Freiberg disease (active management)
Protecting the painful joint comes before exercises. Use only permitted options during recovery, without pain or pressure on the metatarsal head. Toe movements are alternatives, not a full circuit.
1.Move your toes without using your hands
When movement is allowed, sit and support your foot without resting on the sore area.
Slowly bend and straighten your toes through a small, comfortable range, then relax. Do not push the toe with your hands or try to reach the limit.
5 slow movements, once a day; relax between movements.
2.Ball under the arch and heel
Recovery: movement allowed and painless
Sit with a tennis ball under the sole.
Roll it slowly under the arch and heel, completely avoiding the painful metatarsal area at the forefoot. Keep pressure comfortable; do not stand on the ball.
3 minutes each foot daily; rest as needed.
3.Gently gather a towel
Only when toe movement is allowed and painless, sit with a towel under your foot.
Gently draw a small section towards you by bending your toes, then release. Do not add weights or press on the sore joint.
5 small grips, once a day; an alternative to the other toe exercises.
4.Wall calf stretch
Recovery: movement allowed and painless
With loading allowed, put your hands on the wall, back leg straight and heel down.
Move your hips forwards gently to a mild calf stretch. Hold and relax without painful forefoot pressure; stop if it hurts.
3 × 30 seconds, twice daily; rest 30 seconds.
Exercises — continued
5.Lift the toes in turn
Recovery: movement allowed and painless
Sit with the foot resting comfortably.
Lift only the big toe with the others down. Then lower the big toe and lift the other toes; relax and alternate slowly without causing joint pain.
15 each movement, twice daily; relax between attempts.
6.Spread the toes
Recovery: movement allowed and painless
Sit with the foot supported and toes relaxed.
Gently spread the toes, hold briefly and relax. Do not push them apart by hand or with separators; keep the affected joint painless.
10 repetitions, twice daily; relax between attempts.
7.Balance without rolling onto the edge
Recovery: weight-bearing allowed and painless
With loading allowed, stand beside a table, eyes open and natural foot contact painless.
Hold the support and lift one foot slightly. Balance without shifting onto the outer edge, then put it down. Stop for forefoot pain.
3 × 20 seconds each leg daily; rest 30 seconds.
Cycling and low-impact activities may still load the forefoot. Return to weight-bearing and sport follows the individual clinical plan.
Suitability depends on the individual medical assessment. Starting exercises without assessment can be dangerous.
When to stop
- Stop for sudden or increasing pain, swelling or difficulty moving; contact your clinician.
- Fever, a hot/red joint, inability to bear weight, tingling, numbness or sudden weakness: urgent assessment; emergency care if severe.
Dott. Daniele Priano · Paediatric orthopaedics
Exercise instructions and videos online · Printed: 28/10/2026
Protecting the painful joint comes before exercises. Use only permitted options during recovery, without pain or pressure on the metatarsal head. Toe movements are alternatives, not a full circuit.
Exercises
- 1
Move your toes without using your hands
When movement is allowed, sit and support your foot without resting on the sore area.
Slowly bend and straighten your toes through a small, comfortable range, then relax. Do not push the toe with your hands or try to reach the limit.
5 slow movements, once a day; relax between movements.Active toe movement
Illustrated video with synthetic narration. Play loads YouTube. Open on YouTube
The video shows the movement. Follow the dose and precautions on this sheet.
- 2
Ball under the arch and heel
Recovery: movement allowed and painless
Sit with a tennis ball under the sole.
Roll it slowly under the arch and heel, completely avoiding the painful metatarsal area at the forefoot. Keep pressure comfortable; do not stand on the ball.
3 minutes each foot daily; rest as needed. - 3
Gently gather a towel
Only when toe movement is allowed and painless, sit with a towel under your foot.
Gently draw a small section towards you by bending your toes, then release. Do not add weights or press on the sore joint.
5 small grips, once a day; an alternative to the other toe exercises.Towel curls
Illustrated video with synthetic narration. Play loads YouTube. Open on YouTube
The video shows the movement. Follow the dose and precautions on this sheet.
- 4
Wall calf stretch
Recovery: movement allowed and painless
With loading allowed, put your hands on the wall, back leg straight and heel down.
Move your hips forwards gently to a mild calf stretch. Hold and relax without painful forefoot pressure; stop if it hurts.
3 × 30 seconds, twice daily; rest 30 seconds.Wall calf stretch straight knee
Illustrated video with synthetic narration. Play loads YouTube. Open on YouTube
The video shows the movement. Follow the dose and precautions on this sheet.
- 5
Lift the toes in turn
Recovery: movement allowed and painless
Sit with the foot resting comfortably.
Lift only the big toe with the others down. Then lower the big toe and lift the other toes; relax and alternate slowly without causing joint pain.
15 each movement, twice daily; relax between attempts.Toe yoga
Illustrated video with synthetic narration. Play loads YouTube. Open on YouTube
The video shows the movement. Follow the dose and precautions on this sheet.
- 6
Spread the toes
Recovery: movement allowed and painless
Sit with the foot supported and toes relaxed.
Gently spread the toes, hold briefly and relax. Do not push them apart by hand or with separators; keep the affected joint painless.
10 repetitions, twice daily; relax between attempts. - 7
Balance without rolling onto the edge
Recovery: weight-bearing allowed and painless
With loading allowed, stand beside a table, eyes open and natural foot contact painless.
Hold the support and lift one foot slightly. Balance without shifting onto the outer edge, then put it down. Stop for forefoot pain.
3 × 20 seconds each leg daily; rest 30 seconds.Single leg balance
Illustrated video with synthetic narration. Play loads YouTube. Open on YouTube
The video shows the movement. Follow the dose and precautions on this sheet.
Exercise sheet
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Cycling and low-impact activities may still load the forefoot. Return to weight-bearing and sport follows the individual clinical plan.
For children, an adult stays nearby. Use a clear surface, a stable support and secure band anchors; avoid small objects that could be swallowed.
When to stop
Stop exercising and contact your clinician for:
- Acute or sudden pain during exercise
- Significant swelling after exercises
- Pain that progressively worsens over days
- Fever or general malaise
- Difficulty walking or using the limb after exercises
- Any neurological symptoms (tingling, numbness, sudden weakness)
- A red or hot joint, or inability to bear weight: seek prompt assessment; use emergency care if severe.
Suitability depends on the individual medical assessment. Starting exercises without assessment can be dangerous.