In brief: A review of the records of 62 runners treated for stress fractures showed that initial x-rays were positive in 47.2% of the cases, while bone scans were positive in 95.8%. A combination of errors in training and changes in footwear accounted for 44% of the fractures, and all the patients had alignment problems. The runners had waited until their performance was seriously impaired to seek treatment. The authors concluded that if point tenderness and soft-tissue swelling are recognized early, stress fractures can be prevented with rest, muscle rehabilitation, and orthotic control of excessive pronation.