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What is Kohler’s disease?

Kohler's Disease is damage to the navicular bone (bone in the midfoot) which affects young children between the age of 3 and 7 years and is caused by repeated trauma during development of the bone. Children with Kohler’s disease will typically complain of foot pain or may limp slightly. Kohler’s disease belongs to a group of related diseases termed ‘osteochondroses’ which involves growth disturbances of a bone and its surrounding joint. Treatment of Kohler’s disease involves immobilisation and rest in a camwalker boot for a period of 6 weeks to allow the symptoms to subside.

Physiotherapy treatment will help restore mobility and function following immobilisation and therefore enhance your child’s recovery.

Mobility rehabilitation exercises guided by an experienced physiotherapistAbove: Mobility rehabilitation exercises guided by an experienced physiotherapist

What causes Kohler’s disease?

The cause of Kohlers disease is not well known. It is thought Kohler’s disease is caused by temporary or permanent loss of the blood supply to the navicular bone as the child is developing. Without a blood supply, the bone tissue dies (avascular necrosis) which causes the bone to collapse. A reduction in blood supply is thought to be a result of repetitive stress on the bone.

How is Kohler’s disease diagnosed?

If Kohler's disease is suspected, x-rays of the foot will be obtained to confirm a diagnosis. The x-rays are usually abnormal and show damage to the navicular bone in the midfoot.

Soft tissue massage and mobilisations to relieve pain and stiffnessAbove: Soft tissue massage and mobilisations to relieve pain and stiffness

What are the symptoms of Kohler’s disease?

Kohlers disease is characterised by:

Physiotherapy for Kohlers disease

At, our paediatric physiotherapist will provide specialist physiotherapy treatment for Kohler’s disease. Physiotherapy treatment following immobilisation should commence as soon as possible for the best possible results. Physiotherapy is important as it will restore range of movement, balance and muscles strength so your child can return back to the activities they enjoy as soon as possible. At, physiotherapy treatment will be focused on:
  • Restoring range of movement in the foot and preventing stiffness
  • Increasing muscle strength
  • Improving balance
  • Enhancing mobility
  • Facilitating return to daily and recreational activities mobility
A structured rehabilitation program will be developed suited to your child so that your child gets the most out of their treatment and reaches their maximum potential. Physiotherapy treatment may include:
  • Stretching and strengthening exercises to improve range of movement in the foot and increase muscle strength
  • Teaching you how to mobilise safely with or without support
  • Practicing functional movements such as sit to stand and getting up and down stairs.
  • Activities to improve balance and facilitate mobility
  • Advice on how to gradually increase your child’s activity levels in a safe and effective way
  • Hydrotherapy to relax stiff muscles and to strengthen weak muscles
Our physiotherapists also work closely with podiatrists who can give more advice on orthotics for your child if necessary.

For more information to see if your child would benefit from physiotherapy or to book an appointment please call 0330 088 7800, or book online today!

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