What is a Navicular Stress Fracture?
A navicular stress fracture is described as a small crack in the navicular bone (a boat-shaped bone located at the top of the middle part of the foot), which occurs from too much stress being placed on the bone from repetitive activities.
![Picture of Navicular Stress Fracture](https://assets.yourpractice.online/2630/3d-images/navicular-stress-fracture-sp1.jpg)
What are the Causes of a Navicular Stress Fracture?
Some of the factors that might contribute to the development of a navicular stress fracture include:
- Increased sports training amount, frequency, or intensity
- Modification of the apparatus, such as new footwear or a new training surface
- Poor nutrition (vitamin D deficiency and low-calorie intake)
- Low bone density
- Atypical foot structure, such as high arches
- Excessive pronation (inward tipping of the foot)
- Restricted ankle dorsiflexion (the ability to raise your foot toward your knee).
What are the Symptoms of Navicular Stress Fracture?
Signs and symptoms of a navicular stress fracture include:
- Swelling or bruising over the middle part of the foot
- Intense pain
- Discomfort in the arch and center or top of the foot
- Tenderness when pushing on the navicular bone
- Discomfort when moving, running, or leaping. Patients frequently only experience discomfort initially after performing vigorous activities like jogging or leaping. However, it can turn into a steady pain even when at rest and escalate to pain with low-intensity activities like walking.
Diagnosis of Navicular Stress Fracture
Your doctor will review your symptoms, and medical history and perform a thorough physical examination to check for swelling or bruising restricted range of motion, or tenderness. Diagnostic tests that may be ordered include:
- X-rays: During this study, high electromagnetic energy beams are used to produce images of broken bones. However, stress fractures may be difficult to visualize on X-rays.
- CT scan: This study creates detailed images of the foot using X-rays from different angles.
- Bone scan: This is a nuclear imaging study that helps your doctor identify hard-to-detect stress fractures or any bone disorders.
- MRI Scan: This is an imaging study that uses a large magnetic field and radio waves to produce detailed images of the foot.
What are the Treatments for a Navicular Stress Fracture?
Treatments for a navicular stress fracture include:
- Rest: Your doctor will advise you to avoid high-impact exercises and activities. Weight-bearing on the affected leg is limited until the area is healed which can take 4 to 8 weeks.
- Ice: Apply ice for 10 minutes at a time to relieve pain and inflammation.
- Compression: Pressure should be applied to the affected site to reduce pain.
- Elevation: You need to elevate your leg when possible, to relieve swelling.
- Medications: Your doctor will recommend over-the-counter anti-inflammatory medications to reduce inflammation and pain.
- Physical therapy: After the initial rest period, your doctor will recommend special non-weight-bearing exercises and other techniques to strengthen the bones and improve your range of motion.
If these methods are found to be ineffective, your doctor will recommend using
- Splints: These are made of plastic and fiberglass and are used to immobilize the joint.
- Casting: This acts as a protective shell made of fiber or plaster molded in a way to protect the broken bones.
- Bracing: Braces are made of plaster or fiber and act as a protective shield to align the damaged bone.
Surgery for Navicular Stress Fractures
Surgery is usually not needed to treat navicular stress fractures. However, if non-invasive treatments fail to repair your fracture, surgery may be considered. The fracture is often fixed during surgery using one or more screws, and occasionally a bone graft.
Prevention
These steps you can take to help prevent navicular stress fractures are:
- Before beginning an exercise or training regimen, choose supportive shoes and replace them when they begin to wear out. Typically, supportive footwear has a rigid sole and is well-cushioned throughout, especially at the arch.
- Particularly following a period of comparatively little exercise, ease into your new training regimen.
- Stretching should be done before exercise, with the calf muscles and Achilles tendon receiving special attention.