## Iselin disease (active management) During the painful phase, reduce running, jumping and strain on the outer foot. Introduce stretching and strength work when allowed and painless. Outward band resistance is a selected progression, not an initial exercise. - ![Wall calf stretch](https://ortopediaevolutiva.com/clinical-print-figures/0e46416d0daccea2.webp) #### 1. Calf stretch: straight knee When weight-bearing is allowed, place your hands on a wall and the leg to stretch behind you, knee straight and heel down. Slowly move forwards until you feel a gentle calf stretch. Hold and relax; stop if the outer border of your foot hurts. 3 holds of 20 seconds, once a day; rest 20 seconds. - ![Calf stretch: bent knee](https://ortopediaevolutiva.com/clinical-print-figures/2f5ec3467c15a168.webp) #### 2. Calf stretch: bent knee Only when standing and stretching are allowed, without local pain. Place your hands on a wall, with one foot slightly behind the other and both heels on the floor. Slowly bend the back knee until you feel a gentle stretch low in the calf. Hold, then relax without bouncing. 3 holds of 20 seconds, once a day; rest 20 seconds. - ![Pull your foot up against a band](https://ortopediaevolutiva.com/clinical-print-figures/06502562526f2882.webp) #### 3. Pull your foot up against a band After clearance for strengthening, sit with your foot free. Loop a light band around your forefoot, secured ahead to a stable table. Pull your toes towards your shin and slowly return. Keep your leg still; avoid band pressure over the sore area. 8 repetitions every other day; relax between movements. Stop for pain at the fifth metatarsal base or worsening afterwards. - ![Turn your foot out against a light band](https://ortopediaevolutiva.com/clinical-print-figures/41be9cba1cec5d56.webp) #### 4. Turn your foot out against a band After pain settles and resisted eversion is allowed. Sit with your leg still. Loop a light band around your forefoot, secured on the inner side. Move your foot outwards and return without turning your knee. Avoid pressure over the fifth metatarsal base. 8 repetitions every other day; relax between movements. Stop for pain or worsening within 24 hours. - ![Raise and lower both heels on the floor](https://ortopediaevolutiva.com/clinical-print-figures/1d51ebafc8cd29c2.webp) #### 5. Raise and lower both heels on the floor When standing strengthening is allowed, place your hands on a wall with your weight over both feet. Slowly raise both heels and lower them with control. Do not switch to one foot or use a step. 1 set of 8 repetitions, every other day; relax between movements. Stop for outer foot pain or limping afterwards. - ![Balance and proprioception](https://ortopediaevolutiva.com/clinical-print-figures/a6e8b0b1f6413c47.webp) #### 6. Balance on one leg Recovery: painless loading without later worsening With weight-bearing allowed, stand on firm ground holding a table, eyes open; an adult stays beside children. Lift one foot and hold. Put it down before losing balance; stop for pain or instability. 3 × 30 seconds each leg daily; rest 30 seconds. Resume running only at the agreed stage and reduce the load if pain returns. Tolerating exercises does not establish readiness for sport. 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](https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle/iselin-exercises) · Printed: 28/10/2026 ![QR: exercise sheet and videos](https://ortopediaevolutiva.com/exercise-qr/en-piede-caviglia-iselin-esercizi.svg) - [Home](https://ortopediaevolutiva.com/en) - [Conditions](https://ortopediaevolutiva.com/en/conditions) - [Iselin disease (active management)](https://ortopediaevolutiva.com/en/conditions/iselins-disease) - Exercises [Back to Foot & Ankle](https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle) # Iselin disease (active management) 6 exercises Print exercise sheet / PDF Share exercise sheet During the painful phase, reduce running, jumping and strain on the outer foot. Introduce stretching and strength work when allowed and painless. Outward band resistance is a selected progression, not an initial exercise. ## Exercises - 1 #### Calf stretch: straight knee ![Illustration: Calf stretch: straight knee](https://ortopediaevolutiva.com/assets/202-stretch-muro-due-posizioni-v1-ca848sl5.webp) When weight-bearing is allowed, place your hands on a wall and the leg to stretch behind you, knee straight and heel down. Slowly move forwards until you feel a gentle calf stretch. Hold and relax; stop if the outer border of your foot hurts. 