Pain guide · Foot pain

Freiberg's disease: pain under the second toe joint, offloading, and getting back to sport and dance

Freiberg's disease (Freiberg's infraction) is pain at the joint at the base of the second toe, sometimes the third, when the end of the metatarsal loses part of its blood supply and softens. It mostly starts in teenagers between about 11 and 17, girls far more often than boys, and it's rare: in one UK hospital's count of the children born there, about 1 in 2,833 developed it. It needs an X-ray to diagnose, and a specialist manages it.

Most cases settle over about 2 years. Treatment takes the load off the joint: a break from the sport that hurts, sometimes a walking boot, then stiff or rocker-soled shoes and a metatarsal pad or insole. An NHS leaflet says about 1 in 10 people need an operation. This guide covers the warning signs, what offloading and surgery involve, what's known about returning to sport and dance, and a staged plan with 3D demos that protects the joint.

3-stage exercise plan When to get help 29 sourcesUpdated 21 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

Call 999 or go to A&E: after an injury, you heard a crack, the foot or ankle has changed shape or points at an odd angle, a bone is sticking out, there is a bad cut over it, you're in severe pain, or the toes look blue or white, feel numb or are cold to touch. These can mean a broken bone. Don't drive yourself.
Contact NHS 111 if you have severe pain in the ball of your foot, you're not able to walk, your foot has changed shape, you heard a snap, grinding or popping noise at the time of an injury, you feel faint, dizzy or sick from the pain, your foot is hot, swollen and painful, or you have pain in the ball of your foot and feel hot, cold or shivery. These might be signs of a broken bone after an injury, or an infection.
Same day: a sudden, very painful, hot, swollen, red joint, often the big toe, especially with a high temperature, feeling shivery or being unable to eat. It may be gout, but it could be a joint infection (septic arthritis), which is urgent.
Pain, swelling, redness and warmth over a bone, or a very high temperature with feeling generally unwell: ask for an urgent GP appointment or contact NHS 111. It could be a bone infection. Take your child to a GP if they don't want to use a leg and seem irritable: young children don't always get a high temperature with a bone infection.
Same day: you have diabetes and a new foot problem, such as an ulcer or wound, signs of infection, or a hot, swollen foot with a change in colour, even if it doesn't hurt. Contact your diabetes foot team or GP: NICE asks for these to reach a specialist foot service within 1 working day, and a suspected Charcot foot is kept off weight until it has been checked.
Same day: in a cast or boot, pain that is getting worse, toes that are numb or burning, a cast that feels too tight, toes that are swollen, blue or white, or a bad smell from under the cast.
After surgery: redness, swelling, oozing or a smell from the wound, or a fever. Contact your surgical team the same day, or NHS 111 out of hours.
Same day (GP or NHS 111): throbbing pain and swelling in one calf, with red or darker skin. It could be a blood clot (DVT). Watch for it after an ankle injury or time in a cast or boot.
Call 999: calf or leg pain or swelling with breathlessness or chest pain. It could be a clot that has reached the lungs.

See a doctor or physiotherapist if

See a GP if pain in the ball of your foot is stopping you doing normal activities, is getting worse or keeps coming back, or hasn't improved after treating it at home for 2 weeks, or if you have any tingling or loss of sensation in your foot, or diabetes.
A teenager with pain, swelling and stiffness at the joint at the base of the second or third toe, especially if it stops sport or dance: see a GP. It needs an X-ray, and early X-rays can look normal, so pain that carries on may need a scan.
One spot on a foot bone that hurts with every step and later at night: a possible stress fracture.
A second toe that is drifting across its neighbour or lifting off the ground, or pain and swelling under its base: see a GP or podiatrist. The joint at the base of the toe may be unstable.
Swelling and pain in several toe joints, or in both feet, with stiffness in the mornings: see a GP. Joint inflammation such as rheumatoid arthritis can look similar.
See a GP for bone pain or tenderness, particularly if it's worse at night, or a lump or swelling that is growing.
Still painful after about 6 months of consistent offloading (rest from the sport that hurts, a boot if advised, and offloading shoes or insoles): ask your specialist about other options, including surgery.

Understand it

What it is

The rounded end (head) of a metatarsal, one of the long bones in the middle of the foot, loses part of its blood supply. It's usually the second metatarsal, sometimes the third. An NHS children's orthopaedic leaflet explains that the area of bone dies and crumbles, the head flattens at the joint surface, and the joint at the base of the toe becomes painful. It's also called Freiberg's infraction.

