Kohler’s Disease

Causes and Risk Factors of Kohler's Disease

• Disrupted Blood Supply: A temporary loss of blood flow to the navicular bone can lead to bone deterioration and inflammation.

• Delayed Ossification: The navicular bone ossifies later than other foot bones, making it more susceptible during growth spurts.

• Mechanical Stress: Repeated pressure or stress on the midfoot from activities such as running or jumping can exacerbate the condition.

• Age and Gender: Boys aged 3 to 7 are more commonly affected, although girls can also develop the condition.

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Signs and Symptoms of Kohler's Disease

•  Pain: Pain and tenderness in the arch or middle of the foot, which may intensify with weight-bearing activities.

• Swelling: Mild swelling around the navicular bone.

• Limping: A noticeable limp or reluctance to bear weight due to discomfort.

• Stiffness or Limited Movement: Reduced range of motion in the affected foot.

• Localised Warmth: The area may feel warm to the touch in some instances.

Treatment and Management of Kohler's Disease

Kohler's disease typically resolves on its own as the bone heals and regains its blood supply. Most children recover completely within 6 to 12 months without long-term complications. However, appropriate management and regular monitoring of the child’s progress are essential to support proper healing and prevent potential long-term complications.

• Rest and Activity Modification: Limiting weight-bearing activities, such as running or jumping, to promote healing.

• Immobilisation: In severe cases, using a cast or walking boot to protect and support the affected foot.

• Footwear: Ensuring shoes provide adequate support and cushioning to minimize stress on the midfoot.

• Physical Therapy: Once the pain subsides, gentle exercises can help restore mobility and strengthen foot muscles.

• Customised Insoles: Using orthotic devices to improve foot mechanics and reduce pressure on the affected area.