Stress fractures of the foot and ankle are common injuries that require a high index of suspicion to make the appropriate diagnosis. If required, advanced imaging modalities should be used to establish the diagnosis. When developing a treatment plan for the runner, the sports medicine physician must keep the athlete informed as to the nature of the injury and the necessity of the treatment. A fitness plan must be developed with the runner to ensure that strength, flexibility, and cardiovascular conditioning are maintained during this period. Ideally the physician should develop this plan with the runner and not dictate the type of activity that is used to obtain these goals.