Freiberg described six cases in 1914 and thought a minor injury set it off. Today it's thought to come from several things together: repeated stress, the foot's mechanics and the blood supply. It's more common when the second metatarsal is long compared with the first, and one review links the teenage peak to changes in the blood supply as the growth plate closes. It belongs to the same family of growing-bone conditions (osteochondroses) as Köhler's and Sever's disease.

Sources 1, 2, 3, 4

Who gets itEmerging evidence

It usually starts between about 11 and 17, and girls get it far more often than boys: about 5 to 1 in one surgical review, and 3 to 1 in a UK reference for doctors. The second metatarsal is affected in about 68%, the third in 27% and the fourth in 3%, and both feet in about 1 in 10. In one case report, a 20-year-old developed it in both feet within months of taking up dance.

It's rare. In one UK hospital's count of the children born there between 2000 and 2023, 44 of 124,644 developed it, about 1 in 2,833. Adults get it too, and most people in the published studies, which are mostly of operations, were adults: 516 adults against 194 under 18, where the age was given. In a US series of 19 teenage athletes, the median age was 12.7, 68% were girls, and their sports were dance (32%), football (27%) and track (18%).

Sources 5, 2, 6, 4, 7, 8, 9

How it shows

Pain in the front of the foot over the head of the second metatarsal, usually when you put weight on it or are active, and worse in high heels, with swelling and stiffness at the joint at the base of the toe. There can be a limp, a small swelling at the joint, and hard skin under the metatarsal head.

Sources 2, 1, 10

X-rays and scans: what they do and don't showEmerging evidence

It's diagnosed on X-rays. Early on, the X-ray can look normal while a magnetic resonance imaging (MRI) scan already shows changes in the bone; later the head looks flattened, dense and broken up, and the joint space can narrow. Comparing the other foot helps in early cases. Specialists stage it from I (a fine crack in the bone) to V (a flattened, misshapen head with arthritis), and stages I and II usually do well without surgery.

Two cautions. A normal early X-ray doesn't rule it out if the pain carries on. And the X-ray changes can outlast the pain, because the head remodels slowly: a children's hospital notes that some heads never fully remodel. We found no study of how often Freiberg-like X-ray changes appear in people without symptoms.

Sources 1, 11, 2, 4, 3, 10

How it usually goesEmerging evidence

An NHS children's orthopaedic leaflet says that in most cases it improves by itself: the blood supply returns, the bone heals and reforms over about 2 years, and by adulthood the foot causes few symptoms. Complex cases, where the bone breaks down, can lead to early arthritis in that joint. A Canadian children's hospital says it typically settles within 2 years.

In the US series of 19 teenage athletes, 16 (84%) were cleared for full sport without surgery, after a median of 3.7 months, though the series only included young people followed until they were cleared. A specialist review says non-surgical care works in about 60% of early cases.

Sources 1, 10, 9, 3

What helps, and how strong the evidence is

A specialist manages it, and offloading comes firstEmerging evidence

The aim is to take load off the joint while the bone heals. A UK reference for doctors advises less weight-bearing activity for 4 to 6 weeks, supportive shoes with a metatarsal pad or bar under the sore bone and, if it's severe, a short walking cast until the symptoms settle, usually within 3 to 4 weeks. A Canadian children's hospital stops painful sport and high-impact activity for 6 weeks, uses a walking boot for 4 to 6 weeks if it's very painful and an anti-inflammatory painkiller for 4 weeks, then a custom insole with a metatarsal pad if symptoms continue. An NHS leaflet adds comfortable, well-padded shoes with plenty of room for the toes, and no high heels.

A review describes a shoe that keeps weight off the front of the foot, or a stiff shoe with a rocker sole, after 3 to 6 weeks of unloading. In the US series, most of those who returned to sport without surgery had been treated in a boot or cast. One case report suggests the design of an insole matters: two prescriptions gave very different results in the same person, so a podiatrist or orthotist should fit it. None of this has been tested in a trial.

Sources 2, 10, 1, 4, 3, 9, 12

What exercise can and can't do: untestedMixed evidence

No study has tested exercise for Freiberg's disease. Exercise can't restore the blood supply or reshape the metatarsal head: offloading and time do that.

