Navicular Stress Fracture

What is a navicular stress fracture?
The navicular bone is a bone in the ankle which sits on top of the calcaneus or heel bone. A stress fracture of this bone is one of the more common stress fractures seen in the feet of athletes, especially those involved in sprinting, jumping or hurdling.

What are the symptoms?
-A poorly localized midfoot ache associated with exercise.
-Pain goes away quickly with rest only to return again during exercise.
-Pain when the thumb is pressed into the top of the foot over the navicular (this is sometimes called the N spot).
-An X-ray may or may not show the appearance of a stress fracture therefore a bone scan or MRI is of more use.

What is the usual treatment?
-Non weight bearing immobilization in a cast for 6 weeks.
-After 6 weeks the 'N' spot is felt. If it is tender then the cast is re-applied for a further 2 weeks non weight bearing.

What about rehabilitation?
-Mobilization of the stiff ankle joint.
-Deep tissue sports massage to the calf muscles.
-Strengthening exercises for the ankle and lower leg.
-A gradual return to full activity and training over a 6 week period.
-Excessive pronation needs to be corrected before full training resumes.