If you run or play sports and battle foot pain, it’s possible to have a stress fracture in your foot. Can you return to running or sports after a navicular stress fracture?
My soon to be 15-year-old son has been diagnosed with a navicular stress fracture. He was casted for 6 weeks, and after that he just walked on it for 4 weeks. He was recently released to activity and after 1 1/2 weeks, he is beginning to feel pain again. He has been running but not more than a mile at time (If that much). What to do? Also he has severe heel pain on the bottom of both heels. I thought it was plantar fasciitis, but the foot doctor said Sever’s disease? Could these two pains be related? Please help. My son is at the end of his rope with all this pain. His was out of football and does not want to miss baseball season.
What is a navicular stress fracture?
Navicular stress fractures are difficult problems in athletes. Unlike some stress fractures, which heal uneventfully with a short period of rest, these unfortunately often don’t heal. Sports medicine surgeons tend to take these injuries much more seriously. In general, once an athlete has been diagnosed with a navicular stress fracture, treatment involves either complete nonweightbearing in a cast or even surgery to place 1 or 2 screws across the fracture. If the fracture doesn’t heal, a much bigger surgery, involving screws and even bone graft at the nonunion site, is often needed.
When can you return to sports after a navicular stress fracture?
Knowing when an athlete can return to walking, let alone running and sports, after suffering a stress fracture can be difficult. Due to the risky nature of these injuries going on to nonunion, I often order a CT scan or an MRI to better determine if it has healed. Often plain x-rays are too inconclusive. Also, if the athlete is still having pain, I think it’s safe to hold off from stress on the bone. Running and certainly sports are delayed in these situations.
What is Sever’s disease?
As for heel pain, Sever’s disease is a common cause of pain on the back of the calcaneus (heel bone) below where the Achilles tendon inserts. It typically doesn’t hurt at the base of the arch of the foot (where plantar fasciitis does). It is common in athletic kids between ages 8 and 12, in my experience, while the growth area in this region is experiencing stress with activity. Kids in running sports or sports with jumping and landing from jumps, like basketball and gymnastics, often have it. Treatment is usually conservative in that rest from the offending sport for a few weeks until pain decreases is enough. Other measures, including heel cups, orthotics, and physical therapy, can be used as well.
Plantar fasciitis is not common in high-school aged athletes, but we do see it occasionally. Again, the location of the pain is different, and the symptoms are different in terms of timing of the pain and inciting events. Another problem worth considering in an athlete of a running sport is a calcaneus stress fracture.
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