Keeping Active with Freiberg’s

posted in: Fitness 79

Keeping Active with Freiberg’s

Australia Zoo, MixHart 17

I’ve  decided to post about my recent sports injury to prevent other athletes from doing unnecessary damage to their feet and also, to clear up any misconceptions about why I haven’t been able to run and do other high impact sports for the past year.

My “wild and free” sporting life changed last May.

I felt an extreme sharp “snapping”pain in my right foot while walking with my daughter, after her Kung Fu lesson. The pain was so intense that I took off my sandal and hobbled barefoot along the sidewalk to the car.

As walking was very painful, I made an appointment with my general physician. He informed me the x-ray looked okay so there was nothing to be done–he could not help me. The pain continued. Believing that there was nothing to be done, I’d rest my foot for a week and then try to do my beloved sports again. I could no longer dance or run but I could walk my dogs and hike, despite the pain.

Last fall, I spent many hours a day, five days a week, on my feet, teaching writing at a local college. Each day, after work, my right foot was in extreme pain and my toes numb. I had to take off my shoe and drive home barefoot.

I returned to my doctor and begged to be referred to a sports medicine specialist. After a six month wait, I finally got an appointment. The specialist palpated the foot, and told me that x-rays are often inconclusive when dealing with many foot fractures. He advised me that I was to completely immobilize and rest the foot for 3 months: I had to wear a boot-cast and crutches for twelve weeks (I’d just purchased a season pass for alpine skiing–thankfully, the ski resort put the money towards my next year’s pass purchase).

I hobbled all over campus on crutches and finished the term without missing any classes. In retrospect, this was not a good decision for me to make, as walking all over campus on crutches, with a heavy backpack, proved to be very hard on my (good) left foot and my actions damaged my left ankle.

After twelve long weeks (I couldn’t even walk my dogs), the boot came off and I went on a vacation to Florida. As I walked along the beaches in bare feet, I soon realized that the foot was far from healed. The pain returned with a vengeance. By vacation’s end, I could barely walk on it. I returned to the sports medicine doctor and begged for an MRI.

I was advised that it may take up to a year or more to get an MRI; however, the universe was with me and the MRI technician students needed to practice foot MRIs and I was able to get an MRI almost immediately!

Great Barrier Reef, Mix Hart 17

The Bad

The MRI results were unexpected: I have a condition called Freiberg’s Infraction (also called Freiberg’s Disease). It is a rare disease that involves the metatarsal bone (most often the second) in the foot. Repeated sports trauma limited the blood flow to the bone and finally caused the bone to die and become necrotic. It is  most common in athletic teens (females), who have long, lean bones, specifically, long metatarsal bones. Repeated high-impact sports and also wearing high heels exasperates the problem.

I am lucky, I’ve most likely had this for a decade or more, but my body managed to self-heal until now. I believe intense, high impact dancing (sometimes, unfortunately, on cement and tile surfaces), and running on roads caused frequent, reoccurring trauma and finally my body could not self-heal, and the blood loss was too great; thus, the bone began to die.

I am disappointed in the medical system in my home city. I had to fight every step of the way to be taken seriously.

I am also disappointed in the FiveFinger barefoot runners that I wore for years to dance and run in. I believe these contributed to my developing Frieberg’s. I remember after running, I’d develop a round, marble-sized, blood-filled ball under my foot, behind my 2nd metatarsal (at least a few times a season). It would hurt to walk and would take about a week to heal. I assumed it was regular running ware and tare (even though none of my other running friends experienced this). Now,I realize it was a serious injury, with blood loss, in the metatarsal joint. I had no idea that running in Vibram’s FiveFinger runners was not protecting my feet from the extreme impact on my foot bones.

The diagnosis has felt devastating at times; I am a person whose livelihood is sports and being active. 

Kalamalka Lake, BC,Mix Hart 17

Where Do I Go From Here?

It’s been over a year since the first initial bone collapse. I live in Hoka runners (for all occasions) with a podiatrist designed insole.

I will never wear high heels again. I always hated wearing high heels and never understood how anyone could wear them for more than 20 minutes a day. However, many of my really ‘hip’ footwear have just enough of a heel to make them dangerous for my metatarsal and thus, I will have to give away at least a dozen expensive boots and shoes 🙁 My daughters will benefit from this shoe give away. #nohighheels

I hike and have attempted to dance (a few times). My foot hurts and I cannot dance properly–no jumping or hopping. I cannot go barefoot anymore, walking in sand is especially painful. I worry that my foot may never heal enough to return to walking barefoot in the sand, surfing, running and “real” dancing. However, it is a worry and not the truth; thus, I manage my foot pain daily and work on adding new activities until I am able to run again.

Snowshoeing Knox Mountain, Mix Hart 17

My advice to athletic women with long, slight bones is to be aware: recurring front foot pain and/or numbness when engaging in high impact sports or while wearing high heels could be the beginning of Freiberg’s.

The Good

There are a few good things that have come from this personal struggle:

I wanted to start swimming laps, but never found the time. Being unable to do many sports while in the boot, I took up lap swimming during our time living in Australia. We lived in downtown Brisbane in a high rise apartment with a swimming pool. Every morning, I went down to the outdoor pool and swam laps for half an hour. I am now the lap swimmer I longed to be.

In the winter, I love being outside, skiing through high alpine forests all day long. This past winter, I watched my family leave for the ski hill on weekends and I felt depressed. How would I survive the long winter without skiing? I’ve always wanted to snowshoe but couldn’t justify the time and money required to do it as my family chose alpine skiing as our main winter sport. Finding myself unable to ski, I thought perhaps the soft snow might be easier on my foot and so I took up snowshoeing. I adore walking through secluded forests in my new snowshoes.

I love being on the water. I wanted a paddle board for years but never purchased one. I decided that paddle boarding would be easier on my foot than surfing (which requires toe strength). I researched and bought a Paiwen: a lightweight SUP, designed exclusively for women. I am addicted to SUP now! After an early morning lake paddle, before I head to shore, I like to sit on my board and meditate for a few minutes–it is an amazing way to start the day.

79 Responses

  1. Debbie
    | Reply

    I hope you dont mind me contacting you? Since January I have had numerous xrays, ultrasound, and mri scans. The pain and swelling in my joint has been so bad have been unable to walk anywhere! Seen various Podiatrists who say the head of my metatasal joint is flattened and has necrosis. They have also suggested stress fracture. None of them seem to know what the problem is. On radiologyst suggested Freibergs. I have been in a hard boot now for 2 months, its ok while wearing it, but symptoms come back straight away when I take it off. feeling so depressed as I love walking and the weight has piled on!! Dont suppose you can suggest who in the medical profession I should see? Perhaps a “bone” specialist?

