Freiberg Disease: How to Care for Your Child

Kids with Freiberg disease have pain in the ball of the foot. It happens from a change in the shape of the metatarsal (a bone in the foot). It's most common in females who are active in ballet and gymnastics. When found and treated early, most kids with Freiberg disease heal completely within a few months. Sometimes, if the injury to the bone is severe, surgery is needed.

Activity

• Your child needs to cut down on or avoid all activities that cause pain. Non–weight-bearing exercises (like swimming or weightlifting) are usually OK. 

• When your health care provider says it's OK, your child can gradually increase activities. If they have no pain, they can continue to add more activities and training.

• If an activity causes pain or swelling, your child should stop doing it. They can try the activity again after the foot stops hurting or switch to a less intense activity.

• Have your child wear supportive, well-padded shoes during activities. They should avoid walking barefoot and not wear high heels while the bone is healing.

Follow your health care provider's advice for:

• Giving your child acetaminophen (Tylenol^® or a store brand), ibuprofen (Advil^®, Motrin^®, or a store brand) OR naproxen (Aleve^®, Naprosyn^®, or a store brand). Follow the directions on the label for how much to give and how often.

• Any movement exercises or stretches your child should do and any activities to avoid.

• Whether your child should go to a bone doctor (orthopedist), sports medicine doctor, or physical therapist to help them build strength and flexibility and create a plan for returning to full activities and sports.

• When your child can return to sports. Usually, this is when the sports activity does not cause pain while your child does it or afterward.

• Any special shoes, shoe inserts, or pads your child should wear.

• When your child should follow up.

Your child has foot pain:

• that doesn't get better after following your health care provider's recommendations

• that gets better, but then comes back

What causes Freiberg disease? Health care providers don't know the exact cause of Freiberg disease. But in some kids, repetitive activities (like jumps done in gymnastics and ballet) cause the developing area on the metatarsal bone to lose some of its blood supply and become flattened. These changes lead to pain and soreness in the ball of the foot and sometimes limping.