The navicular bone is located near the top of the calceneus bone, which is the main heel bone in the ankle at the back of the foot. The navicular bone spreads further forward to midway along the top of the foot. A stress fracture to the navicular bone is a common injury to various sportspeople such as track athletes.
Symptoms of Navicular Fracture
Pain will be present midway along the top of the foot, and this is likely to be worse during physical exercise. It can be dull, aching and even vague pain, and may go away during periods of rest but will start up again with activity. The ache can radiate into the arch of the affected foot and potentially cause abnormal walking. You can usually recreate the pain when pressing your thumb into the top of the foot at the navicular position. The area on the upper inside of the foot may be tender to touch, and swelling can accompany the injury.
Causes of Navicular Fracture
Navicular fractures are predominantly caused either through a single incident or over a longer period due to overuse or other repetitive strain. Single traumatic blows to the area can arise due to an accidental fall, a hard collision with an object or fellow athlete, or as a result of major twisting of the foot and ankle. This twisting is a regular risk for track athletes such as sprinters, hurdlers and various jumpers. High impact sports involving repetitive large forces to the feet can lead to a single injury of this sort, or contribute to a fracture sustained over time. These sorts of sports include tennis, football, gymnastics and basketball, and can lead to a navicular fracture particularly if you exercise with fatigued muscles, for too long, or without proper warm ups or stretching. Bone conditions like osteoporosis can also contribute to the injury.
Medical Treatment for Navicular Fracture
In most cases a navicular fracture can be treated conservatively by implementing a cast that immobilises the injured foot for around 6 weeks while the fracture heals. During this period it will be necessary to use crutches to walk and to avoid much weight bearing. The doctor will then remove the cast and assess whether more time is needed (by testing for tenderness) or if you can move on to physical rehabilitation.
Occasionally the injury will be severe enough to warrant realignment surgery, in which a metal plate or other method is used to keep the bone in position. This will also require wearing a cast and using crutches after the treatment has been successfully carried out.
Rehabilitation from Navicular Fracture
Physical therapy will involve mobilisation of the ankle joint to remove rigidity and build strength in the area. Stretching and strengthening exercises are key to this process, as is a gradual recommencing of your former physical activities. This process can last for a month or slightly longer.
Prevention of a Navicular Fracture
Always wear shock absorbent and supportive footwear suited specifically for your activities. To avoid overuse, warm up correctly and be responsible with your exercise, learning to stop if your muscles are weakened.
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