Forefoot Pain in a Female College Soccer Player

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Todd A. Evans
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Sharon N. Domorski
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Wayne J. Sebastianelli
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Margot Putukian
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Jay N. Hertel
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Idiopathic forefoot pain, often termed metatarsalgia, is a common complaint among running athletes. Whereas several causes are often included in the differential diagnosis, Freiberg’s infraction is rarely considered. The signs and symptoms present with Freiberg’s infraction however, can mimic those present with more common forefoot injuries. The article presents the case of a female Division-I college soccer player who developed and was successfully treated for bilateral Freiberg’s infraction. Her initial complaint of unilateral forefoot pain, induced only by vigorous running, progressed to intolerable bilateral forefoot pain with light exercise. Conservative treatment was unsuccessful, and therefore surgery was required to enable her continued athletic participation. As with all weight-bearing joints, clinicians need to be aware of the potential for progressive degenerative changes at the metatarsal heads and the steps used in the evaluation and subsequent treatment of Freiberg’s infraction

Evans is with the Division of Athletic Training, University of Northern Iowa, Cedar Falls, IA 50614. Domorski is with HealthAmerica, State College, PA 16803. Sebastianelli and Putukian are with the Center for Orthopaedic and Sports Medicine, and Hertel, the Athletic Training Research Laboratory, The Pennsylvania State University, University Park, PA 16802.

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