Stress fractures are common in athletes. A stress fracture is not a complete fracture of bone, but a small crack that appears in the bone covering. They occur when the repetitive load on the bone is greater than the bone can adapt to, so a small stress fracture occurs. They used to be called march fractures as they are coming in soldiers who did long marches. An uncommon stress fracture is the navicular stress fracture that occurs in the navicular bone, just in from of the ankle. The navicular stress fracture is particularly problematic as it is a major weightbearing bone of the foot, so when it occurs it is often put into a cast even though it is not a complete break of the bone. A classic sign of a navicular stress fracture is what has become known as the ‘n’ spot – this is a tender area on the navicular, just in front of the ankle joint at the highest part of the arch of the foot. Invariably a navicular stress fracture is in a weight bearing cast for around six weeks. On rare occasions a pin may be used to treat a navicular stress fracture.
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