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TARSAL COALITION

Tarsal coalition probably exists from birth with symptoms appearing in late adolescence and early adulthood.  It refers to the abnormal fusing of bones in the tarsal area of the foot, most commonly between the talus and calcaneous or the calcaneous and the navicular.

The fusing of the bones prevents movement between the affected tarsal bones. The fusing can occur with the bone itself or in the cartilage or fibrous material. 

Tarsal coalition can be asymptomatic.  However, symptoms can be induce by trauma, prolong standing, marching or jumping.

Other names or similar foot conditions:

• Rigid flatfoot

Symptoms:

• There may be no symptoms
• Where there are symptoms, there is pain at the coalition site

Signs to look for:

• Tarsal area of the foot falls medially (inward) while the other foot does not
• Rigid flat foot
• Age – late adolescence or early adulthood
• Trauma at the site

Possible Causes:

• Congenital
• Provide support for heel and mid foot
• Create an arch that will correct as much motion of the foot while walking as possible
• Restore alignment to the ankle, top of the foot and knees as much as possible
• Cushion impact of body weight on feet, legs and spine

Solutions:

Arch Supports:

• Bio-Orthotics Winstep or Sundance exercising support with metatarsal lift

• Lower and thinner arch support with longitudinal and metatarsal support, such as the Bio-Orthotics Journey or Silhouette, for use when shoes cannot accommodate the Winstep or Sundance exercising support

• Extra depth shoes with straight last, firm heel counter, extended medial counter, connecting shanks and rocker soles

• For exercise, wear shoes with titanium springs

• MBT physiological shoe

• Negative heel shoe

• Go barefoot on a minimal basis only

• Wear heels and pumps only as long as absolutely necessary

Activities:

• Regular stretching program before and after exercise

• Rotate weight bearing exercises, such as walking or jogging, with non-weight bearing exercising, such as swimming or bicycling

Sources   Image:  footandankle.mdmercy.com Text:  R. Cailliet, MD, Foot and Ankle Pain, D. Janisse, CPed, Editor, Introduction to Pedorthics