Tarsal Coalitions

Sometimes, a deformity that is present in a foot at birth won’t start causing problems until a child reaches adolescence. That is often the case with tarsal coalitions, a fairly common variant in foot structures that may contribute to fatigue and balance problems. Recently, we at Integrity Foot & Ankle Associates in Lorain described how to care for flat feet. We thought that this week we would discuss tarsal coalitions, since they are a common cause of fallen arches, and what can be done about them.

The tarsals are the group of bones at the back of the feet. They include the calcaneus, or heel bone, the talus, which connects to the leg bones, and the navicular, which connects to the bones leading to the midfoot. Tarsal coalitions usually form between the calcaneus and either the talus or the navicular, and a person who has one often has them in both feet. They usually form in utero as cartilage connections, but harden into bone when a person is between eight and sixteen years old. Less commonly, older people may develop tarsal coalitions due to arthritis or injuries. Since most people don’t get foot x-rays for no reason, tarsal coalitions often go undetected until they start causing problems after hardening.

Tarsal coalitions are not always painful, but the inflexibility they cause may result in balance problems on uneven surfaces. Consequently, people with tarsal coalitions are at elevated risk for rolling their ankles. They may also get sore from activities more quickly, or adapt unusual gaits. Shoe inserts can help redistribute the body’s weight comfortably, and steroidal injections may be appropriate in some cases for pain relief. But if dysfunction persists, a podiatrist may consider surgically removing the coalition and replacing it with muscle or fat tissue. Alternatively, if other joints have become overused as a result of compensating for the tarsal coalition, a podiatrist may consider fusing them, as well.

Doctors David J. Hintz and Michael A. Wenowitz run Integrity Foot & Ankle Associates at 1740 Cooper Foster Park Road #B, Lorain, Ohio, 44053. To schedule an appointment, visit Integrity Foot and Ankle or call 440-282-1221.