What it can do is keep you fit and strong while the joint is protected (cycling with the heel or arch on the pedal, and hip and trunk work), rebuild calf, foot and balance strength once walking is pain-free, and prepare you for a graded return to running, jumping and dance. Moves that bend the toe back under your body weight wait until the joint is pain-free and your specialist agrees (our caution).

Sources 3, 13, 14, 1, 10

When surgery is consideredEmerging evidence

An NHS leaflet says about 1 in 10 people need an operation, only after trying all the non-surgical treatments first, usually as a day case. A Canadian children's hospital refers for surgery only after at least 6 months of consistent treatment, and a specialist review usually tries at least 6 months of non-surgical care in the early stages. In the US series of 19 teenage athletes, 3 had an operation.

Most people in the published surgical studies were adults, often with later-stage disease, so their results may not apply to a teenager.

Sources 1, 10, 3, 9, 8

Surgery: what the studies showEmerging evidence

Operations include clearing out the joint, a wedge osteotomy that turns healthy cartilage into the joint, a graft of bone and cartilage from the knee, and later-stage joint operations. A review of 38 small studies found that operations preserving the joint relieved pain and allowed a full return to activity in over 90% (257 operations), and operations sacrificing it in over 70% (70 operations).

In the one randomised trial, 27 athletes had a graft from the knee or a wedge osteotomy and were followed for 3 to 5 years. Both groups improved a lot, and the graft scored higher, though not by a clinically important amount. Graft patients trained again at about 6 weeks and were back to full sport at about 10, against about 8 and 13 weeks after an osteotomy. A meta-analysis of 16 mostly non-randomised studies (259 toes) found larger gains and fewer complications with grafts (1% against 6%).

In 10 teenage athletes, all returned to sport after a graft, at an average of 3.5 months. In 20 children followed for 23 years after an osteotomy, 80% had excellent and 20% good results, worse the more the head had collapsed. Every operation risks a stiff or floating toe and pain moving to the neighbouring metatarsals.

Sources 14, 5, 15, 16, 17, 18, 13

Back to sport and danceEmerging evidence

In the US series of 19 teenage athletes, the median time to being cleared for full sport was 3.7 months without surgery and 8.8 months for the 3 who had surgery; a third of the group were dancers. The series only included young people followed until they were cleared, so it can't tell you how many never return.

In dancers, Freiberg's disease can severely limit relevé, rising onto the balls of the feet, which loads the joint most. The authors of one case report call non-surgical treatment in dancers disappointing, and note that some operations reported as successful would cost a dancer the toe's upward bend that relevé needs. That is one report's view: most of the young athletes in the US series, a third of them dancers, were cleared without surgery. The way back to ballet in this guide borrows an expert protocol written for foot and ankle injuries, which leaves relevé, jumps and pointe until last; it hasn't been tested in Freiberg's disease.

Sources 9, 19, 20

How much pain is OK while you exercise?

Borrowed rules: NHS Lothian's for teenagers, NHS Ayrshire and Arran's for adults

No Freiberg's source gives a pain rule, so these are borrowed. For teenagers in sport and dance, from an NHS children's hospital booklet for Sever's disease, another growing foot problem: keep pain during activity to 3 out of 10 or less, where 0 is no pain and 10 is the worst. A little discomfort during the exercises is fine if it settles after you stop, and on the way back to sport, a little pain is fine if it settles quickly afterwards.

For adults, from an NHS board's programme for plantar plate injuries at the same joints: stay in the green or amber zones of its pain scale during exercise. Pain should be back to its usual level within 30 minutes, and the next morning there should be no increase in pain or stiffness lasting longer than 60 minutes.

Our additions: walking in your everyday shoes should be pain-free before you add running, jumping or relevé, and more swelling or stiffness of the toe joint the next day means dropping back a stage. Until your specialist clears it, leave out anything that bends the toe back hard under your body weight: full tiptoe, kneeling on tucked toes, deep lunges onto the toes and demi-pointe. A painful, swollen joint that isn't settling isn't covered by the rules: see your specialist.

Sources 21, 22

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Protect the joint (about weeks 0 to 6, as your specialist advises)

Stop the sport, running, jumping and dance that hurt: about 6 weeks in one children's hospital's plan. If your clinician uses a walking boot or short walking cast, do only what's allowed in it; then offloading shoes and a pad or insole (see the written steps below). Keep fit without loading the front of the foot.

