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Navicular Stress Fractures: Causes, Symptoms, and Treatment

Introduction:

Navicular stress fractures are a common injury among athletes engaged in activities that involve repetitive stress on the feet. Despite being relatively small in size, the navicular plays a crucial role in weight-bearing and movement, making it susceptible to stress-related injuries. Today we will look into the causes, symptoms and treatment options for navicular stress fractures. 

Causes:

Navicular stress fractures typically occur due to repetitive loading and impact on the foot, commonly seen in activities such as running, jumping, and dancing. Factors contributing to the development of stress fractures include overtraining, improper footwear, biomechanical abnormalities, such as flat feet, and sudden increases in activity levels without adequate conditioning. 

Symptoms:

The onset of navicular stress fractures is often gradual, with symptoms worsening over time. Common signs and symptoms include: 

  • Persistent pain on the top or inside of the midfoot that worsens with weight-bearing activities
  • Tenderness over the navicular bone
  • Swelling and bruising around the affected area
  • Difficulty bearing weight on the affected foot
  • Pain during palpation or when pressing on the navicular bone

Diagnosis: 

Diagnosing navicular stress fractures can be challenging due to their sometimes subtle presentation and the overlap of symptoms with other foot conditions. Your podiatrist may employ a range of diagnostic tools, including:

  • Physical examination to assess for tenderness and swelling
  • X-ray, CT scan or MRI to detect bone abnormalities or fractures

Treatment:

The management of navicular stress fractures typically involves a combination of conservative measures and, in some cases, surgical intervention. Conservative treatment options may include:

  • Rest: Avoidance of weight-bearing activities to allow the bone to heal. 
  • Immobilisation: The use of a cast or walking boot to stabilise the foot and promote healing. 
  • Orthotic devices: Custom orthotics to correct biomechanical issues and reduce stress that has been placed on the navicular bone
  • Physical therapy: Stretching and strengthening exercises to maintain movement within the affected foot and continue to develop strength around the foot. 

In cases where conservative measures fail to promote bone healing, or if the fracture is severe, surgical intervention may be necessary. Surgical options typically involve internal fixation with screws. 

Prevention:

Preventing navicular stress fractures involves a comprehensive approach aimed at reducing stress on the feet and promoting proper biomechanics. Strategies for prevention include:

  • Gradual progression of activity levels to allow for adequate adaptation and conditioning.
  • Wearing appropriate footwear with good arch support and cushioning.
  • Incorporating cross-training activities to prevent overuse injuries.
  • Regularly stretching and strengthening the muscles of the foot and lower leg.
  • Listening to the body and addressing any signs of pain or discomfort promptly.

Navicular stress fractures can be debilitating injuries that require prompt diagnosis and appropriate management to ensure optimal recovery. By understanding the causes, symptoms, diagnosis, and treatment options for navicular stress fractures, individuals can take proactive steps to prevent these injuries and maintain foot health. If you suspect you may have a navicular stress fracture or are experiencing foot pain, consult with a podiatrist or healthcare professional for proper evaluation and treatment.

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