Tarsal Coalitions

By Gary N. Friedlander DPM, FACFAS and Jay C. Larson DPM
February 17, 2016
Category: Foot Problems

Batter up! Spring baseball is almost here. The Phoenix area is a wonderful place to get first hand spring training games. With a number of teams participating in the Cactus league, it provides ample opportunities to get out to the ballpark. Too often our feet can get in the way of enjoying routine activities. Tarsal coalitions are a less common condition that can leave your feet with discomfort.

A tarsal coalition is a bridge between two or more tarsal bones. This bridge can restrict motion needed for normal gait and function of the foot. These bony, fibrous or cartilaginous bridges only have an incidence rate of 1% making them fairly uncommon. Typically, males develop coalitions more often then females and the onset may follow athletic activities or even trauma. Fifty percent of the time these coalitions are bilateral. The most common tarsal coalitions are between the talus and calcaneus bones along with the calcaneus and navicular bones.  A common complaint with these types of coalitions is peroneal spasitc flatfoot, which can be described by a pain found in the foot and ankle and is associated with ankle sprains. This occurs because of the reduced range of motion on specific joints in the foot.

Symptoms

-Decrease ROM in the sub-talar joint

-Muscle spasm

-Deep aching pain, better with rest and worse with activity

A podiatrist may become suspicious of a coalition after a through lower extremity physical exam. X-rays have the potential to view a coalition; however, not all coalitions are strictly bone. Some coalitions are made up of fibrous tissue or cartilaginous tissue.  You podiatrist may order a CT to confirm and further evaluate the suspected coalition. Conservative approach to treating a coalition involves decreasing motion at the symptomatic joint through orthotics, casting, or splints.  Anti-inflammatory medication along with a corticosteroid injection may be indicated depending on the severity of the inflammation and pain.  Your podiatrist may also discuss surgical correction depending on the degree of the coalition and the pain associated with it.

Winter and spring are great times to be in Arizona. What better then to enjoy a few days at the ballpark catching up with your favorite team? Coalitions, yet rare, may be enough to slow you down.  If you notice any changes in their foot health, please consider making an appointment with Dr. Gary N. Friedlander or Dr. Jay C. Larson at Sole Foot and Ankle Specialists in Glendale, Arizona.

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