Navicular stress fractures are small breaks in the flat bone on the top of the foot, often caused by high-impact sports or intensive training. Symptoms include pain and swelling, and treatment involves rest, immobilization, and physical therapy. Surgery is rarely necessary.
A navicular stress fracture is a small crack or break in the navicular bone of the foot. The flat bone is located on the top of the foot, just below the crease created by the ankle when squatting. Stress fractures in the feet are more likely to affect athletes who play high-impact, running-intensive sports, such as soccer, basketball, and track and field. A navicular stress fracture may not be immediately apparent following an injury, and the break can worsen over time with ongoing activity. It’s important to see a doctor at the first signs of foot pain so they can check for a fracture and explain treatment options.
Navicular stress fractures in athletes occur from constant running, jumping, turning, and stopping. Dancers are also highly susceptible to foot fractures, as are military recruits who undergo intensive training regimens. The risk of fractures increases when a person does not fully stretch and warm up before engaging in activity. Physical conditions such as osteoporosis, rheumatoid arthritis, or a minor physical deformity in which one leg is slightly longer than the other can also contribute to a navicular stress fracture.
Many people are unaware that they have suffered stress fractures in their feet until several weeks or months after the initial break. In the early stages, foot pain tends to get worse with activity but improve with rest. Eventually, the pain gets worse and more persistent, and mild swelling may occur.
A doctor can usually diagnose a navicular stress fracture by evaluating the physical symptoms and doing diagnostic scans of the foot. He or she can identify the exact location of the pain and tenderness by pressing on the foot in different places. When the patient reports pain above the navicular bone, x-rays and computed tomography scans are done to closely inspect the area. Treatment decisions are made based on the size and exact location of the fracture.
Most stress fracture patients are fitted with rigid foot casts and instructed to avoid bearing weight on the affected leg. A person can expect to be on crutches for about four to six weeks, at which point the doctor can remove the cast and reevaluate the injury. If the bone appears to be healing properly, guided physical therapy sessions over several months can help the patient gradually rebuild the strength and flexibility of the foot. Surgery is rarely needed for a navicular stress fracture, but a recurring or persistent condition may require permanent fusion of the navicular bone.
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