Navicular Stress Fracture

Any activity that sees the foot exposed to huge landing forces (sprinting, hurdling, games on hard ground), can expose you to this type of injury.  The exact mechanism for this fracture remains under investigation, but the injury is common.  One of the muscles (tibialis posterior) in your calf attaches to the bone.  When this contracts it places a stress upon the bone.  It is thought that a mixture of high load bearing and this muscle contraction can lead to progressive bone damage and ultimately a stress fracture. Because the middle third of this bone has a poor blood supply, fractures may not heal properly and so pain may persist when weight bearing.

Pain may be on the inner arch of your foot.

Pain usually eases quickly when not bearing weight through the foot.

In severe cases, the pain may be aggravated by just walking, and you may also experience pain at night (this is due to the healing processes at work as you are resting).

Clinical examination involving palpation (touching) of the bone to establish any point tenderness called and ‘N spot’.  If this is found then a fracture is suspected although further clinical examination should rule out other causes of the pain.

If the fracture is suspected, an X-Ray may help but is not very good at diagnosing this injury.  A bone scan or MRI may be better.

Physiotherapy (when out of cast) will help mobilise stiff joints and strengthen weakened muscles throughout the limb.  There will also be a period of rehabilitation including a gradual return to activity (your physiotherapist will dictate the pace of this according to your presentation).  Throughout the whole recovery period, pain free strengthening and stretching exercises should be performed to maintain optimal conditions in the whole leg.