    • mixhart
      | Reply

      Hi Debbie, Try an orthopaedic surgeon. Though, in my experience, I had to wear the boot for at least six months and then wear Hoka running shoes after that, at all times. Healing is super slow and I would suggest trying the new laser treatments on the area. I still must be extremely careful in what I do or the extreme pain will return. It is a condition that one has to live with and gradually test adding new activities. Do not get discouraged though, it heals very slowly and you may have to “baby” it indefinitely. I still have to “baby”my foot. Though, I am just now adding trail running back into my life and hope to compete in the near future. I have been receiving many notes from other women with Friebergs. Thus, I may start an online support group. If I do, I’ll let you know!

      • Jessica Sayles
        | Reply

        Hi there! We actually started a facebook group for Freiberg’s Disease! Please join! Would love to know more about the laser treatment!

        https://m.facebook.com/groups/692429221137409

        • izzy
          | Reply

          Thanks so much for sharing! I never imagined how good it would feel to read stories from people suffering from the same painful condition!

    • Debbie
      | Reply

      Hello, i have had severe pain & swelling in my left foot for 8 months, after having x-rays ( inconclusive ) , nuclear bone scan ( inconclusive ) , finally had an MRI end of July 2018. Dr called & said I have Freibergs disease, I have been in a walking cast 3 times this year, thinking stress fractures etc. the last being 3 months & counting as its still on, I am so frustrated, as soon as I walk on my foot within 2 minutes I get severe burning, numbness & pain, after 30 minutes my foot starts to swell up. I am glad I am not alone, i started thinking maybe this was in m head & didn’t think anybody would take me seriously about the issue with my foot. I have read so many of your comments on this web site & it is every bit the same as I am going through. thank you ladies for posting this information, I do hope that you all get the issues resolved, i sure hope i get some relief soon too!

      • mixhart
        | Reply

        Hi Debbie,
        It take more time than you’d hope but with a lot of rest (from even walking), super-padded shoes and time (2+y), your foot will improve (personal experience). It’s easy to get discouraged as healing seems to be one step forward, 2 steps back. 2 1/2 years since I first hurt my foot and I am feeling so much better–I can walk bare foot in the sand without pain! Though, I will always baby that foot so it remains functional (I will never wear high heels again & walk bare foot for only short journeys). Things will improve–M

    • Jen Swift
      | Reply

      Hi ladies! Have either of you tried a cortisone shot to treat your condition? I’ve been suffering with Freibeg’s for four years now and have treated it with an annual cortisone shot. It’s literally like a miracle!

      • mixhart
        | Reply

        Hi Jen,

        I have had a cortisone shot in the past and it seemed to improve the pain. I only wish I could have one now but with Covid-19, it’s impossible to get a shot.

  2. Helen
    | Reply

    Hi I have just read your blog on friebergs disease and it was almost like reading my own story. Same excruciating foot pain with no results from an x ray apart from go home and rest it for a week!! I was a runner but got to the point where after even a short run my foot would throb! After numerous trips to podatrist after being told I have inflexible toes!!!! Finally moved state ( I live in Australia) had another x ray and was told friebergs infraction!! Trying podiatrist inserts no heels no running but cycling is ok!! Theres not much info out there and after reading your reply to someone else I think a suppory group would be great as no one really understands what we go thro on a daily basis. Thanks for taking the time to read this.

    • Courtney vanTol
      | Reply

      Hello,

      Your story sounds very similar to mine, except I have had orthopedic surgery to “correct” my condition. I am very disappointed in my post-op recovery. I was misdiagnosed twice in urgent care. I finally was diagnosed and sent to an orthopedic MD. He had never treated the condition, so his answer was sticking me in a boot for almost 5 months until I could be transferred to a university hospital with a orthopedic podiatry surgeon. By the time I received my surgery dealing with insurance, I was in a boot for over a year. I now have issues with my hips and other knee because of this. My second metatarsal had complete avascular necrosis. I was not a candidate for hardware, so my only choice was to use cadaver soft tissue, and hope that it grew into new bone. I am now one year post op and the same pain I had before has returned in my second toe, but unfortunately has also appeared in my third toe now. I have since switched insurance and I am getting a third opinion now.

      • Courtney vanTol
        | Reply

        Update – January 2021: My cadaver tissue graft failed and I had to have a second surgery to replace that open joint cavity with silicone implant. I have custom orthotics I have to wear all the time. I still continue to have some pain, but not as sever as before. My surgeon recommended cortisone injections which I refused. I visit my acupuncturist and get great results, while it lasts. The biggest thing is reducing my inflammation and swelling at end of work day. I was told by second surgeon this implant may last 10 years if that. Praying for some type of miracle.

        • mixhart
          | Reply

          Hi Courtney,

          I think it’s a good thing you refused the injections–they made my foot worse! Personally, I find cold laser is a great way to reduce inflammation and swelling. Though, check with your doctor as I don’t know how cold laser reacts to silicon.

  3. mixhart
    | Reply

    Hi Helen,
    Freiberg’s is very much a disease one suffers with alone. Unless one is a professional athlete, making a huge income using the feet, medical professionals are not too concerned. However, as this is a condition that takes a long time to heal, and completely limits mobility. I agree, a support group is needed. I’ll send out a notice on this page if I start one and also, let me know if you decide to start one.

  4. Kym Ortenburg
    | Reply

    Hello – I’ve just been diagnosed with Freiberg’s last week ( and neuromas of the 2nd and 3rd metatarsals for which I had some very painful cortisone injections – but they have reduced the swelling). It’s painful and debilitating and I’m not supposed to put any weight on it for at least 4 weeks! Seeing an orthopedic surgeon on 30 Nov.
    I also suspect that I’ve had it a very long time (I’m 55, did ballet, netball and a lot of walking and hiking) and went through periods of pain and recovery – at the time I just thought it was a very sore foot from all the walking I do for my work! I think a support group would be fabulous… I’m contemplating the clearout of my beloved shoe wardrobe and it’s a bit depressing. Good luck everyone! Hope you’re pain free soon.
    cheers
    Kym

    • mixhart
      | Reply

      Dear Kym,

      Yes, I too found a few of the cortisone injections left my foot in agony for 24 afterward, but then the foot felt better than it had for awhile. It is a long, slow recovery but I can assure you, things will get better. I still have pain on my 2nd metatarsal after hard-core dancing in dance-style jazz sneakers, but not enough to stop me dancing. Though, I avoid ballet jumps for now. Oddly,even after 2 years, the skin above the area of my ‘Freibergs’ toe joint is flushed bright pink, while the rest of the foot is a natural colour?! Feel free to keep in touch. …still working on the support group idea! Best shoes I’ve bought to date are the ‘Teva platform universal’ sandals from last summer’s collection. The most comfortable shoe for my ‘Freibergs’ foot ever! Like walking on clouds…

  5. Paul
    | Reply

    Thanks for sharing your story.

