Physiotherapy for a scaphoid fracture of the foot

The scaphoid on the foot is located on the inner side of the foot, i.e. the side of the big toe, and is also called Os naviculare. It is a bone of the tarsal bones. The scaphoid bone of the foot is very small and almost cubic.

It breaks very rarely, usually only under direct gelatinous influence. The navicular bone can break by violent bending or impact, but also by permanent overloading (fatigue fracture). Mostly, however, there are pre-damages due to osteoporosis or inflammations in the tissue. Physiotherapy for a scaphoid fracture is important to maintain the surrounding muscles and to counteract a loss of mobility. In addition, walking with crutches is learned and in the course of healing the slow loading of the foot is learned.

Rehabilitation/physiotherapy

As a rule, the scaphoid fracture can be treated conservatively by immobilisation with a plaster cast. In the case of comminuted fractures, unstable fractures or dislocation (displacement) of the fracture fragments, surgery may be indicated. It is important to preserve and train the surrounding muscles through physiotherapy in the case of a scaphoid fracture of the foot without endangering the fracture in its healing.

For this purpose the bone should be loaded as little as possible. Long-term immobilization, which is necessary for the fracture to heal, leads to atrophy, i.e. a reduction in muscle mass. In physiotherapy, targeted training is used to strengthen the muscles, which are also important in walking and standing, but are now hardly ever strained or demanded and thus tend to deteriorate.

Circulation is also required in therapy in order to avoid circulation weaknesses, for example after sitting up or standing up. The tissue can also be mobilized and stretched manually to compensate for the lack of movement by immobilizing the joints. If there is no movement of the tissue, the different tissue layers can become stuck together over time, which can lead to a long-term restriction of movement.

Manual stretching and mobilization techniques can counteract such a loss of mobility despite the immobilization of the joint. Walking with aids is also learned in physiotherapy for a scaphoid fracture of the foot. In the course of healing, the patient may at some point (according to the doctor’s instructions) put more and more weight on the foot again. During therapy, it is practiced to put the right weight on the foot and not to overstrain it. The gait pattern is practiced after removal of the cast even without forearm crutches to prevent the development of a false gait pattern.