Tarsal coalition describes an unusual connection between at least two bones in the hindfoot that is often detected in adolescence. It can make walking painful and tiresome while making you vulnerable to a range of other foot problems.
There are seven tarsal bones in your foot, located in the back section of the foot (as pictured). Having a tarsal coalition means that instead of these bones being connected by their regular joints and tissues, they are instead connected by either a bridge of bone, cartilage or strong fibrous tissue that severely limits their regular movement – and hence the normal function of the foot.
Tarsal coalitions most often develop in the womb during development, but symptoms don’t tend to appear until the bones begin to mature in the adolescent and teenage years. As such, some kids will not experience any symptoms in childhood or know that they have a coalition. When symptoms do begin, at whatever age that is, they may include:
When a tarsal coalition doesn’t happen during fetal development, it may occur as a result of a previous injury to the area, an infection or arthritis.
While a tarsal coalition can’t ‘go away’, our podiatrists help manage the symptoms of tarsal coalition to optimise your comfort, reduce your pain and keep your feet supported and functioning well. We have good outcomes with this approach, although the course of treatment can be heavily affected by which tarsal bones are affected, how many are affected, the way that they are affected, the movement left available in the area, and how your coalition is affecting your gait.
The first line management for a tarsal coalition is a non-surgical approach and non-symptomatic tarsal coalitions often do not require treatment. For painful tarsal coalitions, depending on your symptoms and severity, we may use:
If we do not see the results we want using these treatment protocols, we may refer you for corticosteroid injections if it is deemed clinically appropriate.
While the conservative treatment options above are the first line in treatment, if your foot continues to be painful and limiting, surgery may need to be considered. We will refer you to a trusted orthopaedic surgeon who will discuss options including fusing the affected joints solidly, or removing additional bone to try to restore more normal motion between the bones involved in the coalition.
How long does it take to recover from tarsal coalition surgery?
This varies from person to person depending on the severity of the initial problem as well as a range of other personal and medical factors. In general, recovery from surgical treatment for tarsal coalition can take several months to a year or more.
Can tarsal coalition be prevented?
No, tarsal coalition is a condition that is typically present from birth and cannot be prevented.
Are there any exercises or physical therapy that can help with tarsal coalition?
Yes, part of your management will likely include a range of therapies including foot mobilisation and bracing to best support your recovery. Stretching or strengthening exercises may be provided where muscle weakness or stiffness is identified and is further complicating your symptoms and the coalition.
Can tarsal coalition cause long-term complications?
Yes, it’s very important to identify and treat tarsal coalition as it can lead to a range of unwanted complications. These include ongoing foot pain, limited mobility at the foot and ankle, arthritis, postural problems and even nerve damage.