    I am one of the rare males who suffers from this condition (I think the ratio is 5:1 female to male.) I am 22 years old and was diagnosed with freibergs at age 20. I am very much into sports and physical fitness and this makes it very difficult to pursue what I love doing. I always wear thick insole shoes along with custom orthotics with metatarsal pads on them, which help somewhat with pain… but not completely.

    I was just wondering what you meant about the new laser treatments for freibergs disease, as you eluded to in your comment earlier? I have heard nothing about such a treatment option in all of my readings on the condition. I was also wondering if you would recommend one of the surgical intervention options.

    Thank you,
    Paul

    • mixhart
      | Reply

      Hi Paul,

      The laser I was referring to is Class IV K-Laser Therapy. You will need to enquire around to various physical therapists/other health professionals to see who does this type of therapy near you. The laser speeds up the healing process. I recommend at least 6 treatments to maximize healing results. If you can afford it, I’d even get more…anything to speed the healing and bone regeneration. I have not considered surgery as I have very little bone damage. Also, it has been 2 and 1/2 years since the first serious mobility-stopping incident (that caused me to seek treatment for this condition) and now, finally, I can say, that my foot feels so much better and I am trail running again. My foot is not perfect but I believe that I can have a very full, athletic life again. Though, it takes time, and wearing spongy-soled shoes exclusively! However, if you have a lot of bone loss, you may have a longer recovery. Though, you have youth on your side, thus, whatever shape your foot is in, your healing process will be faster than anyone diagnosed in middle age.
      Re. surgery options–I have read many mixed reviews on the success/failure rates of metatrarsal surgery. Thus, I would not rush into it, unless you’ve run out of other options and/or you have serious bone degeneration. I hope this helps. Take care, and keep hopeful…I am sure you will be able to do your athletic pursuits again.

  6. mixhart
    | Reply

    ***An update: Just wanted to mention that I experienced marble-sized blood filled bruises on the bottom of my foot once or twice a year after running in 5-toe runners, for at least 1/2 a decade prior to being diagnosed with Freiberg’s. At the time, I thought it was normal running ware and tare. It was obviously that kind of injury and blood loss that exasperated Freiberg’s. If you have marble-sized blood bruises on the bottom of your foot–stop doing whatever sport is causing them. I sure wish I’d known that then!

  7. mixhart
    | Reply

    New facebook support group for Freiberg’s: https://m.facebook.com/groups/692429221137409

    • Tracey J Gordon
      | Reply

      Hello Mixhart,
      I’ve been reading with great interest people’s various treatments with Freiberg’s. I was first diagnosed with this condition in 2003, 2 tears after the birth of my 3rd child and at aged 37. At that time one X ray revealed I had stress fractures in both metatarsals, and then a diagnosis from a podiatrist was advanced Freiburgs disease and I was told nothing could be done. Frustrating to say the least. I couldn’t even look the condition up on the internet!
      My feet improved a bit, but I’ve always suffered from painful feet, even as a baby, much more so in summer. I’ve only ever had one plausible explanation and that is the high degree of hypermobility, so I think that exacerbates my Freiberg’s and I’ve spent my whole life recovering from injuries. I was to be skiing the Camino in 2020, and in many ways Covid has put me in touch with more sympathetic health professionals. The first step was being introduced to Hokas and a good sports podiatrist who has supplied me with an orthotic that actually supports my condition, and a surgeon who has booked me in for PRP and cortisone. Not until AFTER my next hike though, so I can rest for 8 weeks afterwards. I’m hiking the 3 capes walk in Tasmania in 4 weeks, so I can let you know how my treatment goes later in the year.

      • mixhart
        | Reply

        Hi Tracey,

        Thanks for your story. The Tasmania hike sounds amazing! Enjoy your trip. What is PRP?

        • Tracey J Gordon
          | Reply

          Plasma rich injections. Your own blood is used to inject into the area after it has been spun.
          I’m not altogether sure it has worked, but I’ll probably give it another go next year.

          • izzy
            |

            Hi Tracey, what is this: I had PRP and it took almost a month to notice results but it helped me considerably.

            Also where would one go to get cold laser treatments?

        • Kerlly Black
          | Reply

          Hi Tracey. I’ve been diagnosed with Freibergs 2 weeks ago. Feeling quite sad and depressed. Not really in much pain anymore after 4 weeks in a boot ( dr thought it was stress fracture). However was told to try PRP as a healing treatment. How did you go with it? Did u notice any improvement?

          • mixhart
            |

            Hello Kerlly, I had PRP and it took almost a month to notice results but it helped me considerably. I haven’t had to do the treatment since (that was about 2 years ago). I manage my foot by wearing platform, plush, low-drop shoes regularly & cold laser treatment when the pain flares up. SO far, so good. I am virtually pain free now and have resumed all my sorts (including high-impact dance once a week) except running. I do plan to add a shot trail run each week and I hope I’ll be able to maintain living foot-pain free. –Melissa

  8. Trish
    | Reply

    Hello Mixhart,
    I was diagnosed with Freiberg’s disease yesterday! My foot swelled up at the end of August and I was in pain, my GP sent me for a cat scan and the results came back that I had an extra bone in my foot. Saw an orthopaedic surgeon yesterday .. thinking that he would meet and organise to remove the extra bone! He told me about Freiberg and the position with my foot! The cartilege between the bones on my index toe is completely gone, my bone is not as normal, nice and round, rubbing off the other bone, hence the pain!! He says the state of it is beyond repair. I can, in years to come, when I cannot walk possibly, opt for surgery …. using existing tendon to wrap around the bone and use a pin to keep in place! He recommended a podiatrist, but as I only wear shoes a handful of times during the year I said it wasn’t an option. My footwear of choice is Birkenstock .. I have found my feet got very warm and burn if I wear shoes so I have tried to stick to Birks! I am Irish living in Australia so being honest it isn’t a big thing for me 😉 Other option is a steroid injection to ease the inflammation.. He advises that there are different stages of this disease and I am at the end of it where there is no cartilege left and therefore nothing that can be done in the immediate future, apart from the injection. Like everybody else on here, I am active, and have always been, and continuing to be! I am interested to read all your stories and I have asked to join the FB page! My husband has come across a podiatrist recommended pad/bar Metatarsal Bar PPT Cushions on myfootshop.com which can be inserted in my Birks so as a starting point for me, I am going to order and give a go!!! There is a very good youtube clip Jeffrey A Oster who explains exactly about his particular product .. I found it helpful maybe somebody else will too! Thank you for sharing y our stories, it is good to know, while this rare, we are not alone!

