Pain in the Navicular

Well it's been an interesting week or so since my last posting. Although I would normally focus on running activities this post is focused on a minor injury I have been living with for some time.

I have had a mild pain in my right foot since early October and although it was not noticeable at first it has begun to plague me during the past month or so . Although it has been bearable I had noticed my right foot gait has slowly changed and consequently this has unmasked more serious problems lately with numbness in the toes, ankle instability and pain in my inner calf / soleus.

Although I had been trying to manage this using R.I.C.E it just didn't settle down and each time I went out for run I felt unstable on my right ankle and would come back not happy. The last straw was on Thursday this past week. Despite a good fast run for me I had pain and cramping on the inside of my arch and decided that I needed to get down to the physio to sort this out once and for all before the running year has started properly.

After talking to the physio about where I felt pain, injury history, shoe choice etc he reviewed my foot in more detail and eliminated a foot fracture quite quickly which put my mind at rest as it could of ruined the first part of the year. After 5 minutes it was immediately clear to the physio that there was a problem on the underside of my foot with a bone called the "Navicular". I could feel pain as he push on this area and explained that the bone had dropped slightly.

Here is an explanation of its purpose (via Wikipedia)

"The navicular bone is one of the tarsal bones, found in the foot. Its name derives from the bone's resemblance to a small boat, caused by the strongly concave proximal articular surface.

It is located on the medial side of the foot, and articulates proximally with the talus, distally with the three cuneiform bones, and occasionally laterally with the cuboid.

This extension of the foot has a tendency to put stress on two tendons and the ligament that run along its side. The tendon of the peroneus brevis muscle which is the most distal of the two tendons, the tendon of the peroneus longus muscle which extends to the posterior of the ankle, and the posterior talofibular ligament which extends upward partway along the calf muscle, can all be potentially affected by this protrusion."

He went on to explain that due to the slight drop of this bone it was causing stress to the surrounding tendons (posterior tibialis and the peroneus longus) and in the process causing my arch to collapse and caused my foot to pronate beyond normal and stressing out the ankle in the process. As I have quite wide feet he explained that if I had been wearing tight fitting shoes or tieing shoe laces to tightly over a period of time it could explain why the bone popped.

He treated both the foot and calf relieving a lot of the tension. The good news was that after finishing the session he did say that I could go out running the next day as long as I took things at an easy pace but also to come back in 10 days for a follow up to see how things are progressing.

Looking back I remember that the issue first occurred when I had been wearing Brooks Green Silence shoes during August. September, October and November. As this condition doesn't occur overnight  it's a bit like the "Boiling Frog" anecdote. I admit looking back in my training log that I made notes stating that my feet seemed to pop out the sides of these shoes and that I was pulling the laces tight on them to hug my foot as the fit wasn't perfect.

I went out for a gentle 5 miles today and the foot / calf / ankle felt 1000% better. I am being cautious about it though and will continue to do my foot / leg strengthening exercises alongside my running. What disappoints me is how I blindly pushed through the last few months until I got to a point where I couldn't run properly.

It's only 4 weeks until the Thames Trot ultra and I am yet to decide whether I still want to run it. It would be a good training run but I won't make my final decision until the last minute to see how the foot progresses. There is no point ruining an entire season for the sake of one race.

Lesson to all in that make sure you have shoes that fit rather than ones that look good and don't be pig-headed and push through minor injuries that don't get any better especially if you want to run well for the rest of your life.

Happy Running