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What is a Navicular Stress Fracture?

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  • Written By: D. Jeffress
  • Edited By: Jenn Walker
  • Last Modified Date: 05 December 2016
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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 underneath the crease made by the ankle when crouching. Stress fractures in the feet are most likely to affect athletes who play high-impact and running-intensive sports, such as soccer, basketball, and track and field. A navicular stress fracture may not be immediately noticeable following an injury, and the break can worsen over time with ongoing activity. It is important to visit a doctor at the first signs of foot pain so he or she can check for a fracture and explain treatment options.

Navicular stress fractures in athletes occur due to constant running, jumping, turning, and stopping. Dancers are also highly susceptible to foot fractures, as are military recruits who are put through intensive training regimens. The risk of fractures increases when a person does not thoroughly stretch and warm up before engaging in activity. Physical conditions such as osteoporosis rheumatoid arthritis, or a mild physical deformity where 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 worsen during activity but improve with rest. Eventually, pain worsens and becomes more persistent, and mild swelling may occur.

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A doctor can usually diagnose a navicular stress fracture by evaluating physical symptoms and taking diagnostic imaging scans of the foot. He or she can identify the exact location of pain and tenderness by pressing on the foot in different places. When the patient reports pain above the navicular bone, x-rays and computerized tomography scans are taken to closely inspect the area. Treatment decisions are made based on the size and exact location of the fracture.

Most patients who suffer stress fractures are fitted with hard 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 re-evaluate the injury. If the bone appears to be healing correctly, guided physical therapy sessions for several months can help the patient gradually rebuild foot strength and flexibility. Surgery is rarely needed for a navicular stress fracture, but a recurring or persistent condition may require the navicular bone to be permanently fused together.

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serenesurface
Post 3

@simrin, @burcidi-- Hey folks, I'm in the same boat. I just got my cast a couple of days ago and I want to ask you about it since you've already gone through this.

I'm following all my doctor's directions and staying off of my foot. The problem is that I now have more pain after wearing the cast. I don't know if it's the weight of the cast or if it's applying pressure on my navicular bone, but it hurts!

Did you have the same problem when you had your boot cast on?

Do you think it's okay if I take the cast off sometimes? Not to walk, but when I'm sitting down maybe? I know that my foot needs to be in the cast to heal, but I do want to manage this pain without having to take pain killers and I'm not sure how to. Any ideas, anyone?

burcidi
Post 2

@simrin-- I know how you feel. I was also very apprehensive when I had a navicular stress fracture in my foot.

I'm not sure if your doctor talked to you about activity after the boot cast is removed. If he hasn't yet, I'm sure he will. In my case, I wasn't allowed to be active for another after the cast came off. Stress fractures definitely heal and eventually you will be able to get back to a reasonable amount of activity. But you have to take your time for the fracture to completely heal first.

So definitely keep your weight off of that foot until the cast comes off. And afterward, follow your doctor's directions and continue to

take it easy until your foot is ready. As long as you do this, there is no reason why you wouldn't be able to teach your classes again. And if you go to physical therapy (which you should) you will learn how to stretch and warm up so that the fracture doesn't happen again.
SteamLouis
Post 1

I'm a dance teacher and I found out last week that I have a stress fracture. Now I'm in a boot cast and using crutches to get around. I went to my orthopedic because of persistent pain on top of my foot. I really wasn't expecting a stress fracture but in a way I'm glad that it didn't turn out to be something worse.

The other dance teachers at the school are going to be taking over for me for the next month so that I can heal properly. My doctor said that my foot should be as good as new by then. What I'm worried about after this though is that the fracture in the navicular bone will

repeat itself when I get back to dancing.

Does having a stress fracture in the foot once increase the possibility of it happening again?

Being a dance teacher, it's not possible for me to not put pressure on that foot. It's my job! So I'm worried about what this might mean for my profession.

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