    • mixhart
      | Reply

      Thank you for your story, Trish. Happy Birks are working for you. Hope you have experienced some improvement in the last year. Sorry it took me a while to respond!

      • Kerlly Black
        | Reply

        Thank you so much for your reply Melissa. Finding your blog has been helping me so much going through this rare condition. Did you have to be off your foot after the PRP? In boots or avoiding bear weighting for a while? Would you choose cold laser over cortisone injections to manage the pain?

        Glad to hear your back to be yourself again. There is hope after all.

        • mixhart
          | Reply

          Hi Kerlly, I found cortisone shots made my foot worse over time. I would not recommend continuing with them. PRP made my foot pain much improved–it took a month or more to see results. The PRP needle hurt–they inject the plasma right into the joint, but it was worth it. Your foot will hurt for about an hour afterward so take whatever painkillers you are used to–after that, the pain subsided, and my foot seemed to improve. I did not have to return to wearing a boot. But you will have to be off your foot for about an hour afterward. I use the cold laser each and every time my foot pain flares up and it does seem to knock it out before it can take hold. I no longer wear any shoes with a significant drop (from heel to toe) nor can I wear completely flat shoes–there is a balance that I feel and I know right away if the shoe will aggravate the condition. I hope this helps 🙂

  9. mara
    | Reply

    Hi all! Just ran across this blog. I have Freiberg’s disease, got diagnosed about 10 years ago (I am now 38). I figured I would share my experience, so that you can all feel that there is hope, and that you can eventually be pain free, and return to the activities you love (with some precautions). I used to be a runner, and I think probably all that running on pretty lean bone structure and very long metatarsals precipitated the condition. I do remember spending a few months in a LOT of pain. I couldn’t walk at all, and had to use crutches. But eventually making sure I wore rigid sole shoes (I lived in my Merrell hiking boots for about a year), and avoiding high impact activities, eased my pain. I used a special insole with a metatarsal cushion for a while, but realized eventually that it actually contributed to inflammation because it also compressed my forefoot against the top of the shoe (taping my toe to the adjacent one also seemed to cause more pain). I mention it because sometimes those recommendations don’t work for everyone, and you just have to figure out what feels better for you (using pain as an indicator). In my case, the key was to wear shoes that had good cushioning, and which didn’t flex too easily at the metatarsal joint. I was really scared of returning to activity, because I feared relapsing into very bad pain or causing more damage, and I avoided most running and jumping for a long time (and I am a very active person so it was frustrating). But I did a lot of biking ,swimming, and in a way, diversifying my physical activity has been more beneficial to overall fitness. I gradually returned to doing some more impact activities–I won’t go on runs longer than 5 miles, but I can jump rope, dance, and run now pain free, most of the time (I have even been practicing moonwalking, and other dancing footwork involving standing on the toes which was completely unthinkable when I first had the diagnosis), and have recently tried cross-fit and weightlifting with no issues. I believe when I was diagnosed, I was already an advanced stage of Freibergs, but I imagine the “damage” is self-limited, because it has been several years, and although I’ll occasionally have pain (usually when I walk on very soft soled shoes for a very long time, OR do a lot of jumping), I just ice it or rest the foot for a day, and it goes away. The doctors I’ve seen all say that there are conflicting studies on whether or not surgery is actually helpful (unless you have bone fragments floating around the joint or unrelenting pain, I think conservative therapies are best). I’m not a doctor, so can only speak from my personal experience, but I do believe trying out different activities, being very mindful of pain, but without fear, aids in recovery. Strengthening the muscles of the foot will also help take some of the load off the joint, it’s a bit of trial and error, but don’t feel like this diagnosis means you can’t do the activities you love. The body always adapts. Just have patience and my advice is to also be aware of your other foot, because when you are in pain, your other foot will compensate and take most of the load, and this can later contribute to other issues (in my case, I developed some hip pain on my good side, but have successfully treated that as well). Anyway, happy to share more details if anyone is interested.

    • Izzy
      | Reply

      Are you still available for advice and tips?

      I’m desperately looking for a hiking shoe. It’s my favourite activity. After doing the Camino in Merrell Moabs, I haven’t been able to find a shoe in a full year. They are all painful to me. I read here the Hook being suggested: I’ll give them a try, but I’m looking more for a hiking shoe. Has anyone found any?

      I’m pretty desperate as I have purchased 10 pairs of various shoes, try them in the house for about an hour and give up after the pain starts. Help anyone else?

  10. mixhart
    | Reply

    Hi Mara,

    I’m happy you have been able to successfully continue your activities. I’ve experienced similar pain with jumping and long walks in regular shoes. I was hopeful that the pain would just one day disappear but I realize it requires constant management. Sadly, I overdid the activities recently; trail running 4x/week plus hi-impact dancing for 2h at a dance party one evening and the pain has returned with a vengeance Even after a few years with the condition and returning to many of my sports, I am still learning my limits.

    • mixhart
      | Reply

      Thank you!

  11. Karen
    | Reply

    I spent January and February of 2019 in an air cast for frieberg’s disease on my right foot. xrays showed that the physical change in the bone likely went back 6 years, when I broke that ankle and had a plate and pins inserted to stabilize it. I think the strengthening exercises of going up on tiptoe repeatedly (20x non stop, on right foot only, to be cleared to drive again) pushed this over the edge, but I didn’t have pain until this winter. I have been wearing Dansko clogs (2.0 version, which is lighter) since March and they are the only shoes I can wear now. The orthotic inserts and metatarsal pad made it worse, but I can walk extensively in these clogs because they have a rigid and rocker sole, so my foot doesn’t bend and can stand in them without pain for long durations. The only glitch is about 5 minutes of considerable pain when I take the shoes off at the end of the day, and a pronounced limp for about 15 minutes. I suspect the shoes are shifting my weight distribution, but it means I can walk. I’m currently on vacation and logging 15k plus steps per day and am having a big flare up (and of course, I didn’t bring my cast). I will be going back in the cast when I get home. But in the meantime, I’m wondering if anyone has found icing the foot to be helpful when it flares up?

    • mixhart
      | Reply

      Sorry for the delayed reply, Karen, somehow I missed this comment. I find cold laser therapy best for inflammatory flare ups.

