Bilateral foot pain in a collegiate distance runner.

A 19-year-old, white female, college freshman cross-country runner presented to the athletic training center complaining of bilateral plantar foot pain 1 week into the cross-country season. She had been treated for bilateral plantar fasciitis twice in the previous 3 years, and initial evaluation suggested a recurrence. A failure to respond to treatment led us to suspect other causes. Subsequent diagnostic imaging (bone scan, CT scan) revealed bilateral navicular stress fractures. Navicular stress fractures are probably more common than once believed. This case study describes the course of evaluation and treatment in relation to the common presentation, etiology, problems of diagnosis, and treatment of navicular stress fractures.