N is for Navicular Stress Fracture

November 26, 2012

A navicular stress fracture is often season ending for athlete. These fractures can takes months to heal and rehab from as the bone takes a central place in the arch of the foot.

A navicular stress fracture refers to a small crack or fracture in the navicular bone, which is one of the small bones located in the midfoot. Stress fractures occur due to repetitive stress or overuse of the bone, resulting in tiny cracks that can lead to pain and discomfort. Navicular stress fractures are relatively rare but can be a significant injury for athletes and individuals engaged in high-impact activities.


  1. Overuse and Repetitive Stress: Navicular stress fractures often result from repetitive stress or overuse of the foot, particularly in activities that involve running or jumping. Repeated impact on the navicular bone can cause it to weaken over time and eventually lead to a stress fracture.
  2. Foot Structure and Biomechanics: Certain foot and biomechanical factors can increase the risk of developing navicular stress fractures. These include high arches, flat feet, abnormal foot pronation (excessive inward rolling), and leg length discrepancies. These conditions can alter the distribution of forces in the foot and increase stress on the navicular bone.
  3. Training Errors: Rapid increases in training intensity, duration, or frequency without allowing adequate rest and recovery can contribute to stress fractures. Sudden changes in running surfaces or improper footwear can also increase the risk.


  1. Gradual Onset of Pain: Navicular stress fractures typically develop gradually over time. Initially, there may be a dull ache or pain in the midfoot or arch, which worsens with weight-bearing activities and subsides with rest.
  2. Localized Tenderness: Direct pressure on the navicular bone may cause localized tenderness, swelling, or a palpable lump over the affected area.
  3. Pain with Activity: Pain is usually exacerbated during activities that place stress on the foot, such as running, jumping, or even walking.

Diagnosis and Treatment:

  1. Physical Examination: A healthcare professional will assess the foot, examining for tenderness, swelling, and changes in foot structure or alignment.
  2. Imaging Tests: X-rays may not show early-stage stress fractures, so additional imaging tests such as magnetic resonance imaging (MRI) or bone scans may be ordered to confirm the diagnosis and assess the extent of the fracture.
  3. Immobilization and Rest: Treatment typically involves reducing weight-bearing activities and immobilizing the foot with a cast, walking boot, or crutches to allow the bone to heal. This period of rest may range from several weeks to several months, depending on the severity of the fracture.
  4. Rehabilitation and Strengthening: Once the fracture has healed, a gradual return to weight-bearing activities is initiated. Physical therapy may be recommended to restore strength, flexibility, and proper biomechanics to reduce the risk of recurrence.


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