  12. Trish
    | Reply

    Hi there. As someone who has just recently been diagnosed with friesberg, thank you for all the information. I’m wondering if anyone could answer this, I have no pain in my toe area but it’s very painful across the bridge of my foot and cannot walk on foot. Doctor has put me in an air cast. Is this normal to have the intense pain in this area? I guess I have alot reading up on this disease and a shoe clear out to do. Any information is appreciated.. thank you. PS.. In answer to Karen’s question I find heat is best, when foot gets cold it feels like it is going to cramp..

  13. mixhart
    | Reply

    Hi Tish, the metatarsal bones are very long (when you look at a diagram of the foot skeleton); thus, the lower toe doesn’t hurt much with Frieberg’s (in my experience) and the pain is higher up on the bridge (in my experience).

  14. Jessica
    | Reply

    Hello my daughter is 11 and was diagnose with Frieberg’s Diseases back in June. She received a cortisone shot 3 weeks ago but she still has some pain, she has been in an air cast for almost 6 months, and I worry because she is young and growing still. We go see the doctor next week and they are really advising surgery, I am so scared for her. So my question to you is have you had surgery or considered it? I am still doing some research on what other options we might have. My daughter is tired of being in pain and tire of not being able to run and jump around play volleyball like she use too.

    • mixhart
      | Reply

      Hi Jessica,

      I am not a doctor, so I can only comment based on my own experience with Frieberg’s and also on my recent experience with my own daughter at age 11, when she fractured her spine. I did not have surgery as I’ve never read any reports of surgery “curing” Freiburg’s i.e. the foot becoming pain-free and able to resume all normal activities 100%. I do not know the stage of your daughter’s infraction, however, given her young age, bone growth and regeneration are highly possible; thus, I have great hopes for her recovery. My daughter recovered very well from her fractured spine with rest and laser therapy. I also had laser therapy on my foot: Cold-Laser Therapy. Healing takes TIME and children get frustrated missing out on activities with friends, but assure her she WILL heal. If she were my daughter, I would keep the boot on until she is virtually pain-free, and work in laser therapy sessions (at least six with a direct laser(pen-like –not the kind of laser treatment that is like a pad of little lights) and then, when ready, switch her to no-rise runners like Hoka’s for all occasions. Once she can resume her normal activities, she could try wearing other no-rise shoes on occasions (not flat though, she’ll need a fairly thick sole for protection). Make sure her barefoot times are limited. I believe in time she will heal. Once she is an adult, and if Frieburg’s returns, then she can decide if surgery is right for her. Again, this is my limited advice, based on the limited knowledge of the situation. She will be able to do all her fun activities again–maybe she won’t be able to be a professional on-point ballerina, but aside from that, I believe almost anything is possible.

  15. Jessica Trevino
    | Reply

    Thank you so much for your advice! My husband and I have been going back and fourth about other options for our daughter.

  16. Patti McClure
    | Reply

    Thank you so much for all this information. I am 59 and just recently was diagnosed with Freiberg Disease of my 3rd metatarsal, which my orthopedic doctor said is rare as it usually affects the 2nd metatarsal. I have been in the boot longer than I have been out of the boot for 5 months and hoping in two weeks time it has healed enough to walk bootless. It has been difficult finding information about adults with Freiberg’s, and was relieved to finally see some other adult’s story. My feet have been a problem since my forties due to bunions and upper foot arthritis, so my joy of running around has been shelved for a while. Now I would just like to be able to get around. I will look into the laser therapy. Thanks to all for posting here.

    • mixhart
      | Reply

      Hi Patti,

      Thanks for sharing your story. I hope you’re out of the boot soon.

  17. Howard Bradfield
    | Reply

    At 47 I was diagnosed with Frieberg, as a sub 90 half runner it has been a complete nightmare, I have put on loads of weight and lost so much fitness. Cycling hurts the same part of the foot too. I wonder if there is something that can be done to improve the blood flow to the area and encourage repair? Is this what the laser treatment does?
    Does anyone else on here suffer from raynaud’s disease as well – blue or white fingers and toes?
    I wonder if there is a correlation?
    I have been taking coliver oil and glucosamine – perhaps they help.
    I am keen to get back to running and heartened by references to padded shoes and lasers, I shall return 🙂

    • mixhart
      | Reply

      Hi Howard,

      Yes, laser therapy encourages healing in the area. I recommend: cold-Laser Therapy–as many treatments as you can. Healing takes time. It is frustrating but in my experience, with lots of rest, and being mindful of not overdoing high-impact activities each week (I try to limit running and high-impact dance to 3 times/week and bike, hike, SUP, yoga, ski, skate, etc. on the other days), you will be able to return to an active lifestyle. Though, I will never run on pavement/cement again–I trail run only. It is too risky–I never want to compromise my ability to get out there and go!

  18. Howard
    | Reply

    thank you for that, I shall look for information on the K-laser here in the UK,
    Once I have found somewhere I shall post for sharing,… unless you have a recommendation?

    H

  19. Teresa Dowling
    | Reply

    Hi,
    Reading all you’re stories has made me fill a bit brighter this morning!
    I am a 57 year old chef who has enjoyed and I seriously mean it , every 38 years of catering only to now be told I am in the wrong job for me now.
    I used to do a lot of walking ( having done Moon walks for charity -26 miles) lots of training, I swim and generally try to keep fit but now I have had to reduce my work hours , walking in general is really painful and to be honest I feel really down about it all.
    I have suffered all the stages mentioned but lack of excercise has taken its toll and now I am very overweight.
    I am experiencing knee and hip issues , already having a sacroiliac problem with my back it does get me down .
    I have decided to increase my swimming and have just started to use an excercise bike , we shall see how I get on.
    Reading all your stories makes me feel I am certainly not alone , so thanks for sharing!
    Just one thing , where do I find shoes for those smarter occasions that don’t cripple my feet!!!
    Yours
    Teresa

    • Dawn Marie
      | Reply

      Hi Teresa,

      I have Freiberg’s two years now. I’ve had some good luck getting a dressier sandal with Dansko. Not sure if it’s still in production but last year I wore the Stevie model to a wedding. Rigid rocker platform, strippy but supporting straps and it came in a sort of sparky black lizard. I looked dressed up and my foot felt great all night.

      I’ve had good luck with some other Dansko sandals for everyday that have a similar shape sole to the Stevie and also with Dansko clogs.

      Brooks Adrenaline sneakers might work for you. I alternate between those and Hoka One’s. Forever thankful to Mix for the Hoka!

      It’s a limited world for those of us with Freiberg’s!

