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Tarsal Coalition

In this article, we explore tarsal coalition, the types and symptoms of tarsal coalition, how it is diagnosed, and the various treatment options available. 

If you’re in the Greater Columbus, Ohio area and seeking specialized care, consider scheduling an appointment with Orthopedic Foot & Ankle Center. Our team of experts is dedicated to providing personalized care to help you regain comfort and function in your daily activities.

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What is Tarsal Coalition?

Tarsal coalition is a condition where two or more tarsal bones in the foot are abnormally connected. This connection, often between the talus and calcaneus bones or the navicular bones, usually consists of fibrous tissue, cartilage, or bone. These abnormal connections (known as tarsal coalitions) can limit the normal foot motion, leading to pain and stiffness in the affected joint.

Typically, symptoms appear when a child’s bones begin to mature, around ages 9 to 16. A child’s foot might not function properly due to this restriction in movement. In some cases, tarsal coalition causes severe symptoms like intense pain, frequent ankle sprains, or difficulty walking.

Types of Tarsal Coalition

There are three main types of tarsal coalition based on the specific bones involved:

  1. Calcaneonavicular Coalition: This type occurs between the calcaneus (heel bone) and the navicular bone, which is located in the middle of the foot. It’s the most common type and usually causes stiffness and pain on the outer side of the foot.
  2. Talocalcaneal Coalition: This type occurs between the talus (ankle bone) and the calcaneus (heel bone). It often leads to pain deep inside the foot and ankle. This type can significantly restrict foot movement and cause flatfoot.
  3. Talonavicular Coalition: This less common type occurs between the talus and the navicular bone. It can cause pain in the front of the foot and difficulty with foot movements.
A woman with tarsal coalition.

What Causes Tarsal Coalition?

Tarsal coalition occurs when there is an abnormal connection between two or more tarsal bones in the foot. This condition typically develops during fetal growth and is present at birth, even though symptoms may not appear until later in childhood. These abnormal connections, known as tarsal coalitions, can be made of fibrous tissue, cartilage, or bone, and they interfere with the normal foot motion.

A child’s tarsal coalition usually becomes noticeable when the bones begin to mature, often between ages 9 and 16. The affected joint may become stiff and painful, leading to difficulty walking and frequent ankle sprains. Severe symptoms can include intense pain, limited foot movement, and trouble participating in physical activities.

In rare cases, tarsal coalition can be caused by injury, infection, or arthritis. Understanding the cause of a child’s tarsal coalition helps in diagnosing and treating the condition effectively, aiming to restore normal foot function and alleviate discomfort.

What Are the Symptoms of Tarsal Coalition?

A patient with foot pain in Columbus, Ohio.

 Common symptoms of tarsal coalition include:

  • Foot Pain: Pain is usually felt in the back or middle of the foot and can range from mild to severe. It often worsens with activity.
  • Stiffness: The affected joint may feel stiff, making it difficult to move the foot normally. This stiffness can lead to a limited range of motion.
  • Frequent Ankle Sprains: The abnormal connection in the tarsal bones can cause instability, leading to frequent ankle sprains or a feeling of the ankle giving way.
  • Flatfoot: A noticeable flattening of the arch can occur, which may worsen with standing or walking.
  • Difficulty Walking: Pain and stiffness can make walking uncomfortable, causing a limp or an altered gait.
  • Muscle Spasms: Some people experience muscle spasms in the leg, which can further limit mobility and increase discomfort.
 

These symptoms can interfere with daily activities and physical exercise. If left untreated, tarsal coalition can lead to chronic pain and long-term foot problems. Early diagnosis and treatment are essential to manage the symptoms and improve foot function.

How is Tarsal Coalition Diagnosed?

Diagnosing tarsal coalition involves several steps to ensure an accurate identification of the condition. Here’s how it typically works:

  1. Medical History: The doctor will start by asking about the patient’s symptoms, their duration, and any history of foot problems or injuries. Understanding the medical history helps in identifying potential signs of tarsal coalition.
  2. Physical Examination: During the physical exam, the doctor will check for tenderness, stiffness, and limited range of motion in the foot. They may also look for signs of flatfoot or muscle spasms.
  3. Imaging Tests:
    • X-rays: Standard X-rays are usually the first step in imaging, allowing the doctor to see the bone structures and identify any abnormal connections.
    • CT Scan (Computed Tomography): If the X-rays are inconclusive, a CT scan can provide more detailed images of the bones and the exact nature of the coalition.
    • MRI (Magnetic Resonance Imaging): An MRI might be used to get a clearer view of the soft tissues, such as cartilage and fibrous tissue, involved in the coalition.
 

These diagnostic tools help the doctor determine the presence and type of tarsal coalition, which is essential for planning appropriate treatment to relieve symptoms and improve foot function.

How is Tarsal Coalition Treated?

Treating tarsal coalition focuses on relieving pain and improving foot function. There are several approaches to treatment:

  1. Non-Surgical Treatments:
    • Rest and Activity Modification: Reducing activities that cause pain can help alleviate symptoms.
    • Orthotic Devices: Custom shoe inserts can support the foot and reduce stress on the affected joint.
    • Medication: Over-the-counter pain relievers, like ibuprofen, can help manage pain and inflammation.
    • Physical Therapy: Physical therapy is often recommended to strengthen the muscles around the foot and improve flexibility, which can relieve pain and improve mobility.
  2. Casting or Bracing: In some cases, immobilizing the foot with a cast or brace for a few weeks can reduce pain and inflammation.
  3. Steroid Injections: Injecting steroids into the affected area can provide temporary pain relief and reduce inflammation.
  4. Surgical Treatments: If non-surgical methods don’t provide sufficient relief, surgery may be necessary. Surgical options include removing the abnormal connection or fusing the affected bones together to eliminate pain and improve function.
 

Each treatment plan is tailored to the individual’s specific needs, focusing on achieving pain relief and restoring normal foot function. Early intervention can help manage symptoms effectively and prevent long-term complications. 

Seeking Relief from Tarsal Coalition? Schedule an Appointment Today!

If you or a loved one are experiencing symptoms of tarsal coalition, don’t wait to seek help. Contact us at Orthopedic Foot & Ankle Center in Columbus, Ohio, to schedule an appointment with a specialist! Our expert team is dedicated to providing comprehensive care tailored to your needs, helping you get back on your feet and enjoy life to the fullest.


Medically reviewed by Terrence M. Philbin, DO

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