Tarsal Coalition – a cause of stiff painful feet in children and adolescents

What is tarsal coalition?

Tarsal coalition is a condition where there is an abnormal growth of bone cartilage or fibrous tissue across two or more tarsal bones in the foot causing a level of fusion of the joint or joints. The most common type of tarsal coalition involves the calcaneus bone (heel bone) and the talus bone (bone between the heel bone and the ankle bone), but it can also occur between other bones in the foot.

The result is limited range of motion and pain in the area. Tarsal coalition can occur on one or both feet. Symptoms most commonly arise in late childhood or early adolescence, however in some cases symptoms may not flare up until early adulthood.

Causes of tarsal coalition

It is thought that most cases of tarsal coalition are caused by a genetic mutation that disrupts the normal prenatal development of bones in the foot. As the bones ossify from cartilage to bone, the tarsal coalition will harden and become more rigid and painful. Less frequently, tarsal coalition can be triggered by injury to the area, infection or advanced juvenile arthritis.

Symptoms of tarsal coalition

Each individual will experience symptoms differently, however symptoms of tarsal coalition typically arise during physical activity or standing for prolonged periods. The most common symptoms include:

• Pain most commonly felt on the outside and top of the foot that may impair activity
• Stiffness and rigidity leading to a limited range of motion in the foot
• A flat foot
• Muscle spasms

Tarsal coalition treatment

Treatment for tarsal coalition will depend on the severity of the symptoms and the degree of fusion between the affected bones. The podiatrists at our Melbourne clinic will be able to offer treatment options which will usually be multimodal in nature. Conservative treatment options may include

• Rest to relieve pain and reduce associated inflammation
• Immobilisation using specific shoes, a CAM walker, custom orthotics or a brace
• Physical therapy such as foot mobilisation therapy
• Non-steroidal anti-inflammatory drugs (NSAIDs)

In severe cases, or if the tarsal coalition has not been treated with conservative measures in a timely manner, our podiatrists may need to refer for a surgical opinion. With surgery the extra growth of cartilage or fibrous tissue may be able to be removed. In more severe cases the affected bones may need to be surgically fused together to reduce symptoms.

How our Melbourne podiatrists can help

Our Melbourne children’s podiatrists can assess the foot and ankle to arrive at a diagnosis and determine your child’s needs. During this examination the podiatrist will assess any structural concerns and palpate areas of the foot and ankle to assist in diagnosis. We can then assess your child’s foot posture, footwear and gait biomechanics using our video analysis software. This can give us vital information in diagnosing the cause of symptoms.

If a tarsal coalition is suspected our podiatrists may need to refer for radiographic imaging such as an X-ray, CT scan or MRI. Once the correct diagnosis is achieved our podiatrists will then formulate a treatment plan. So if your child is persistently experiencing symptoms consistent with tarsal coalition, come and see us at Melbourne Podiatrists and Orthotics for thorough assessment and quality treatment.

Could your child have a tarsal coalition?

At our Melbourne foot clinic our podiatrists are experts in tarsal coalition diagnosis and treatment.

So if your child suffers from foot pain with limited range of motion and you haven’t recently had their feet checked, book an appointment with one of our friendly children’s podiatrists today!