      Dawn

  20. mixhart
    | Reply

    Hi Teresa, I am happy our stories have helped lift your spirits. As for dressier shoes, I go for no-drop platform soles. The great thing is that they are in style now and I also happen to love the style. I realize they are not for everyone but this is the type of dressier sandal that I can wear comfortably:
    https://shop.nordstrom.com/s/seychelles-calming-influence-platform-sandal-women/5530681/full?origin=keywordsearch-personalizedsort&breadcrumb=Home%2FAll%20Results&color=black%20cork%20leather

  21. ian
    | Reply

    i am a 56 year old male – diagnosed 3 months ago – still trying to keep fit in the Gym but suffering severe pain even after cycling – think i will try swimming – hope one morning to wake up and the pain has gone

    • mixhart
      | Reply

      Ian, have you tried a boot cast? In my experience, only after a prolonged break in a boot, did the pain subside. Swimming worked for me–even though it hurt my foot a little, it was okay and a good cardio. Good luck!

  22. Katherine
    | Reply

    I also have Freiberg’s in my second metatarsal. It is extremely painful and heart breaking when you must give up sports. I was getting into ultra long distance running, the first sport I ever truly fell in love with, and the repeated impact from running finally drove my joint over the edge. I’m really happy I found your blog. It’s great to see you out there seizing the day anyway you can. I found mountain biking as my replacement for trail running, my feet never hurt from it. I have also found Hoka’s to be the best shoe. A bit sad to give up shoes if you loved styling your outfit but way worth it to stay active. Anyway, stay awesome

    • mixhart
      | Reply

      Hi Katherine,

      Thanks for your comment. Happy you’ve found Mnt.biking. It is so hard to give up dreams of participating in a sport in the way you planned: for me, that has been Latin dance (in heeled shoes) and running-road racing. I am thankful; for paddleboarding–I’ve become obsessed with that. I think perhaps the universe is reminding us that we are human, not machines, and competitive type sports–over the long haul–are unnatural and we simply are not built for it.

  23. Susan M
    | Reply

    Hi Everyone, I came across this blog yesterday and was so glad I did! I have been dealing with left foot issue since June, swelling across the top of my foot with severe pain. Went to the ortho foot specialist PA after I could no longer deal with the swelling and pain, they did an x-ray and found a fracture of my middle toe. Placed me in a post op shoe type boot and followed up 2 more times with the PA, toe was healed but all the while the pain on the front fore foot was not getting any better, she had me following up with the actual foot dr the next week. From his exam he felt it was the 3rd metatarsal and had a MRI scheduled. Yesterday had my follow-up appt and the finding are flattening of the 3rd metatarsal head extending into the neck and shaft with intense swelling. I did have a corostroind injection to hopefully reduce swelling and back on the post op shoe.
    I am so thankful to hear all the suggestion of what has worked for everyone. Now to get some new shoes that I can wear outside of the shoe boot that I do not feel is helping. Do you think a short metatarsal walking boot is better? He did mention possibly that.. Also looking for a sandal to wear around the house as I have been a barefoot person all my life growing up in Florida now living in NC.
    Thank you everyone for your comments and suggestion.

    • mixhart
      | Reply

      Hi Susan,

      Thanks for sharing your story. I think a short walking boot is better than a tall one–I felt the tall one was hard on my ankle. As for household slipper–I also am a barefoot girl, as much as I can–I wear Hoka recovery slides around the house and they truly help keep my Freigberg’s foot pain-free. I hope these suggestions are helpful.

  24. Helen
    | Reply

    Hi I have just been diagnosed with Freiburg disease after five months. I have been told to stop all weight bearing activity including walking my beloved dog. It was worse in the beginning with swelling and stiff toes but I have successfully managed it by just applying my own intuition. I tape my toe similarly to if I had a plantar plate tear, and wear orthopaedics in my trainers. This really helps. I’m not going to run anymore but will do resistance training. After a few weeks of rest, I’m going to walk my dog. So long as it’s not causing me pain, I think life to a degree must go on.

    • mixhart
      | Reply

      Hi Helen, Happy you’re finding ways to get active again. In my experience, aside from orthotics, there seems to be zero medical help available. I have yet to find anyone who has had a surgery that “fixed” the chronic pain, aside from very young patients (under age 21). I fought to be able to continue running and other high impact activities, but now I am reconsidering, and may leave running be and focus instead on how to best extend the “life” of my foot, so I can climb mountains until I’m a centenarian!

  25. Danielle
    | Reply

    This post is fantastic. I’ve gained weight due to limiting activity after discovering my Freiberg’s and am generally disheartened. While I’m no spring chicken I’m not over the hill yet, darn it, and I am really encouraged to see you list the lovely alternative activities you engage in to stay active and centered. I’m planning on trying some Hokas soon, but I’ve had good results with Altra for the time being. Thanks again for sharing, and I look forward to exploring your blog.

    • mixhart
      | Reply

      Thank you, Danielle! I hope you’ve found some fun activities to stay active.

  26. anita pressley
    | Reply

    So grateful to have found your blog and the FB page someone mentioned herein! Your story resonated with me from head to toe (ha ha :))! Similar stories in many ways. I believe you mentioned getting Class IV laser treatment. What was that like and how did you gauge it’s effectiveness in helping you? I’m taking the “all hands on deck” approach and am willing to try all treatments to improve my chances of being active into my later years. Thanks so much for putting your story out here!

    • mixhart
      | Reply

      Hi Anita,

      I am still cold layering my foot and I believe it helps. I wear platform, comfortable no-drop shoes and cold laser my foot when it hurts–that’s about all the treatment I do. So far, so good.

