Question
QUESTION: Hello,
I was dx with a navicular stress fx/ which runs into the talonavicular joint in October 09. I have been in a CAM boot and have been using a CMF bone stimulator for the past 2.5 months. I have been completely asymptomatic for the past 4 months-I have had only 1 MRI back in October which confirmed this dx. There have been 2 physicians who have recommended Forteo injections as a last resort before sx( a per Q screw implant) although none have come out and agree to giving me the injections. I have been a collegiate x-country and track runner and have competed in many long distance running events. I have also been dx with mild osteopenia(have been taking 4-6 Citracal daily since October. My podiatrist has recommended switching me to a cast instead of a Cam boot for another month. One other physician has mentioned growth hormone injections. Any suggestions for a 45 year old gal who would some day love to get back to competing again?

ANSWER: This Chicago & Elmhurst Podiatrist says.......

Dear Lisa
I suggest you try to increase your calcium intake with the supplements and diet first.Also light weight training will help
Unless the x-rays demonstrate a non healed fracture-I think it's time to consider light physical therapy and ROM. You have been immobilized and treated for a fair amount of time and should have healed from an uncomplicated stress fracture of the navicular.
Are you pain free out of the boot and in gym shoes?
Get a real good reason to continue with the immobilization.
Lack of movement contributes to bone loss.
Sounds like you may have beat the surgery.
If the pain persists-seek a second opinion from another board certified podiatrist
Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response. The navicular stress fx remains unhealed on x ray which is why the podiatrist continues to want to imobilize me even further with a cast. I have been in the CAM boot approximately 98% of the time  and remain asymptomatic the other 2% of the time while walking around the house in the evening. Thank you in advance for your suggestions regarding this

Answer
This Chicago & Elmhurst Podiatrist says.......

Dear Lisa,

I would continue with the bone stim and slowly increase time out of the cast and do range of motion-as long as you are completely pain free.If there is pain then stay in the walker
Hope This Helps
Good Luck!

Dr George Tsatsos & Svetlana Zats
Podiatrist Chicago 60618 & Elmhurst 60126 Podiatrists
Board Certified in Foot and Ankle Surgery & Orthopedics
New South Loop Location-Chicago 60661
AnkleNFoot.com
Runnersdoc.com
BabyFootDoc.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further