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Jay Lieberman,
DPM, FACFAS
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The navicular is the last bone in the tarsus to ossify (3 years of age). It is interposed between the head of the talus proximally and the three cuneiforms distally. The medial surface serves as one of the primary attachments of the tibialis posterior, and it can be felt through the adjacent skin.
When the medial surface of the navicular is enlarged, it can cause irritation in closed toe box shoes. The curved ridge under an enlarged navicular often makes it difficult to comfortably wear orthotic devices. Older texts suggested that an enlarged navicular resulted in an abnormal insertion of the posterior tibial tendon. It was believed that surgically removing the prominence and reorienting the tendon
