Comparison of towel-gathering exercise and toe exercises for the painful accessory navicular

[Purpose] The towel gathering exercise is commonly chosen in the treatment of painful accessory navicular. However, the effect has not been well documented in clinical settings. So we compared the reduction in pain effect of towel gathering exercise with those of three toe flexor exercises we developed. [Subjects and Methods] Fifteen accessory navicular cases (4 males, 11 females) were chosen as subjects. Their mean age was 20.3±10.7 years old. The three exercises were almost maximal isometric contraction of first toe flexor, 2nd-to-5th toe flexors and 3rd-to-5th toe flexors. All subjects randomly performed the three toe exercises and the towel gathering exercise. Before and after each exercise we assessed the pain by provocative tests such as stepping and others using a visual analog scale (100 mm). [Results] The exercises of 2nd-to-5th toe flexors and 3rd-to-5th toe flexors showed overtly significant improvement of pain. On the other hand, the effects of both the towel gathering and first toe exercises were less significant. Especially, the towel gathering exercise showed the poorest effect of pain relief.