Navicular Stress Fracture – James Hird vs Alex Fasolo

Navicular Stress Fracture. Two AFL players, two different clubs and two different eras of our great game…so what is it that James Hird and Alex Fasolo have in common? Not much I hear you say???

One was the captain of the club he now coaches, had an outstanding AFL career, decorated with premierships, Anzac medals, a norm smith medal and he even took home Charlie after only 5 seasons! Wow! The other, is an up and comer, only into his 3rd AFL season with his whole career ahead of him. So what is it they share…?

They have both suffered a Navicular stress fracture.

There have been quite a few AFL players over the years that have suffered the effects of this dreaded injury. It is an injury that is becoming one of the most feared amongst AFL and sporting circles. Due to prominent AFL players being struck down with a Navicular stress fracture the profile of this injury has grown in the media in recent years. James Hird is probably the most notable name but recently Alex Fasolo, Jack Trengove and Shaun Higgins have all suffered Navicular stress fractures within the last 12 months.

The Navicular bone

The Navicular bone is located in the inside/middle of the foot, is positioned between the forefoot (ball of foot) and the rear foot (heel) and forms some of the key joints within the arch and mid foot. It is surrounded by the cuneiforms and talus and with excessive force and impact is often jammed and crunched between these other bones. It is thought that limited ankle joint range of motion, in particular dorsiflexion, and over pronation of the foot are possible contributors to the development of this injury. In comparison to other areas and other joints the Navicular has a reduced blood supply and as it is under constant pressure and loading, does not have the same opportunity to heal and repair.

A Navicular stress fracture is more common among people participating in high impact sports involving running or jumping. Pain often begins as a dull aching but sometimes sharp pain in the inside of the foot and middle of the arch. If not assessed, managed or diagnosed early pain will gradually worsen.
Treatment of this injury is often seen as quite severe but when we are aim to have our AFL stars running and jumping at full fitness before the finals come around, it really needs to be.

Early diagnosis

Early diagnosis is essential to prevent more serious damage and a CT scan or sometimes bone scan is often used to clarify the extent of the fracture. Following this total non-weight bearing in the form of an offloading cast is used to immobilise the joint is used allowing healing to take place. For serious or more severe Navicular stress fracture injuries or if healing is slow and delayed, surgery may be required.

It’s not easy is it to return to full fitness post a Navicular stress fracture and it is crucial the area is allowed to heal without any setbacks. Not many people realise how serious this injury is and that it can easily be career ending…just ask Geelong’s Matty Egan.
James Hird managed to defy the odds, resurrect his career and become one of the game’s greatest players…only time will tell what the future holds for Fasolo and Walk On Podiatry wishes him well with his recovery!