Stationary cycling demonstrated on the 3D figure

3D demoStationary cyclingBeginner · Cardio machine

15 to 30 min, easy, pedalling with the heel or arch, in a stiff-soled shoe · Editorial, as in our plantar plate tear guide. Not in a cast unless your clinician allows it

Easier: Recumbent exercise bike · Harder: Air bike intervals

Glute bridge demonstrated on the 3D figure

3D demoGlute bridgeBeginner · No equipment

2 sets of 10 to 12, pressing through the heels · Editorial dose

Easier: Pelvic tilt into bridge · Harder: Single-leg glute bridge

Side-lying leg raise demonstrated on the 3D figure

3D demoSide-lying leg raiseBeginner · No equipment

2 sets of 10 to 15 on each side · Editorial dose

Easier: Lateral band walk · Harder: Lateral band walk, band at the feet

3D demoDead bugBeginner · No equipment

2 sets of 8 on each side · Editorial dose

Easier: Dead bug heel taps · Harder: Forearm plank

Seated calf stretch with a towel demonstrated on the 3D figure

3D demoSeated calf stretch with a towelBeginner · Other / check instructions

3 holds of 30 s, with the towel round the middle of the foot, not the toes · Editorial, as in our bunion surgery guide

Harder: Wall calf stretch (gastrocnemius)

Ankle circles demonstrated on the 3D figure

3D demoAnkle circlesBeginner · No equipment

10 slow circles each way · The move page's dose. Out of a boot only if your clinician allows

Harder: Ankle CARs (controlled articular rotations)

Move on when: Walking in your everyday supportive shoes, out of any boot, is pain-free, the joint is no more swollen the next day, and your specialist agrees.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Rebuild strength in supportive shoes (about weeks 6 to 12, as your specialist allows)

Calf, foot and balance strength without bending the sore joint back under load. Keep wearing the offloading shoes and insole.

Wall calf stretch (gastrocnemius) demonstrated on the 3D figure

3D demoWall calf stretch (gastrocnemius)Beginner · A wall

3 holds of 30 s on each side · Editorial dose

Easier: Seated calf stretch with a towel · Harder: Heel-on-step calf and hamstring stretch

Soleus wall stretch demonstrated on the 3D figure

3D demoSoleus wall stretchBeginner · A wall

3 holds of 30 s on each side · Editorial dose

Easier: Seated calf stretch with a towel · Harder: Toes-tucked kneeling (toe squat)

Tibialis raise demonstrated on the 3D figure

3D demoTibialis raiseBeginner · No equipment

2 sets of 15 · Editorial dose. Heels down and the front of the foot lifted, so it unloads the toes

Harder: Single-leg tibialis raise

Single-leg stand demonstrated on the 3D figure

3D demoSingle-leg standBeginner · A wall

3 holds of 30 s on each leg, in shoes · Editorial dose

Easier: Tandem stance and heel-to-toe walk · Harder: Single-leg reach matrix

Slow calf raise demonstrated on the 3D figure

3D demoSlow calf raiseBeginner · A wall

2 sets of 10, only halfway up · Editorial dose. The move page says to stop short of full tiptoe with pain in the ball of the foot

Easier: Seated bent-knee calf raise (soleus raise) · Harder: Standing dumbbell calf raise

3D demoStep-upBeginner · A step

3 sets of 8 on each leg · Editorial dose

Easier: Low step-up · Harder: Dumbbell step-up

Move on when: Half-height calf raises, step-ups and 30 minutes of walking don't bring on pain at the joint, it's no more swollen the next morning, and your specialist clears you for impact.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Back to running, sport and dance (often from about 3 months, once cleared)

A graded return, building time before speed and leaving full relevé, sprinting push-offs and jumps until last. Teenagers keep pain during sport to 3 out of 10 or less, and keep to NHS Lothian's weekly limits: no more than 4 high-intensity sessions a week, not on 2 days in a row, and weekly hours of organised sport no more than their age (borrowed from Sever's disease). Dancers: see the return-to-ballet stages below.

