Midfoot pain in athlete- navicular stress fracture in athlete

Part 1
50 marks (1250 words)
A female 32-year old recreational runner, who is currently symptom free but with past problems of mid-foot pain, comes to you for advice as she is planning on running a marathon in six months’ time.
Critically discuss what might predispose this runner to injury, say how you would assess the runner and explain the advice you would give her.
Your answer should include:
● An account of your history and examination.
• Reference to possible predisposing factors for this injury.
• Discussion of reasons for any tests and investigations
• Justification of a differential diagnosis for her past mid-foot pain supported with evidence

Part 2
30 marks (750 words):
The athlete returns 4 months before she is due to run the marathon, having been training for 8 weeks. She has again developed midfoot pain and on this occasion you diagnose a navicular stress fracture. She is still keen to take part in the marathon as she has already collected a large amount of sponsorship money.
Critically discuss (a) your immediate management and (b) the advice you give her for the time leading up to the event.
Your answer should include:
• Review of the management options
• Argued evaluation of the options
• Justification of preferred course of action/advice

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