What is a navicular stress fracture?

Why Cameron Giles may never play again

Navicular stress fractures can be the ultimate career ending foot injury for many athletes. And as podiatrists they can be very difficult to treat if not detected early and treated aggressively. In recent years Cameron Giles has been missing in action at the Carlton FC and it has just been revealed that Giles will never return to AFL footy due to a navicular stress fracture.

We will run through Navicular stress fractures in this blog, the importance of early detection and management options as well as when to consider surgery.

The Navicular is the bone is found at the top of the arch. Stress fractures in this bone can be very slow to heal due to the decreased blood supply and increase in stress that can go through this bone. This stress is caused when the arch collapses and the navicular bone is crushed between bones either side of it during gait.

Early detection is pivotal in the successful treatment of Navicular stress fractures. As with most stress fractures, they can take up to 6 weeks to show up on normal X-Rays. Early immobilisation and a period of non-weight bearing is vital in the treatment of this injury. MRI’s are commonly ordered by your Podiatrist if there is any uncertainty around the diagnosis of this injury.

Pain in this area is often difficult to diagnose due to the many pathologies associated with this area. The pain will generally be a gradual onset over days to weeks which is painful during most weight bearing activities as well as pain at night time.

Treatment is initially aggressive immobilisation usually with a CAM walker/ cast as well as crutches. After the stress fracture is initially healed any biomechanical abnormalities may need to be corrected to assist with the rehab process. If aggressive immobilisation does not allow the fracture to heal or the bone becomes necrotic, a surgical opinion must be sought. Close monitoring of the area and successive imaging may be needed to ensure timely resolution.

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