Foot injuries occur frequently in distance runners and can notably impact training performance. Common diagnoses include plantar fasciitis, tendinopathies of the forefoot or midfoot, and stress fractures of the metatarsals. Occasionally, more obscure structures may be involved. We describe a 37-year-old male distance runner who presented with symptoms of heel pain and ecchymosis, suggesting an acute plantar fascia injury. However, findings of magnetic resonance imaging revealed a tear to the quadratus plantae (QP). The patient gradually returned to normal levels of physical activity, with complete resolution of symptoms by 4 months after the initial injury. Healthcare providers should be aware of the possible presence of a QP tear in patients who present with symptoms suggestive of acute plantar fascia rupture.

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