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Tarsal coalition

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What is it?

This is a condition where some of the bones in the middle of the foot are naturally fused together. This happens during foetal development. This often presents in a child as pain in the middle of foot in a sporty individual and is usually best diagnosed with a combination of clinical (hands on) diagnosis and imaging (x-ray and MRI).

Symptoms most often occur when they start puberty (between ages 9-14) and the bones start to mature. We often find that children with tarsal coalition have rigid flat feet which can be painful as activity levels increase. It can be difficult for them to walk on uneven ground. It is also true that tarsal coalitions often aren’t discovered until adulthood.

How can I help myself?

If your child is in pain then reducing their activity level often helps. Appropriate pain relieving medications (i.e.calpol) can also be given if the pain won’t settle down. Well supporting footwear and a change in activity level can often settle the issue down.

When to see a Podiatrist?

The best thing to do is get this properly diagnosed in the first instance.

Your podiatrist will use clinical diagnosis and often offer some conservative treatments. If they suspect your child has a tarsal coalition they will need to refer on for an MRI for confirmation. Once we have a full picture of the nature of the coalition (which bones are fused) we can then offer the best treatment options moving forwards. This may include total rest, orthotic devices in their shoes to alter the pressure form the affected joints, alteration of footwear, stretching and strengthening exercises and also strapping.

Sometimes a surgeon will offer a mobilisation under anaesthetic to improve movement at the joints and if this is unsuccessful, surgery may be required.

Tarsal coalition
Tarsal coalition
Tarsal coalition