Q: Navicular Injury: Symptoms and Treatment?

Hi Lauren,

I stumbled across your website while I was looking up information about navicular stress fractures. Could you describe what it felt like and what was your treatment? Thanks so much!

-Footsie

A:

Hey Footsie-

Navicular injuries are really tough to diagnose without a bone scan or MRI (or in my case, both).  The bone is in the mid-foot, and part of it can be touched on the top of the foot and another part on the inside near the arch.  People describe varying symptoms, for example, mine never hurt when I pushed on the bone, but most people’s do.  The bone has the most strain on it during push off, at that exact moment between when it has absorbed all the shock from the landing and begins to spring load to push the force back up.  So some people feel it on the landing and others on the push off.  From people I have known with the injury, most people describe pain when they run faster paces, and pain on uneven terrain.  I had tons of pain on left turns, and none on right turns.

As for treatment, I had surgery.  Rehab?  I heard many different things from many different doctors, but in the end, I decided to be conservative to prevent long term damage and this is what I did:

  • 8 weeks of no weight bearing, but every day, massaging the foot and activating the muscles for a few minutes.  The last 4 weeks of that I also did theraband ankle/foot exercises.
  • After that, I wore a boot (no crutches) for 2 weeks and started doing real calf raises, also moving to elliptical with no boot for 30 minutes and bouncing in the pool.
  • Then for 2 weeks I walked vigorously and did elliptical, added some walking drills (no bouncing), and continued the bouncing in the pool.
  • Then I had my coach make a sensible return to running schedule that took at least 6 weeks to get to running 6 days a week (low mileage), supplemented by cross training.  I never did more than 45-90 minutes of cross training per day throughout, knowing that my body needed energy to heal.

There were bumps along the way, and times I had to take a day off, or cross train when I didn’t want to, but things progressed.  My only regret is that I didn’t get assessed by a PT immediately after ditching the boot (week 10) to see what imbalances it caused so I could spend the first 6 weeks working to correct them.  Those imbalances change your form when you start running and cause all sorts of other injuries if not addressed.   Its a sucky injury, but its surmountable, (and character building to say the least.)

-Lauren