Common Foot Problems

Tarsal Coalition

Tarsal coalition occurs when two bones in the hind foot – the tarsal bones – fail to separate. This abnormal connection may also involve cartilage or fibrous tissue and lead to pain, stiffness and limited motion in one or both feet.

The tarsal bones consist of the calcaneus (heel bone), talus, navicular, cuboid and three cuneiform bones. In a normally functioning foot, these bones work together to provide the necessary motion during activity.

Tarsal coalition usually occurs as an abnormal development of the bones during the nine months of pregnancy. Less common occurrences of this condition include infection, arthritis or previous trauma to the area.

Although most people inherit this condition, symptoms often do not arise until the bones have matured around ages 9 to 16. Patients may not experience any symptoms during childhood, but develop pain and symptoms later in life.

Tarsal coalition may present with one or more of the following symptoms:

  • Mild to severe pain when walking or standing.
  • Tired or fatigued legs.
  • Muscle spasms in the leg that cause the foot to turn outward when walking.
  • Flatfoot in one or both feet.
  • Limping when walking.
  • Stiffness of the foot and ankle.

A child’s bones often need to mature before a tarsal coalition can be diagnosed. In fact, this condition sometimes is not identified until adulthood. To diagnose a tarsal coalition, Dr. Radovic will ask how long the symptoms have been developing, and will thoroughly examine the foot and ankle. X-rays and advanced imaging studies may be ordered to fully evaluate the condition. The findings of this examination may vary depending on the severity and location of tarsal coalition.

Non-surgical treatment of tarsal coalition aims at resolving the symptoms and reducing motion of the affected joint. Dr. Radovic may recommend one or more conservative options based on the severity of the condition and response to treatment, including:

  • Physical therapy involving massage, ultrasound therapy, and exercises that increase range of motion.
  • A corticosteroid injection into the affected joint to help reduce pain and inflammation. A series of injections are sometimes necessary.
  • Custom orthotic devices to distribute weight away from the joint, limit joint movement and relieve pain.
  • Injection of an anesthetic agent into the leg to relax spasms. This treatment is commonly performed before immobilization.
  • Wearing a cast or a cast boot to immobilize the foot and rest the affected area. Crutches may also be used to relieve weight from the foot.

Surgery may be an option for patients who do not feel sufficient relief from non-surgical treatments. Dr. Radovic will determine the most suitable procedure or procedures after considering the patient’s age, condition, activity level and arthritic changes.

To learn about Tarsal Coalition Surgery

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