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Midfoot Pain

Because of its location in the midsection of the foot, sandwiched between the long bones of the midfoot (called the metatarsals) and the heel bones, your navicular bone is a common site of fractures. In the vast majority of cases, these fractures or breaks are stress fractures — overuse injuries caused by repetitive stress on the midfoot area. Runners, jumpers, dancers and other athletes are especially prone to these injuries, however they can occur in people who have reduced flexibility in their feet or arthritic changes in these small bones.

Symptoms of Navicular Fractures Located along the inside of the arch of the foot, the navicular bone plays an important role in supporting your arch. It provides strength to your whole body when weight bearing. Your navicular bone is subjected to significant stresses, and when your muscles and connective tissues in the arch of your foot become weakened or over stressed, excessive strains can be exerted on this small bone, increasing the risk of fractures.

The most common symptom of navicular stress fractures is a persistent aching in the arch or midsection of the foot that is worse when weight bearing. Sometimes, pain can radiate along the inside edge of the foot. Often, these symptoms can be confused with plantar fasciitis, a condition that occurs when the strong fibrous tissues in the arch become inflamed and irritated, developing tiny tears. An X-Ray or MRI will confirm a fracture if it is there. Your physiotherapist can refer you for an objective diagnosis.

How are navicular fractures treated? Once a navicular fracture is diagnosed, treatment will depend on the severity of the fracture and the symptoms it’s causing. In most cases, patients will need to have the arch of the foot well strapped or wear a cast for a period of at least six weeks.

In most cases physiotherapy will be necessary to help the foot and ankle regain strength and flexibility. Your Physiotherapist will choose from a variety of available modalities the most appropriate protocol for you but it will probably be a combination of Laser Therapy, Interferential Therapy and Manual Therapy to help the fracture to heal faster and with minimal residual scar tissue. Because of the location and function of the navicular bone, and also because circulation in this area is not robust, healing can take several months before normal function is restored.

In very severe fractures that cause the bone to separate or shift out of alignment, surgery may be necessary.

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