beanstock
07-30-2008, 05:19 PM
I've been on crutches for the last 8 weeks, first in a cast and then in a walking boot that I wasn't allowed to walk on. I have a navicular foot fracture. Saw orthopedic doctor yesterday and she has given me permission to bear weight on the foot now, as long as I'm wearing the boot.
Today is my first day, and granted I've done a bit of walking (the restroom is a loooonnnggg hallway away from my office). I'm seeing some increased swelling -- not a lot, but definitely some. No increased pain or tenderness. I'm wondering if this is normal, to swell more once you start bearing weight again. I ask b/c the doctor warned me that navicular fractures are tricky to heal, and that sometimes they just don't, so we'll be watching for increased pain and swelling over the next weeks. Should I worry yet?
Today is my first day, and granted I've done a bit of walking (the restroom is a loooonnnggg hallway away from my office). I'm seeing some increased swelling -- not a lot, but definitely some. No increased pain or tenderness. I'm wondering if this is normal, to swell more once you start bearing weight again. I ask b/c the doctor warned me that navicular fractures are tricky to heal, and that sometimes they just don't, so we'll be watching for increased pain and swelling over the next weeks. Should I worry yet?
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janewhite1
07-30-2008, 05:30 PM
By bearing weight, you mean you are putting some of the weight on the foot and some on the crutches, right?
beanstock
07-30-2008, 05:34 PM
No, I've actually been given permission to ditch the crutches and walk in the boot. My doctor is encouraged by the overall decrease in swelling and the lack of pain, so she thinks things are going well, but she warned me that these often fail to heal on their own. She also said the x-ray won't really show healing for awhile, so we're watchng for pain and swelling in the meantime.
forevergimpy
07-30-2008, 08:15 PM
bean-
I would be hesitant to go from 8 weeks with no weight bearing to full weight bearing. That's quite an adjustment for a foot even with the protection of the boot. If it were me, I'd ease into it. That way you will get a clear picture of the results. If you have no pain when bearing weight I'd transition from NWB, to WB with 2 crutches, then down to one crutch then finally without any support.
I am recovering from surgery to my navicular and cuboid (a spur had actually fused them together) and my transition to walking without support (even in the boot) has been slower than I would have wanted. My doc said just today that part of the problem is that the boot isn't as supportive to that area of the foot as a fiberglass cast would be. I opted for the boot anyway so I could take if off to increase my ROM and clean my leg. I guess it's the price I'm going to pay. Good luck to you. :)
I would be hesitant to go from 8 weeks with no weight bearing to full weight bearing. That's quite an adjustment for a foot even with the protection of the boot. If it were me, I'd ease into it. That way you will get a clear picture of the results. If you have no pain when bearing weight I'd transition from NWB, to WB with 2 crutches, then down to one crutch then finally without any support.
I am recovering from surgery to my navicular and cuboid (a spur had actually fused them together) and my transition to walking without support (even in the boot) has been slower than I would have wanted. My doc said just today that part of the problem is that the boot isn't as supportive to that area of the foot as a fiberglass cast would be. I opted for the boot anyway so I could take if off to increase my ROM and clean my leg. I guess it's the price I'm going to pay. Good luck to you. :)
Hankster13
08-01-2008, 10:56 AM
Beanstock,
I am not sure that you want to hear my story. I am at 13 months and counting with my fracture....
As is typical for this fracture, lived with it untreated for months. I started to tape my foot in July so that i could do karate. I had it looked at by an athletic therapist who treated it like a soft tissue injury. Finally had it diagnosed the last week of October. tried 9 weeks of NWB in a boot. When it was obvious that that wasn't going to heal it i was scheduled for surgery, which i had in Feb. Two screws inserted. 6 more weeks of NWB in a cast this time. For a total of 5 months of NWB and crutches. UGH!
Had my cast off and was told i "might need a cane for a few weeks" and "no you shouldn't need PT". I chose to do PT anyway (smart) and went straight to a cane that day (less smart).
