Treatment of Freiberg’s disease with rigid foot plates

carbon plates, metatarsalgia, rigid insoles

Freiberg’s disease or Freiberg’s infarction is a painful problem of the lesser metatarsophalangeal joints in the foot, most commonly the second next to the big toe joint. It typically causes the joint to flatten and collapse like a crushed eggshell (see the x-ray above). It is more common between the ages of 11 to 17 yrs, but can happen at older ages and the consequences of the conditions can persist well beyond that age group.

The joint behind the toe is typically painful on walking, tender to poking at it and the movement of the joint is painful. There may be some swelling. An x-ray typically shows a flattening of the head of the metatarsal bone. The exact cause of the problem is not so clear, but it is assumed to be related to overuse (ie too much sport) in those who are prone to it.

The treatment of Freiberg’s typically involves some level of activity limitation and perhaps accommodative padding (eg felt) to relieve pressure on the painful area. The toe may be strapped to restrict movement. In the more painful cases, a walking brace (eg moon boot) can be used for 4-6 weeks. At the last stages and if nothing else helps, then there are surgical options.

One bit of advice that you often see given is to use a stiffer-soled shoe or a rigid carbon plate in the shoe to make the shoe stiffer or more rigid. The rationale behind this is that if dorsiflexion of the toe is painful in Freiberg’s disease, then restricting the amount the foot can dorsiflex at the affected joint will help with the symptoms, reduce the pain and help facilitate healing. Strapping or tape can also be used in the short term and if that helps, the Fix Toe product can be used over the medium to long term to help.

See our other news posts on Hallux Rigidus Insoles and Turf Toe Inserts or Insoles