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.
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.
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.
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.
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.
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.
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 · Printed: 28/10/2026
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.
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
The video shows the movement. Follow the dose and precautions on this sheet.
- 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.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.
- 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.Ankle dorsiflexion with a resistance band
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: 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.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
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.Short foot exercise
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
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.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
The complete sheet is ready to print. For a shorter copy, select the activities to include.
Customise the printed copy
0 of 6 exercise cards included
Select at least one item for a customised copy.
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.