At 12 weeks post op, the xray showed no healing. at 20 weeks post op the fracture line was beginning to appear "fuzzy". So some healing has begun. I go again in just over 3 more weeks for another x-ray.
So the fact that healing is finally taking place (7-8 months later) is good. But i still have issues with my foot. There is always some swelling over my arch. I can not push off with my foot, my gait is affected, i tend to walk on the outside of my fooot for relief, and with the exception of two rare good days, cannont rise onto the ball of my foot. There is also pain, when i walk always, and worse if i have been more active. Some of it seems to be "bone" pain and some seems to be "soft tissue" pain, almost like a sprain on the top of my foot. I am tender to touch over my navicular.
I am somewhat active now (FAR below my normal level of activity) have been going to the gym 4-5 times a week since before my surgery, can walk about 45 minutes with the dog, but suffer the next day for it, and have done a few karate classes and then suffer for several days for it. I feel that progress in how my foot feels plateaued about three months ago. i have as yet been unsucessful in getting my surgeon to pay attention to my concerns, he just keeps saying give it a couple of months and come back for another xray. I will be armed with a long list of written questions at my next appointment.
I am sorry that this very long ramble is not all that encouraging. However as you probalbly know from reading medical journals on line, thjere are plenty of cases wghere the navicular heals and people return to full activity.
I am not sure that you want to hear my story. I am at 13 months and counting with my fracture....
As is typical for this fracture, lived with it untreated for months. I started to tape my foot in July so that i could do karate. I had it looked at by an athletic therapist who treated it like a soft tissue injury. Finally had it diagnosed the last week of October. tried 9 weeks of NWB in a boot. When it was obvious that that wasn't going to heal it i was scheduled for surgery, which i had in Feb. Two screws inserted. 6 more weeks of NWB in a cast this time. For a total of 5 months of NWB and crutches. UGH!
Had my cast off and was told i "might need a cane for a few weeks" and "no you shouldn't need PT". I chose to do PT anyway (smart) and went straight to a cane that day (less smart).
At 12 weeks post op, the xray showed no healing. at 20 weeks post op the fracture line was beginning to appear "fuzzy". So some healing has begun. I go again in just over 3 more weeks for another x-ray.
So the fact that healing is finally taking place (7-8 months later) is good. But i still have issues with my foot. There is always some swelling over my arch. I can not push off with my foot, my gait is affected, i tend to walk on the outside of my fooot for relief, and with the exception of two rare good days, cannont rise onto the ball of my foot. There is also pain, when i walk always, and worse if i have been more active. Some of it seems to be "bone" pain and some seems to be "soft tissue" pain, almost like a sprain on the top of my foot. I am tender to touch over my navicular.
I am somewhat active now (FAR below my normal level of activity) have been going to the gym 4-5 times a week since before my surgery, can walk about 45 minutes with the dog, but suffer the next day for it, and have done a few karate classes and then suffer for several days for it. I feel that progress in how my foot feels plateaued about three months ago. i have as yet been unsucessful in getting my surgeon to pay attention to my concerns, he just keeps saying give it a couple of months and come back for another xray. I will be armed with a long list of written questions at my next appointment.
I am sorry that this very long ramble is not all that encouraging. However as you probalbly know from reading medical journals on line, thjere are plenty of cases wghere the navicular heals and people return to full activity.
beanstock
08-01-2008, 12:12 PM
Hankster,
Wow, that's a long time to be out of commission! I'm sorry you've had to go through this. Prior to my injury, I was as active as it sounds like you were, and it's really been hard, to be so physically confined. I'm going nuts here!
I have read a lot online, some of it is encouraging and much of it is not (such is the nature of the internet). So far I feel pretty good about things, because I don't have much pain or tenderness and the swelling is minimal.
I do have the tissue pain you speak of though -- I wonder if that's referred pain, or if it's because I'm walking on different parts of my foot to avoid putting pressure on the navicular bone. Every time I get a little twinge of anyting, I panic (which means I'm panicking a lot!).
What are the symptoms of nonunion in the navicular bone? That's one thing I haven't been able to really find online. I'd assume that pain and swelling are bad signs, but is it possible to be not healing even in the absence of those symptoms?
