A significant breakthrough in the diagnosis and treatment of unexplained medial ankle pain in sportspersons has emerged from the Jaipur Institute of Pain and Sports Injuries (JIPSI). Dr. Gaurav Kant Sharma, a renowned musculoskeletal and sports radiologist, has identified a previously undocumented accessory muscle in the anteromedial part of the ankle, now referred to as the Accessory Tibionavicular Muscle. This is the first reported case globally and could change the way clinicians approach unexplained ankle pain in athletes and active individuals.
The case involved an 18-year-old football player who experienced persistent dorsomedial ankle pain while playing football that was unresponsive to conventional therapies. Cross-sectional imaging using MRI and dynamic musculoskeletal ultrasound was employed to investigate the cause of pain. The imaging revealed a partial-thickness tear and fibrosis of an anomalous muscle, which Dr. Sharma and his team confirmed as an entirely new variant muscle. This accessory tibionavicular muscle had not been previously described in anatomical or radiological literature.
Accessory or anomalous muscles in the ankle region are not uncommon, but most are asymptomatic and discovered incidentally. However, they can sometimes present as mimics of more commonly known conditions like tarsal tunnel syndrome, chronic impingement, or soft tissue tumors. Their clinical relevance lies in their ability to compress adjacent structures or develop pathology themselves, leading to pain, weakness, or restricted movement.
In this case, the accessory tibionavicular muscle was determined to be the primary cause of the athlete’s symptoms, representing a rare and previously unrecognized cause of chronic medial ankle pain. This discovery has opened new avenues in musculoskeletal diagnostics, especially in patients who do not respond to typical treatments or whose pain lacks an obvious source.
The treatment offered at JIPSI was just as innovative as the diagnosis. Dr. Sharma opted for a non-surgical, regenerative approach using ultrasound-guided Platelet-Rich Plasma (PRP) therapy. This technique involves injecting a concentration of the patient’s own platelets and growth factors , rich in healing potential , directly at the site of injury under precise ultrasound guidance. The patient responded remarkably well, with pain reduction and improved mobility, avoiding the need for surgical intervention.
Dr. Gaurav Kant Sharma is widely respected in the field of sports medicine and musculoskeletal radiology. His work combines diagnostic precision with interventional innovation. He is the developer of the internationally recognized Gaurav Botchu Technique for frozen shoulder, a breakthrough method published in the Journal of Ultrasound from Polan, in addition to various other techniques like GIBPS technique and GIPSI technique. His expertise in sports imaging, injury pattern recognition, and regenerative therapy has positioned JIPSI as a national and global leader in sports injury management.
JIPSI, located in Jaipur, India, has been at the forefront of non-surgical treatments since its establishment in 2021. The center is led by a multidisciplinary team including Dr. Sharma and Dr. Prableen Kaur, an internationally certified interventional pain Physcian and a team of musculoskeletal & sports Physiotherapists. Together, they offer a holistic, patient-centered model of care for athletes and individuals suffering from chronic sports Injuries and musculoskeletal conditions.
Key highlights of JIPSI’s clinical approach include:
- Use of advanced diagnostic tools like high-resolution musculoskeletal ultrasound and expert interpretation of Musculoskeletal MRI for accurate and timely diagnoses.
- Focus on regenerative therapies such as PRP, Growth factor concentrate (GFC), Bone Marrow Aspirate Concentrate (BMAC), Adipose tissue (MFAT) injections and Stem Cell Injections to accelerate healing in addition to an extremely long list of Sports and musculoskeletal minimally invasive interventions.
- A multidisciplinary treatment model integrating Musculoskeletal & Sports radiology, pain management, and physical rehabilitation under one roof.
- Specialized sports injury protocols that ensure faster recovery and return-to-play for athletes.
- Personalized, non-surgical treatment plans tailored to the unique needs of each patient.
Some of the common conditions treated at JIPSI include:
Partial tendon and ligament tears around Ankle, shoulder and almost all joints.
Plantar fasciitis
Tennis elbow/Golfers’ elbow
Hamstring and rotator cuff injuries
TFCC tears
Hamstring and adductor tendon injuries
Joint osteoarthritis and other ligament partial tears
Dr. Sharma’s discovery of the accessory tibionavicular muscle has not only contributed a new entity to the anatomical understanding of the ankle but has also emphasized the importance of considering anomalous muscle pathology in patients with persistent or unexplained medial ankle pain.
With a clear focus on innovation, JIPSI continues to set new benchmarks in pain management and sports rehabilitation by:
Pioneering non-surgical approaches to musculoskeletal and nerve pain
Leading research and publishing on advanced techniques and new anatomical insights
Providing minimally invasive interventions guided by imaging for pinpoint accuracy
Empowering patients to recover faster and return to an active lifestyle
In addition to sports injury care, JIPSI is also a referral center for complex pain conditions such as trigeminal neuralgia, frozen shoulder, complex regional pain syndrome (CRPS), sciatica, and joint arthritis, offering targeted interventions, nerve hydrodissections, and radiofrequency ablation.
Dr. Sharma emphasized the broader implications of this discovery by stating, “This case highlights the value of expert precise imaging and clinical correlation in sports medicine. Identifying the accessory tibionavicular muscle helped us avoid unnecessary surgery and treat the condition with precision and confidence.”
The identification of the accessory tibionavicular muscle is expected to prompt more clinicians to consider rare anatomical variants when evaluating chronic or atypical medial ankle pain. It also reinforces JIPSI’s role as a pioneer in musculoskeletal care, combining scientific research, clinical excellence, and compassionate healing.
For more information or to schedule an appointment, visit www.jipsi.in
