Navigating Freiberg's Disease: The Desire to Run Again
Greetings! I’m a 36-year-old male, standing at 5’9” and weighing 165 lbs before my diagnosis, but I've since gained weight to 175 lbs. For the last six years, triathlons have played a significant role in my daily life. After enduring intermittent pain for six months, x-rays confirmed that I have Freiberg’s disease affecting the second toe on my right foot. My eagerness to return to running and training is palpable. I’ve taken the advice of my podiatrist and invested in carbon-plated shoes, and I've also incorporated insoles with padding designed to help under the ball of my foot, which reduces how much I move my toes. I’m consulting a physiotherapist, though unfortunately, they’re unfamiliar with this particular condition. When I reached out to surgeons for assistance, they dismissed the idea of PRP therapy as ineffective for my situation and suggested that surgery would not be advisable at this time. I am reaching out to see if anyone has additional insights or advice. I attempted my first run in two months yesterday—a flat route that lasted about 15 minutes—but I’m experiencing some discomfort again. This setback is disheartening, especially considering my job and lifestyle require me to be on my feet frequently.
Answers (1)
3/24/2025, 3:40:42 PM
OpenHealth AI
It's understandable that you're feeling frustrated and eager to return to running after your diagnosis of Freiberg's disease. Managing this condition can indeed be challenging, especially for someone with an active lifestyle like yours. Here's how you can approach your situation moving forward.
Summary of Key Points:
- Freiberg's disease primarily affects the second metatarsal head, leading to pain and walking difficulties.
- It's important to gradually return to activity and manage pain effectively.
- Focus on supportive footwear, loading techniques, and strength training.
Explanation:
Freiberg’s disease involves the death of bone tissue in the second toe's metatarsal because of reduced blood flow, which often leads to pain and difficulty in weight-bearing activities like running. The interventions you've already implemented, such as carbon-plated shoes and padded insoles, are excellent first steps. However, recovery requires a gradual approach to prevent further discomfort.
Next Steps:
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Rest and Recovery: Allow your body additional recovery time. Consider implementing a rehabilitation program focused on low-impact exercises that don’t exacerbate your symptoms. Activities like swimming, cycling, or using an elliptical machine can help maintain your fitness while reducing stress on your foot.
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Gradual Return to Running: When you feel ready to run again, start with a very short duration (5-10 minutes) and increase time carefully based on your comfort level. Incorporate walking breaks if necessary, and continue to monitor any discomfort. Allow at least 48 hours before your next run to gauge how your foot responds.
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Strengthening Exercises: Introduce foot and ankle strengthening exercises to help stabilize the area around your second metatarsal. Exercises can include toe curls with a towel, calf raises, and resistance band workouts targeting the foot's intrinsic muscles. Aim for 2-3 sessions per week.
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Manage Pain and Discomfort: If your foot pain increases again, consider using ice after activity and over-the-counter pain relief if needed (consult guidelines for usage). Regularly check in with your physiotherapist for exercises tailored to your condition and modify your treatment plan based on progress.
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Explore Additional Resources: Given that your physiotherapist may not be familiar with Freiberg's disease, seek educational resources or connect with specialized physiotherapists who have experience with this condition. They may provide more tailored strategies.
It’s a journey, and while setbacks can be discouraging, stay focused on your long-term goals while listening to your body. You’re taking significant steps to manage your situation, and with time and care, you'll increase your chances of safely returning to running. Please keep me posted on your progress.
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.