Wow, that's a long time to be out of commission! I'm sorry you've had to go through this. Prior to my injury, I was as active as it sounds like you were, and it's really been hard, to be so physically confined. I'm going nuts here!
I have read a lot online, some of it is encouraging and much of it is not (such is the nature of the internet). So far I feel pretty good about things, because I don't have much pain or tenderness and the swelling is minimal.
I do have the tissue pain you speak of though -- I wonder if that's referred pain, or if it's because I'm walking on different parts of my foot to avoid putting pressure on the navicular bone. Every time I get a little twinge of anyting, I panic (which means I'm panicking a lot!).
What are the symptoms of nonunion in the navicular bone? That's one thing I haven't been able to really find online. I'd assume that pain and swelling are bad signs, but is it possible to be not healing even in the absence of those symptoms?
dncergrl53
08-01-2008, 12:33 PM
I had a different surgery, but my doctor told me he was more concerned with the healing of the tiny blood vessels in the foot than the bone. He advised me to keep the foot elevated over the level of my heart for most of 8 weeks and to keep the swelling down at all costs. (So I laid on the couch with my foot up on the back of the couch.) Swelling is just the blood pooling in the foot which stresses those tiny, healing blood vessels. And the blood carries the nutrients to enable the bone to heal. Having the foot low and not moving (i.e. standing, sitting) is worse than walking because walking moves the blood through the foot via the muscles working. I was very conservative in my post op treatment and it paid off. I had no pain, and now my foot looks and feels great and I have no complications. So, my bottom line advice is elevate high for a long time. You wouldn't walk on a fractured hand in a cast. I also did more PT than suggested both to get the new foot working as good as possible and 2, to address the associated compensations for my wonky gait pre-surgery for years.
Hankster13
08-01-2008, 01:06 PM
I don't know about symptoms for non-union specifically. Before my ORIF when i ditched my crutches and hopped around the kitchen, i could feel a uncomfortable but not painful looseness. That may be partly because i had lost all muscle tone in my foot. I didnt walk on it again until after it had screws in it. The pain i experience is mosly different from pre diagnosis. Also, i didnt really have any swelling or discolouration in my foot prediagnosis. Now the swelling (though not a lot) is usually there. An exception is the other day when i had to wear a work boot all day. when i took it off there was no swelling, but ther was bruising in that area. The next day no brusing, but swelling back.
My PT told me that the pain through my mid-foot could be refered pain from the navicular.
My PT told me that the pain through my mid-foot could be refered pain from the navicular.
Hankster13
08-01-2008, 01:35 PM
Was yours a stress fracture or an acute injury? If a stress fracture, do you know what caused it? How long do you think it was between the injury and diagnosis?
beanstock
08-01-2008, 02:21 PM
Mine is a stress fracture. I'm pretty sure I did it when I was running and hit a mole-hole, though at the time I didn't realize it was broken. Walked on it for about two weeks before getting it diagnosed. I had lots of swelling though, and the fact that it wasn't going away was my first clue that I needed to get it checked out. I had pain too, but not as severe as I might have expected. It looks and feels tons better now, even though I'm putting weight on it (while wearing boot). I just want it to heal...
Hankster13
08-01-2008, 08:54 PM
Not sure how i did mine. Likely a combination of running, karate and working construction (lots of walking on cement). And i went months letting it get worse. At first it was only sore occasionally. By the time i had it figured out, i had been on a hiking vacation in the Rockies and earned my black belt in karate all with a broken foot. Of course by then it hurt all the time. I suspect i gave it lots of time to break clean through. We never did determine that. I haven't had an MRI or CAT scan. And the surgeon didn't expose enough of the bone to tell, as he was more concerned about not disturbing the blood supply.
Hopefully your being more on the ball, and reacting early, will bode for a better outcome for you. Keep me posted.
I am not sure if age is a factor either, but i am 43.
Hopefully your being more on the ball, and reacting early, will bode for a better outcome for you. Keep me posted.
I am not sure if age is a factor either, but i am 43.