title: Management of dancers with symptomatic accessory navicular: 2 case reports.
abstract: METHODS
  Case report.
  
  
  BACKGROUND
  Symptomatic accessory navicular can be a source of pain and disability. The treatment considerations for accessory navicular in dancers may differ due to increased demands on the foot, the repetitive nature of the movements, and the specific footwear required. The purpose of this report is to describe the management (1 conservative and 1 postoperative) of 2 adolescent dancers with symptomatic accessory navicular.
  
  
  METHODS
  Case 1 was an 11-year-old female who underwent surgical excision of a symptomatic accessory navicular. Case 2 was a 15-year-old female who, following a traumatic injury that caused pain judged to be related to her accessory navicular, was managed nonsurgically. Treatment included pain management, range-of-motion exercises, trunk and lower extremity strengthening, balance and proprioception training, orthoses, crosstraining, and a guided return-to-dance progression.
  
  
  RESULTS
  Both patients had improved pain, dance technique, strength, and patient-reported outcome scores that allowed a full return to dance.
  
  
  CONCLUSIONS
  The 2 dancers presented here had foot pain believed to be related to a symptomatic accessory navicular. In both cases, treatment targeted specific impairments to improve function and disability. The guided progression of activities was intended to facilitate a return to dance that protected healing tissues and prevented a recurrence of symptoms. Clinicians should be aware of the effect of a symptomatic accessory navicular in the young dancer and potentially effective nonsurgical treatment options for this condition.
authors.affiliation: Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA. TerRSmith@selectmedical.com
authors.forename: Teresa Riemer
authors.initials: TR
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D002648:Child; D003615:Dancing / Q000293:injuries*; D005260:Female; D005534:Foot Diseases / Q000601:surgery* / Q000628:therapy; D006801:Humans; D019637:Orthopedic Procedures / Q000534:rehabilitation; D013639:Tarsal Bones / Q000002:abnormalities / Q000601:surgery; D016896:Treatment Outcome