Elliptical trainer demonstrated on the 3D figure

3D demoElliptical trainerBeginner · Cardio machine

10 to 20 minutes at a moderate effort, building towards 30 · The move page's dose. Heels down

Harder: Stair-stepper machine

Treadmill jogging demonstrated on the 3D figure

3D demoTreadmill joggingIntermediate · Cardio machine

Walk-jog intervals, in supportive shoes · Editorial

Easier: Treadmill walking · Harder: Sprint intervals

Single-leg calf raise from a step demonstrated on the 3D figure

3D demoSingle-leg calf raise from a stepIntermediate · A step + A wall

2 to 3 sets of 8 to 10 on each leg, halfway up at first, on the floor before a step · Editorial dose

Easier: Slow calf raise · Harder: Single-leg pogo hops

Ankle bounces (mini pogo) demonstrated on the 3D figure

3D demoAnkle bounces (mini pogo)Beginner · No equipment

2 sets of 20, in shoes, only once cleared for impact · Editorial dose

Harder: Pogo hops

3D demoSkippingBeginner · No equipment

3 runs of 20 m · Editorial dose

Easier: Ankle bounces (mini pogo) · Harder: Alternate-leg bounding

Single-leg reach matrix demonstrated on the 3D figure

3D demoSingle-leg reach matrixIntermediate · No equipment

3 rounds of 5 reaches in each direction on each leg · The move page's dose

Easier: Standing crossed-leg side reach · Harder: Single-leg Romanian deadlift

Move on when: Full training stays within the pain rule and the joint is quiet the next morning. If pain persists after about 6 months of consistent care, ask your specialist about other options.

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

Offloading the joint (written steps)

From a Canadian children's hospital, a UK reference for doctors, an NHS leaflet and a review. Your specialist's plan comes first.

1. In the first weeks, stop the running, jumping, repetitive or high-impact sport and dance that hurt: about 6 weeks in one children's hospital's plan.
2. If it's very painful, your clinician may use a walking boot for 4 to 6 weeks, or a short walking cast, which usually settles symptoms within 3 to 4 weeks. Do only what they allow while it's on.
3. Then wear cushioned, roomy shoes with plenty of room for the toes and a stiff or rocker sole that stops the toe bending as you push off. No high heels, flip-flops or soft, bendy soles.
4. A metatarsal pad or bar, or a custom insole, takes pressure off the joint. Ask a podiatrist or orthotist to place it: in one case report, two designs gave very different results.
5. Expect X-rays at intervals until it settles: every 6 months in one hospital's plan.

Sources 10, 2, 1, 4, 12

Back to ballet (written steps)

Borrowed from an expert return-to-ballet protocol for foot and ankle injuries (Glasser 2022), as our plantar plate tear guide does; it isn't specific to Freiberg's disease. Start once walking is pain-free, you can stand on one leg for 30 seconds, and your specialist agrees. Stay at each stage until it's pain-free. Relevé and demi-pointe load the sore joint most, so drop back a stage if it swells or aches the next day. Pointe work comes only after the last stage is pain-free.

1. In trainers or jazz shoes: demi-plié to half range, tendus, rond de jambe à terre, and relevé on two feet. Any single-leg work uses the sore leg as the working leg, not the supporting leg.
2. Full demi-plié, building to grand plié; dégagé; relevé on one foot; bourrée; développé and arabesque. Turns only with the sore leg as the working leg.
3. Full barre without restriction; fondu, and turns with the sore leg as the supporting leg, singles first.
4. Fouetté and à la seconde turns on the sore leg; small jumps without beats, such as glissade, pas de chat and changement.
5. Small jumps with beats and all petit allegro except temps levé.
6. Grand jeté, tour jeté, saut de chat and temps levé, and partner work. Pointe work can start once this stage is pain-free.

Source 20

After Freiberg's surgery (as your team allows)

Weight-bearing, shoes and when toe movement starts depend on the operation, so your team's plan comes first. In the one trial, athletes started training 6 to 8 weeks after surgery and were back to full sport at 10 to 13 weeks, depending on the operation; teenagers returned to sport an average of 3.5 months after a graft from the knee. Once your team allows, pick up the plan at stage 2.

