Navicular Stress Fracture

Navicular Stress Fracture Description
Navicular Stress Fracture is an overuse injury to a bone in the foot.  The tarsal navicular is a small bone in the mid-foot.  Tarsal navicular stress fractures generally occur from chronic overuse such as occurs with running on hard surfaces. Navicular stress fractures are uncommon injuries, but are more common in sprinters, hurdlers, high jumpers, long distance runners, soccer, and basketball players

Navicular Stress Fracture Anatomy
Navicular Stress Fracture is

Navicular Stress Fracture Symptoms
Navicular Stress Fractures cause vague pain and swelling in the midfoot. The pain generally begins without an associated injury and worsens with activity such as running or jumping.  The midfoot may be tender.

Navicular Stress Fracture Treatment 
Navicular Stress Fracture s diagnosed based on a detailed history, physical exam and xrays performed by an orthopaedic surgeon, or sports medicine specialist.  CT scans or MRI are often needed to diagnose a navicular stress fracture.

Athletes with navicular stress fractures are typically treated in a non-weight bearing short leg cast until the fracture is healed.  This typically takes 6-8 weeks.  The average time to return to activity after a navicular stress fracture is 4.9months.  Surgery is required for certain stress fractures of the tarsal navicular.  Bone stimulators may be helpful as well.  Surgery is  considered for high-level athletes due to the risk of nonunion and concerns for prolonged symptoms and time off from their sport. 

Continued weight bearing without treatment can lead to fragmentation, dislocation and collapse of the medial column of the foot.
Athletes returning to sports after a Navicular Stress Fracture should begin with a graduated exercise program. First they should be pain free with daily activities with full range of motion and at least 85% strength in the injured leg compared to the uninjured leg. Exercise begins with light jogging in a straight line, followed by sprinting in a straight line. When these have been done without pain the athlete can proceed to doing agility type drills such as 45º cuts, 90º cuts and jumping. Agility drills should begin at half-speed and proceed to full-speed provided the athlete remains pain free.

Navicular Stress Fracture Prevention
Prevention of Navicular Stress Fracture involves wearing proper shoes and ensuring the shoes are not worn out from overuse.  Running on concrete and hard surfaces should also be avoided.

Navicular Stress Fracture Risk Factors
Navicular Stress Fracture is associated the following sports: Basketball; Dance; Gymnastics; Running; Soccer.

Navicular Stress Fracture Rehab and Exercise Program
Navicular Stress Fracture

Navicular Stress Fracture Outcomes
Navicular Stress Fracture

Similar injuries that can be confused with Navicular Stress Fracture include:

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