## Köhler disease (active management) These activities are for an authorised recovery phase; they do not heal the navicular. They may be inappropriate during immobilisation or non-weight-bearing. Begin with permitted movements; strength and balance require permission to load the foot. - ![Move your ankle while sitting](https://ortopediaevolutiva.com/clinical-print-figures/2a5d013a23af6300.webp) #### 1. Move your ankle while sitting Only when free movement is allowed, not during immobilisation. When movement is allowed, sit with your leg supported and your foot free. Slowly bring your toes towards you, then point them away without reaching the limit. Relax; an adult should not pull your foot. 5 complete movements, once a day; relax between movements. - ![Toe yoga and toe control (seated)](https://ortopediaevolutiva.com/clinical-print-figures/ea157d30a7c55b56.webp) #### 2. Toe control while seated Recovery: movement allowed and painless Sit with the foot supported without painful pressure, respecting prescribed loading limits. Lift the big toe with the others down, then reverse and relax. Move only the toes; stop for pain in the middle of the foot. 10 alternations once daily; relax between attempts. - ![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, without navicular pain; this loads the foot. Sit with your foot free. Loop a light band around your forefoot, secured ahead to a stable table leg. Lift your toes towards your shin and slowly return, keeping knee and foot aligned. Avoid pressure over the midfoot. 1 set of 8 repetitions, every other day; relax between movements. - ![Calf stretch (gentle)](https://ortopediaevolutiva.com/clinical-print-figures/0e46416d0daccea2.webp) #### 4. Wall calf stretch Recovery: weight-bearing allowed and painless Only with weight-bearing and stretching 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; stop for pain in the middle of the foot. 3 × 20 seconds each leg daily; rest 30 seconds. - ![Progressive short-foot](https://ortopediaevolutiva.com/clinical-print-figures/cbc0d35b86485c99.webp) #### 5. Shorten the foot while seated Recovery: weight-bearing allowed and painless Only with loading allowed, sit and rest the foot lightly on the floor. Draw the toe bases towards the heel, slightly lifting the arch without curling the toes. Hold and relax; stop if pain or limping increases, including afterwards. 10 × 5 seconds, twice daily; relax between holds. - ![Balance and proprioception (advanced phase)](https://ortopediaevolutiva.com/clinical-print-figures/a6e8b0b1f6413c47.webp) #### 6. Balance holding a support Recovery: weight-bearing allowed and painless With weight-bearing allowed, stand on firm ground holding a table, eyes open; an adult supervises children. Lift one foot and hold; put it down before losing balance. Do not use unstable surfaces; stop for pain. 3 × 20 seconds each leg daily; rest 30 seconds. Cycling and swimming are not automatically allowed during non-weight-bearing. Agree the return to weight-bearing and sport according to pain, examination and the prescribed pathway. 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/kohler-exercises) · Printed: 28/10/2026 ![QR: exercise sheet and videos](https://ortopediaevolutiva.com/exercise-qr/en-piede-caviglia-kohler-esercizi.svg) - [Home](https://ortopediaevolutiva.com/en) - [Conditions](https://ortopediaevolutiva.com/en/conditions) - [Köhler disease (active management)](https://ortopediaevolutiva.com/en/conditions/kohlers-disease) - Exercises [Back to Foot & Ankle](https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle) # Köhler disease (active management) 6 exercises Print exercise sheet / PDF Share exercise sheet These activities are for an authorised recovery phase; they do not heal the navicular. They may be inappropriate during immobilisation or non-weight-bearing. Begin with permitted movements; strength and balance require permission to load the foot. ## Exercises - 1 #### Move your ankle while sitting Only when free movement is allowed, not during immobilisation. ![Illustration: Move your ankle while sitting](https://ortopediaevolutiva.com/clinical-home-color/seated-ankle-pump-color.webp) When movement is allowed, sit with your leg supported and your foot free. Slowly bring your toes towards you, then point them away without reaching the limit. Relax; an adult should not pull your foot. 5 complete movements, once a day; relax between movements. Ankle up-and-down movement — OrtopediaEvolutiva exercises Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=et6LODO7VMk) The video shows the movement. Follow the dose and precautions on this sheet. - 2 #### Toe control while seated Recovery: movement allowed and painless ![Illustration: Toe control while seated](https://ortopediaevolutiva.com/assets/074-03-toe-yoga-v1-BBMCn1uF.webp) Sit with the foot supported without painful pressure, respecting prescribed loading limits. Lift the big toe with the others down, then reverse and relax. Move only the toes; stop for pain in the middle of the foot. 10 alternations once daily; relax between attempts. Toe yoga Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=Mq0nRBXNg9M) The video shows the movement. Follow the dose and precautions on this sheet. - 3 #### Pull your foot up against a band After clearance for strengthening, without navicular pain; this loads the foot. ![Illustration: Pull your foot up against a band](https://ortopediaevolutiva.com/assets/081-band-dorsiflexion-v1-D58hhnBR.webp) Sit with your foot free. Loop a light band around your forefoot, secured ahead to a stable table leg. Lift your toes towards your shin and slowly return, keeping knee and foot aligned. Avoid pressure over the midfoot. 1 set of 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 #### Wall calf stretch Recovery: weight-bearing allowed and painless ![Illustration: Wall calf stretch](https://ortopediaevolutiva.com/assets/202-stretch-muro-due-posizioni-v1-ca848sl5.webp) Only with weight-bearing and stretching 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; stop for pain in the middle of the foot. 3 × 20 seconds each leg daily; rest 30 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. - 5 #### Shorten the foot while seated Recovery: weight-bearing allowed and painless ![Illustration: Shorten the foot while seated](https://ortopediaevolutiva.com/assets/075-04-short-foot-v1-BiH-0NHQ.webp) Only with loading allowed, sit and rest the foot lightly on the floor. Draw the toe bases towards the heel, slightly lifting the arch without curling the toes. Hold and relax; stop if pain or limping increases, including afterwards. 10 × 5 seconds, twice daily; relax between holds. Short foot exercise Illustrated video with synthetic narration. Play loads YouTube. [Open on YouTube](https://www.youtube.com/watch?v=TF3CGbfgXFQ) The video shows the movement. Follow the dose and precautions on this sheet. - 6 #### Balance holding a support Recovery: weight-bearing allowed and painless ![Illustration: Balance holding a support](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 supervises children. Lift one foot and hold; put it down before losing balance. Do not use unstable surfaces; stop for pain. 3 × 20 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 Move your ankle while sitting Toe control while seated Pull your foot up against a band Wall calf stretch Shorten the foot while seated Balance holding a support 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. Cycling and swimming are not automatically allowed during non-weight-bearing. Agree the return to weight-bearing and sport according to pain, examination and the prescribed pathway. 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 - [Royal Children's Hospital — Kids Health Info: Ankle sprains](https://www.rch.org.au/kidsinfo/fact_sheets/Ankle_sprains/) - [AAOS — Foot and Ankle Conditioning Program](https://www.orthoinfo.org/recovery/foot-and-ankle-conditioning-program/) - [Akron Children's / KidsHealth — A to Z: Kohler's Disease](https://www.akronchildrens.org/kidshealth/en/parents/az-kohler.html) [Condition information](https://ortopediaevolutiva.com/en/conditions/kohlers-disease)[Book a visit](https://ortopediaevolutiva.com/en/locations#prenota) [Previous Juvenile hallux valgus](https://ortopediaevolutiva.com/en/parents-kids/exercises/foot-ankle/hallux-valgus)[Next 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/kohler-exercises Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.