Navicular Stress Fracture

Patient Information

NA

GP Information

Background Information

• A condition caused by excessive weight bearing activity or a recent increase in activity / change in training conditions.
• Patients typically complain of poorly localised pain around the medial arch of the foot, worse on activity, relieved by rest.
• Examination may reveal medial arch swelling with pain on direct palpation over the navicular.

Investigation Guidelines

• MRI is the investigation of choice after a failure of conservative management.

Management Recommendations

Conservative measures include

• PRICE
• NSAIDs
• Avoid activities that exacerbate symptoms.
• Patient education.
• Protective boot for up to 6 weeks.
• OTC orthotics if flat footed.
• Excercise to improve strength, balance and core stability.
• Gradual return to activity.

Referral Indications;

• Diagnostic uncertainty.
• Some complete stress fractures may be candidates for early fixation.