![]() ![]() It is critical to eliminate pressure on the bone to allow it to heal. If not treated correctly navicular stress fractures tend not to heal. Treatment of Navicular Fractures – Phase 1 On occasion, the navicular stress fracture is seen on x-ray, but often requires a bone scan, CT scan or an MRI to be seen. Sometimes there is a little swelling in the area. We suspect a navicular stress fracture when a patient has pain with direct pressure on the top of navicular bone. This can be a problem as it can lead to a delay in diagnosis. Instead, most patients describe a kind of nagging pain that gets worse over time. Usually, patients do not have a history of an acute injury. Later, or in more severe navicular injuries, pain can occur with more sedate activities such as walking. Initially, the pain is worse during and just after athletic activity and reduces with a period of rest. People with navicular injury typically have vague pain in the mid portion of the foot – just in front of the ankle. Throughout the whole recovery period, pain free strengthening and stretching exercises should be performed to maintain optimal conditions in the whole leg.A navicular stress fracture, figure 1, is an injury to the bone on the inside of the foot between the ankle bone and the midfoot. ![]() There will also be a period of rehabilitation including a gradual return to activity (your physiotherapist will dictate the pace of this according to your presentation). Physiotherapy (when out of cast) will help mobilise stiff joints and strengthen weakened muscles throughout the limb. GENERAL TREATMENT Strict immobilisation and non weight bearing in a cast for up to 8weeks, and immobilisation should continue until there is no point tenderness. If the fracture is suspected, an X-Ray may help but is not very good at diagnosing this injury. If this is found then a fracture is suspected although further clinical examination should rule out other causes of the pain. In severe cases, the pain may be aggravated by just walking, and you may also experience pain at night (this is due to the healing processes at work as you are resting).ĪSSESSMENT INFORMATION Clinical questioning will highlight common signs and symptoms and any traumatic occurrences that may have caused the condition.Ĭlinical examination involving palpation (touching) of the bone to establish any point tenderness called and ‘N spot’. Pain usually eases quickly when not bearing weight through the foot. Pain may be on the inner arch of your foot. SIGNS & SYMPTOMS Possible slow onset of pain in the middle of your foot, but due to the traumatic tendency of this injury, the pain could be sudden. Because the middle third of this bone has a poor blood supply, fractures may not heal properly and so pain may persist when weight bearing. It is thought that a mixture of high load bearing and this muscle contraction can lead to progressive bone damage and ultimately a stress fracture. When this contracts it places a stress upon the bone. One of the muscles (tibialis posterior) in your calf attaches to the bone. The exact mechanism for this fracture remains under investigation, but the injury is common. When high forces are placed through it, it is possible to get a crack in it.Īny activity that sees the foot exposed to huge landing forces (sprinting, hurdling, games on hard ground), can expose you to this type of injury. GENERAL INFORMATION The navicular is a large bone in the middle of your foot and is among the most common reasons (in sport) causes of pain in this region. ![]()
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