Does your child complain of pain on the inside of their foot after sport? Do they seem to have flatter feet than their friends, or avoid running and jumping they used to love? This could be an accessory navicular, a common but often misunderstood cause of foot pain in active children.
The good news: it’s very manageable once you know what you’re dealing with.
What Is an Accessory Navicular?
An accessory navicular is an extra piece of bone or cartilage that forms on the inside of the midfoot, near where the posterior tibial tendon attaches. Not everyone has one. For those who do, it usually causes no trouble at all. Problems tend to start during growth spurts or with a jump in sport and activity levels, when the area becomes irritated and painful.
What It Looks Like
Parents often notice:
- A bony bump on the inner side of the foot
- Pain after running, jumping, or long periods on their feet
- A foot that looks flatter than usual
- Redness or swelling over the bump
- Reluctance to join in on or complaining of pain after sport or play
This pain can genuinely limit a child’s activity, but it rarely needs to keep them on the sidelines long term.
Red Flags to Watch For
Most cases of inner foot pain in kids come down to an accessory navicular. But a few other conditions can look similar, so it’s worth knowing what else to keep an eye on:
- Stress fractures. These come from repetitive load on the bone, often during a big jump in training or competition. Pain tends to build gradually and gets worse with activity.
- Tarsal coalition. This is when two bones in the foot are joined together when they should move independently. It often shows up as a stiff, achy foot rather than one sore spot, and can make the foot feel like it “locks up.”
- Posterior tibial tendon dysfunction. This affects the tendon that supports the arch. It can feel similar to an accessory navicular, but tends to involve more swelling along the inside of the ankle, not just the foot.
The easiest way to tell these apart is a proper assessment. If pain comes on suddenly, is severe, or is paired with swelling that won’t settle, it’s worth getting checked rather than waiting to see if it improves on its own.
How We Help
At ProFeet Podiatry, we take a whole-foot approach. Treatment usually includes: Orthotics to support the arch, reduce strain on the posterior tibial tendon, and take pressure off the sore area.
Orthotics definitely aid in overall biomechanics supporting kids’ feet for sports and play!
Targeted exercises and stretches for the posterior tibialis muscle and lower leg muscles, including calf raises and progressive loading/strengthening to build resilience over time.
Load management, so your child stays active while giving the sore area time to settle. This might mean adjusting training volume, swapping high-impact sessions for lower-impact ones for a while, or building in extra recovery between games. The goal isn’t to stop activity altogether. It’s about finding the right balance so pain calms down without your child losing fitness or falling behind their teammates.
Supportive footwear to provide that offloading and comfort aspect while kids are running around enjoying their activities. They work together with an orthotic device to help kids continue to stay active without becoming too sore at the end of the day.
Most kids respond really well to conservative care and get back to full activity without any drama.
When to See a Podiatrist
If your child has ongoing inner foot pain, a visible bump, or is avoiding activities they normally enjoy, it’s worth getting it checked early.
