What is Tarsal Coalition

Tarsal coalition is a type of foot disorder. Seven bones (tarsals) make up the back of your foot, which includes the heel. Normally, these bones move freely within the foot and alongside one another.

If you have a tarsal coalition, two or more of these bones have abnormally fused together in a bridge (bar) of bone, cartilage, or fibrous tissue. This can cause pain, difficulty walking, and other foot problems.

Tarsal coalition can affect one foot or both feet. The condition can be mild or severe depending on:

• How many tarsal bones are affected. Often, two bones are affected, but it can be more.
• The size of the bars. Larger bars lead to more severe symptoms.

What are the causes?

This condition is most commonly caused by a gene defect (gene mutation) that is passed down through families. In rare cases, this condition can be caused by:

• Arthritis in the feet.
• A previous foot injury.
• An infection.

What increases the risk?

This condition is more likely to develop in:

• Children and adolescents.
• People who have arthritis.
• People who have had a previous foot injury or infection.

What are the signs or symptoms?

Symptoms of tarsal coalition often begin in childhood or adolescence as bones begin to harden. Symptoms include:

• A flat foot.
• Difficulty walking.
• Walking with a limp.
• Foot stiffness.
• Tiring easily when walking or standing.
• Pain when standing or walking.
• Muscle spasms.

How is this diagnosed?

This condition is diagnosed based on your symptoms and medical history. Your health care provider will do a physical exam to check your foot. Your health care provider may also do imaging tests to confirm the diagnosis, such as:

• X-ray.
• MRI.
• CT scan.

How is this treated?

Treatment for tarsal coalition depends on the severity of your condition. Treatment may include:

• Rest.
• Over-the-counter or prescription medicines for pain.
• Steroid injections.
• Physical therapy.
• Orthotics, such as heel cups, wedges, and arch supports.
• A cast or a walking boot.

You may need surgery to repair the tarsal coalition if nonsurgical treatments do not help.

Follow these instructions at home:

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If directed, apply ice to the injured area.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times per day.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises daily as told by your health care provider or physical therapist.
• Keep all follow-up visits as told by your health care provider. This is important.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Ask your health care provider when it is safe to drive if you have a cast or walking boot on your foot.

If you have a cast:

• Do not stick anything inside the cast to scratch your skin. Doing that increases your risk of infection.
• Check the skin around the cast every day. Report any concerns to your health care provider. You may put lotion on dry skin around the edges of the cast. Do not apply lotion to the skin underneath the cast.
• Do not let your cast get wet if it is not waterproof. If it is not waterproof, cover it with a watertight plastic bag when you take a bath or a shower.

If You Have a Walking Boot:

• Wear the walking boot as told by your health care provider. Remove it only as told by your health care provider.
• Do not let your walking boot get wet if it is not waterproof.
• Keep the walking boot clean.

Contact a health care provider if:

• Your pain gets worse.
• You have new pain in the foot.
• Your muscle spasms get worse.
• You have a harder time with walking.

Get help right away if:

• Your foot is numb or cold.
• Your toenails turn blue, gray, or another dark color.