  27. Kirsten Perkinson
    | Reply

    Hi all
    Also a longtime caterer and studied ballet 18 years 7 pointe. Then I stood on my feet for four years in painting school , making pottery, and cooking since I was 20. I never sat/sit down.
    Always active, I’m sure I pranced danced ran and swam my way to foot pain, which I remember since I was a little kid. Always jumping and climbing. With a narrow heel and high arch, the front of my feet were so wide though, that shoes never fit me correctly. I had a permanent crease on the bottom of my foot, but had no idea that was unusual; jamming my foot into point shoes since I was 14 . Going barefoot and wearing flip-flops and having piles of shoes in my car wherever I go, my kids teasing me about always changing my shoes.
    But I don’t regret any of it, though now I am unsure how to proceed. I love swimming and now I have started again, my strong feet are getting less crampy. There is constant pain (1 foot has Freiburg 1 foot has osteoarthritis ) and I don’t want to give up my little kitchen, my neighborhood dinner shop, Saturday breakfast. I serve a community I love, and I’m on my feet 60 hours a week at least.
    I know I could drop a little weight, even 10 pounds would be meaningful, I know I can get down on the floor more and stretch every day
    I’m not sure about the metatarsal bars-at first I thought they were helping and now I’m questioning that. I find Brooks are the best for my kind of foot and I bought some Hokas but I’ve not worn them because they still feel tightness at the width of my foot. I cannot walk on half toe it feels crippling.
    I’m an avid ocean swimmer and this all began in August, when I was running around and body surfing for 10 straight all day long and gorgeous perfect weather, when suddenly I was hobbled by the intense sharp pain in my right foot, joined eventually by my left foot fullbore.
    I’m shocked at how quickly the onset has been.
    I wore the boot I walked with crutches I wear those tennis shoes every day and some fake rubber Birkenstocks at home because they are sort of flat. I’m thinking about trying hiking boots, and I even considered low rollerskates with a hard insole at work and an arch support! The foot ortho counseled against custom orthotics, but I’m not sure why. I’ve seen two ortho doctors and now I’m considering a podiatrist. Is it OK to massage Freiburg’s‘s?
    I also developed some weird intense itching on the top of my feet a few years ago, no other place on my body.
    I had it tested for fungus which it was not. It comes and goes without rhyme or reason. I wear the same clothes I use the same soaps. I don’t know if this is related to nerves?
    Let me know what you think, because I run a small business with 2 1/2 employees, and I suddenly really have some thinking to do, especially in this economy.

    • mixhart
      | Reply

      Hi Kristen,

      Sorry this reply is late but I had an insanely stressful year with no time to check my blog! I found a good podiatrist who designed decent insoles–so many have no clue how to create a good orthodox for Freigberg’s–keep looking until you find a knowledgable person. Orthotics with a padded “ball” under the damaged joint have helped me the most. I personally find weird itching is nerve related–probably from walking differently due to foot pain. I believe a foot massage is a good idea and cold laser on the foot. Also, I swear by no-drop Hoka platform running shoes (all day long) with a good orthotic–they do make wide width Hokas in case you haven’t tried them. I hope your business is going well!

  28. mixhart
    | Reply

    Update: This past July, I was bitten by a black widow spider on my Freiberg’s foot. It took about a month for the venom to completely leave my toe (I used cold laser on the toe to keep it from getting worse). Sadly, I report that black widow venom does not cure Freiberg’s 🙁

  29. Sherry
    | Reply

    I just found your original post. I’ve had this disease in my right foot for at least 10 years. I’ve had numerous injections over those years. Sometimes they work…sometimes not. I’ve tried orthotics once but they didn’t work for me. Over the last few years I’ve notice my left foot is beginning to have the same issue. My ortho doc told me, the last time I got an injection, to buy shoes a half size larger to prevent the toes from pushing on the end of the shoes. I’m very active and find it very hard to deal with the pain but sitting in a chair is not an option. I walk my dog twice a day and workout at least 5 days a week. The throbbing pain is unbearable sometimes. Even hurts to push the gas peddle. I’m at a loss.

    • mixhart
      | Reply

      Dear Sherry, sorry for the late reply! What type of injections are you receiving? I found that steroid injections made my Freiberg’s worse over time, yet the PRP injections made my Freiberg’s better over time. At first, I was given orthotics that did not work, so I researched what design of orthotics work best for Frieberg’s & then switched doctors, and asked the new doctor to make me more suitable orthotics for Friebergs (ones that have a ball-like padding in the upper area). Now, I wear exclusively Hoka-style plush runners or Doc Martin-style sandals and boots at other times (when I need to look smart). I also had a PRP injection in the joint and do cold-laser treatment if any pain flares up, So far so good–I live virtually pain-free now. I hope this helps.

  30. Lisa
    | Reply

    Hi!
    I’m just reading through all of these posts and becoming super sad. I was told a month ago that I have avascular necrosis in my second toe and that I should stop running for six weeks and that it should get better. Instead of getting better it got worse and when I told the doc she put me in a boot and said that it should be better in another month. I’ve been in the boot for a week now and my foot definitely does not feel better. I’m worried and scared because I run for mental health and I have not ever been able to find anything that helps my depression as effectively. I’m so worried I’ll never be able to run again. I literally need to run. What would happen if I just ran anyway?

    • mixhart
      | Reply

      Hi Lisa,

      Don’t panic. Give your foot the time it needs to heal. I highly recommend cold laser therapy to help speed things along. I would try to cycle or swim while you wait for it to heal. Once the pain is gone, make sure you have great orthotics and wear no-drop, cushioned shoes as much as possible. Everyone is different, but I believe that if you baby your foot by giving it lots of time to heal, and then wear super cushioning shoes with special insoles as often as possible, in time, it will heal to the point that you will most likely be able to run again. You might have to switch to running on more natrual trails that are not paved, or running shorter distances each day. In my experience, if you make allowances, you will find a way to run again–relatively pain free. If you continue to run before it heals, it will get worse and worse and you probably will ruin your chances of running again. Letting you foot heal until it is pain free, is your best option for continuing your running passion.

      • Lisa
        | Reply

        Thank you so much for taking the time to answer my question.

        • mixhart
          | Reply

          My pleasure 🙂

  31. Cate Garrett
    | Reply

    I’ve had stage 4+ Frieberg’s Disease for my entire life. I’ve found the following to be helpful:

    1. Keep your ortho-boots. Use them when you’re in pain. Canes and crutches, also.
    2. Don’t let the pain keep you out of the game, there’s no point letting your muscles weaken, too. Go do the thing – as long as it doesn’t cause injury – bc you’re going to be hurting anyway. Might as well enjoy it where you can.
    3. Get a pair of DC skate shoes – because they are great quality and wide width, and last a long time – and use metatarsal pads (to realign the collapsed MT bones when you walk, helps prevent injury) and your Rx inserts when you can.
    4. Change the way you walk intermittently. One day, wear flats, another day wear very low heels (enough to change the walk but not enough to truly incline). Another day walk on the balls of your feet primarily, another day walk barefoot. By changing the way you walk, you change the pressure points you walk on, and it takes the pressure off of not only your feet, but also your legs and lower back.
    5. Non-impact, low intensity sports (yoga, swim, lie-down Pilates, etc) to give you what you need without putting you on your feet
    6. Consult a hematologist. Sometimes bloodflow restriction to the bones can be connected to a clotting disorder.

    There are a lot of other tips but I can’t remember them right now. Find me online if you want.

    • mixhart
      | Reply

      Hi Cate, thank you for your helpful advice. I am impressed at your footwear tips. Stage IV Freiberg’s is not easy to manage and your success is truly inspirational!

  32. Chuck
    | Reply

    Mixhart – Thanks so much for creating this blog! I wish it had been around when I was diagnosed.