Sources 15, 17

Positions to swap, and why

Habit or position	Why it matters	Instead
Calf raises to full tiptoe while the joint is sore	Full tiptoe bends the toe joint back under your body weight and loads the metatarsal head most; the move page says to stop short of full tiptoe with pain in the ball of the foot.	Seated calf raises first, then raises only halfway up.Try: Seated bent-knee calf raise (soleus raise)
Kneeling with the toes tucked under, or deep lunges onto the toes	Your body weight bends the sore joint back (our caution, as in our plantar plate tear guide).	A seated calf stretch with the towel round the middle of the foot.Try: Seated calf stretch with a towel
The plantar fascia stretch	Pulling the toes back bends the sore joint too (our caution, extending the move page's warning about a stiff or painful big toe joint).	Wall calf stretches.Try: Wall calf stretch (gastrocnemius)
High heels, flip-flops and soft, bendy soles	They load the front of the foot, and NHS and specialist advice is no high heels.	Stiff or rocker-soled shoes with a pad or insole.
Pogo hops, running, jumping and dance in the first weeks	Rest from what flares it: about 6 weeks in one children's hospital's plan.	Cycling with the heel or arch on the pedal, and hip and trunk work.Try: Stationary cycling
Going straight back to full training	A gradual return within the pain rule, with no more than 4 high-intensity sessions a week for teenagers (borrowed from Sever's disease).	Walk-jog first, then small bounces, then sport-specific work.Try: Ankle bounces (mini pogo)
Waiting for the X-ray to look normal before any activity	X-rays are repeated only every 6 months in one hospital's plan, and some heads never fully remodel.	Follow the pain rule and your specialist's clearance.

Routines to follow

Low-impact leg workout (no jumping)

A gentle leg strength routine with no jumping: sit-to-stands, step-ups, wall sits, bridges and calf raises.

20 minBeginner7 movesA bench or box, A step

Balance exercises routine

Balance practice in 10 minutes: tandem stance, single-leg stands, marches, heel walks, tree pose and floor transfers.

10 minBeginner7 movesA wall, A bench or box

Foot and ankle strengthening routine: toes, arches, calves and balance

A 15-minute barefoot routine for stronger toes, arches, calves and ankles, finishing with balance. You need only a towel, a wall and a resistance band.

15 minBeginner11 movesA wall, Other / check instructions

Dance warm-up: feet, hips, spine and small jumps

A dance warm-up for class, rehearsal or performance: easy cardio, ankle circles and rises, leg swings, spine moves, turnout, balance and small jumps.

15 minBeginner16 movesA wall, A dumbbell

More moves for this area

Questions people ask

What is Freiberg's disease?

Part of the head of a metatarsal, usually the second, loses its blood supply, so the bone softens and can flatten at the joint at the base of the toe. It's also called Freiberg's infraction.

Who gets Freiberg's disease?

Mostly teenagers, between about 11 and 17, and girls far more often than boys: about 5 to 1 in one review and 3 to 1 in another. Adults can get it too. It's rare: in one UK hospital's count of the children born there, about 1 in 2,833 developed it.

What are the symptoms?

Pain, swelling and stiffness at the joint at the base of the second (sometimes third) toe. It's worse when walking, pushing off, playing sport or wearing heels, sometimes with a limp.

How is it diagnosed?

With an X-ray. Early on the X-ray can look normal, so an MRI scan may be needed if the pain carries on.

Does Freiberg's disease go away?

Usually. An NHS leaflet says the bone heals and reforms over about 2 years, and by adulthood the foot usually causes few symptoms. Badly collapsed cases can lead to arthritis in the joint.

What's the treatment?

A specialist manages it: rest from the activities that hurt for about 6 weeks, a walking boot or cast if it's very painful, then cushioned shoes with a stiff or rocker sole and a metatarsal pad, bar or insole. An NHS leaflet says about 1 in 10 people need an operation.

What shoes and insoles help?

Cushioned, roomy shoes with a stiff or rocker sole that stops the toe bending as you push off, and no high heels. A metatarsal pad, bar or custom insole takes pressure off the joint; ask a podiatrist or orthotist to fit it.

Can I keep doing sport or dance?

Not the activities that hurt in the early weeks. In one US series of 19 teenage athletes, 84% were cleared for full sport without surgery, after a median of about 4 months, and dancers come back in stages, with relevé and pointe last.

Do exercises help Freiberg's disease?

They can't heal the bone: offloading and time do that. They keep you fit and strong while the joint rests and prepare you for sport and dance, though no trial has tested them.

When is surgery needed, and what's recovery like?

When pain carries on despite good non-surgical care, usually after at least 6 months of it. In small studies, operations relieved pain and allowed a full return in most people, and in one trial, athletes were back to full sport 10 to 13 weeks after surgery.

Is it the same as a plantar plate tear or Morton's neuroma?

No. A plantar plate tear is a torn pad under the toe joint, usually in adults, with the toe drifting or lifting, and Morton's neuroma gives burning or shooting pain between the toes. Each has its own guide.

Can adults get Freiberg's disease?

Yes. Most people in the published surgical studies were adults, often with later-stage disease. The treatment principles are the same.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.