

How to Treat Supernumerary Bone Problems in the Foot

As with all physical ailments, the objective is to eliminate the pain that limits activity. Therefore, if the inflammation caused by an excess bone irritates you while playing your favourite sport, it’s recommended to rest, apply ice to the affected area and take painkillers if necessary. In addition, your podiatrist will suggest long-term solutions, including tendon strengthening exercises related to this condition to help increase endurance and flexibility. Orthotics and corticosteroid infiltration may also be considered.

These means, although satisfactory to a certain extent, are mainly used to reduce acute pain and prevent possible twisting or false movements that could aggravate your condition. However, they do not always prevent recurrence, since the bone is still there. If your extra bone is giving you a hard time, surgery may be necessary. Through a tiny incision, the accessory bone will be removed and the involved tendon will be anchored to the correct bone. 

To prevent the most unpleasant symptoms of this condition, it’s important to have a healthy sports routine and to vary your movements in order to make your muscles and joints better able to withstand the shocks. Consult with your podiatrist as soon as an unusual pain occurs, as this is the best course of action before it’s too late.