    I’m a 52 year old male and former football player who’s been dealing with Freiberg’s in both feet for about 20 years. I know I’m not the typical demographic for Freiberg’s but I do like Taylor Swift :>) I’ve had 6 total surgeries but am in a good place now. I’m able to walk 3 miles nearly every day and lift weights 4-5 days a week (although I go light on leg day).

    Here’s some tips I have for folks dealing with Freiberg’s:

    – If you haven’t been diagnosed and you’re having similar symptoms to what you’re seeing here, insist on getting a referral to an orthopedist and getting an MRI. Xrays are unlikely to show anything until it’s too late (cartilage is gone and bones are starting to degrade). Even in early stages Freiberg’s will show up on an MRI.

    – Immediately stop all of your high impact exercises, especially running. Find activities you like that do not stress your feet. Upper body weights, yoga, swimming, biking and if your pain level isn’t too bad, walking. If you can afford it, an Elliptigo is a great option.

    – Cortisone injections can give you some amazing short term pain relief. However, it’s unlikely they’re going to help you in the long term at all. They’re great for inflammation and pain but won’t fix necrosis/lack of blood flow. If you ramp up your activity after an injection because you don’t feel any pain, you could make yourself worse when the injection wears off. If a doctor ever tells you to get more than one injection in the same spot in less than a year, find another doctor.

    – Spend the money on a couple of pairs of really good running/cross-training shoes with excellent support. My foot surgeon recommended the Brooks Beast and they work really well for me. Orthotics/supports haven’t been hugely helpful for me but they really help some folks.

    – Research a good orthopedic surgeon that specializes in feet. Hopefully you won’t need a surgery but if you have Freiberg’s you might at some point. Shout out to Dr. John Campbell at Mercy hospital in Baltimore he’s amazing!

    – If you do need a surgery, I recommend avoiding implants (unless it’s your big toe). The problem is the implants are so small in any of the smaller toes, they tend to break. My titanium implant broke after less than one month of putting weight on it (and nothing high impact).

    – If you do need a surgery that involves not putting weight on your foot for an extended period of time, get yourself a knee scooter. You can get a cheap one that’s perfectly functional on Amazon for $100.

    • mixhart
      | Reply

      Thank you, Chuck, for sharing your experience and for the great tips:) Happy to hear that that you’re able to enjoy an active life again.

  33. Susan Hathaway
    | Reply

    Hi there,
    New here and still at pre x-ray stage after gait analysis.
    Thanks for keeping this thread going – now I’m optimistic about being able to walk into my bath chair after reading this, and will be swimming while I offload my probable Freiberg’s foot.
    Podiatrist customised orthotics for me to use with my various shoes and I am now researching the Hoka range.

    Does anyone have any particular models to recommend? I’m not a runner – I just want to be able to keep doing gentle rambles and keep walking around cities when I take trips.

    As the models are so different, does anyone have recent experience of which ones work best?

    The website has a shoe chooser and the suggested models vary according to your choice of walking surface – so ‘neighbourhood’ suggests Bondi, but ‘trail’ suggests Challenger.

    I guess I probably go with my majority use (pavements not trails) but I wondered if anyone has any recent experiences to offer?

    Thanks!

    • mixhart
      | Reply

      Hi Susan,

      I just purchased myself a pair of Hoka Challenger 7 Air–I love them. They have a 5 mm heel-toe drop. I also wore a pair of Bondi’s and hiked all over Ireland (city & trails) this summer and loved them too 🙂 Also, I use Speedgoat Mid hiking shoes to hike winter trails .
      *The thing to look for in Hokas (when you have Freiberg’s) is the heel to toe drop. The smaller the drop, the less pressure you’ll have on your Freigberg’s foot. I like to get 4mm drop (ideally) or 5 mm drop is great too. Stay away from the 6 mm drop (or more) shoes.

      https://www.hoka.com/en/ca/womens-trail/challenger-7/1134498.html.

      Happy trails,
      Melissa

  34. Susan Hathaway
    | Reply

    Hi Melissa,
    Thanks for your note, I will give those a try.
    I waited until the x-ray results arrived to reply -GP says the x-ray is normal so on to an ultrasound. I’ll be interested to see if the podiatrist spots anything different.
    Reading other’s experiences I know that my pain is mild so it could still be Freiberg’s with minimal damage so far.
    I appreciate everyone’s notes here as it seems to be a condition that can be tricky to pinpoint.
    I am very lucky to live close to a running shop that will only sell you the right shoe for you and they have a long service corridor for ‘road testing’ so I will take your recommendations with me and try a few pairs on.
    When I tried the Cliftons with my orthotics, the insoles were too wide so I came away empty handed as nothing was right for me and my insoles.
    I will have to see if I can get the orthotics trimmed – that might work.
    Any thoughts on using orthotics with hokas? Are the hokas rigid and rocker soled enough to offload toes without additional insoles?
    Any thoughts on orthotics generally? I’ve had mine 3 weeks and didn’t get the memo about wearing them in gradually so it’s been a bumpy ride testing them in different shoes and letting my delicate soles get used to the cheese grater below!
    What pragmatic pearls of wisdom does anyone have?
    And I would like to thank Cate for posting all her tips on how to manage the condition – it reminds me to vary the footwear daily – I think that helps.

    Thanks,
    Susan

  35. Chiara Marjaniemi
    | Reply

    Hey, loved reading all of these. I have been diagnosed with freibergs for about 7 weeks was in a boot now into the hoka shoe. I am a 15 year old freshman in high-school and I am just praying that I might be able to play lacrosse or prehaps cross country in the future. I am in the hoka shoe and have no pain what so ever. I have a couple questions for those who might know…. Can you fully recover from this? If I have sudery will I be able to play sports again? Will this be something that I will have for the rest of my life? If I return to sports what tips do you have for me, or what should I watch out for. Thank you and stay strong!❤️

  36. Becky
    | Reply

    Hello, I’m 30 and from the UK. When I was 18 I was diagnosed with Freibergs and had surgery to realign the bone so the base of the bone with a naturally curved head was realigned and pinned to the metatarsal that had completely shattered. I was told I’d never be able to run and having always been a runner it shattered me. I wore the post-op boot for about 6-8 weeks and once the pain had gone I did start running again. Since then I’ve been lucky to run 2 marathons and a 100km run, and have run consistently about 3 times a week over the past 10 years. I’m now training for another marathon and am getting the familiar pain back again next to the original joint. My original friebergs toe was in the middle (It’s not always the 2nd one), and now it’s the 4th (between middle and little toe). I’m quite certain it’s the same thing, and wonder if anyone here has had the condition come back, or has gone 10+ years post-op with any relapse and knows what options are next?

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