3 holds of 20 seconds, once a day; rest 20 seconds. Wall calf stretch straight knee Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=qDyTZUMFMrQ) The video shows the movement. Follow the dose and precautions on this sheet. - 2 #### Calf stretch: bent knee Only when standing and stretching are allowed, without local pain. ![Illustration: Calf stretch: bent knee](https://ortopediaevolutiva.com/clinical-approved-color/46bf1fb47fb7ef7f.webp) Place your hands on a wall, with one foot slightly behind the other and both heels on the floor. Slowly bend the back knee until you feel a gentle stretch low in the calf. Hold, then relax without bouncing. 3 holds of 20 seconds, once a day; rest 20 seconds. Wall calf stretch bent knee Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=1Op8Y5V1olc) The video shows the movement. Follow the dose and precautions on this sheet. - 3 #### Pull your foot up against a band ![Illustration: Pull your foot up against a band](https://ortopediaevolutiva.com/assets/081-band-dorsiflexion-v1-D58hhnBR.webp) After clearance for strengthening, sit with your foot free. Loop a light band around your forefoot, secured ahead to a stable table. Pull your toes towards your shin and slowly return. Keep your leg still; avoid band pressure over the sore area. Stop for pain at the fifth metatarsal base or worsening afterwards. 8 repetitions every other day; relax between movements. Ankle dorsiflexion with a resistance band Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=yx8jzE6MCeI) The video shows the movement. Follow the dose and precautions on this sheet. - 4 #### Turn your foot out against a band After pain settles and resisted eversion is allowed. ![Illustration: Turn your foot out against a band](https://ortopediaevolutiva.com/assets/143-elastico-eversione-v1-BzUKLvbQ.webp) Sit with your leg still. Loop a light band around your forefoot, secured on the inner side. Move your foot outwards and return without turning your knee. Avoid pressure over the fifth metatarsal base. Stop for pain or worsening within 24 hours. 8 repetitions every other day; relax between movements. - 5 #### Raise and lower both heels on the floor ![Illustration: Raise and lower both heels on the floor](https://ortopediaevolutiva.com/assets/117-calf-raise-supported-v1-B986l6oq.webp) When standing strengthening is allowed, place your hands on a wall with your weight over both feet. Slowly raise both heels and lower them with control. Do not switch to one foot or use a step. Stop for outer foot pain or limping afterwards. 1 set of 8 repetitions, every other day; relax between movements. Double leg heel raises Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=SoBrObxIuNo) The video shows the movement. Follow the dose and precautions on this sheet. - 6 #### Balance on one leg Recovery: painless loading without later worsening ![Illustration: Balance on one leg](https://ortopediaevolutiva.com/assets/076-07-equilibrio-monopodalico-v2-Wzt1j-br.webp) With weight-bearing allowed, stand on firm ground holding a table, eyes open; an adult stays beside children. Lift one foot and hold. Put it down before losing balance; stop for pain or instability. 3 × 30 seconds each leg daily; rest 30 seconds. Single leg balance Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=l9XVRIlMOzo) The video shows the movement. Follow the dose and precautions on this sheet. ## Exercise sheet The complete sheet is ready to print. For a shorter copy, select the activities to include. Customise the printed copy Calf stretch: straight knee Calf stretch: bent knee Pull your foot up against a band Turn your foot out against a band Raise and lower both heels on the floor Balance on one leg 0 of 6 exercise cards included Select at least one item for a customised copy. Print exercise sheet / PDF Print selected exercises / PDF Clear selection The full web page remains available. Your selection is not saved or shared. Resume running only at the agreed stage and reduce the load if pain returns. Tolerating exercises does not establish readiness for sport. 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. Sources - [East Lancashire Hospitals NHS — Tip Toe Walking](https://elht.nhs.uk/services/paediatric-physiotherapy/information-patients/tip-toe-walking) - [AAOS — Foot and Ankle Conditioning Program](https://www.orthoinfo.org/recovery/foot-and-ankle-conditioning-program/) - [Lurie Children's — Iselin Disease (Apophysitis of the Fifth Metatarsal)](https://www.luriechildrens.org/en/specialties-conditions/iselin-disease/) [Condition information](https://ortopediaevolutiva.com/en/conditions/iselins-disease)[Book a visit](https://ortopediaevolutiva.com/en/locations#prenota) [Previous Freiberg disease (active management)](https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle/freiberg-exercises) --- Canonical: https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle/iselin-exercises Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.