Each bone in your foot has a specific design and role to play in supporting your body. They work together to absorb shock and distribute force so that you are able to move efficiently and without pain. Sometimes, however, those bones don’t grow quite correctly, as with tarsal coalition. This can dramatically impact the stability and strength of your lower limbs
Overgrowth in the Bones
Tarsal coalition is an abnormal fusion between foot bones that are normally separate. You have five tarsals that make up your midfoot and your heel. When you have this condition, hard bone or fibrous cartilage grows in between or along the sides of two tarsals, connecting them. It can develop across joints, severely restricting or completely impairing movement, or between two bones that don’t normally move. The rest of the foot has to work harder to compensate for the unusual fusion, which causes pain and stiffness. You develop a rigid, flattened foot that doesn’t accommodate uneven surfaces very well.
This condition develops as a result of a genetic problem. The abnormal growth begins during your childhood, when your bones are still soft. The problem usually goes unnoticed, however, until the bones begin to solidify during the teen years. Then the connection between the tarsals hardens and affects how the foot sits and moves. Over time, the strain from having a stiffened midfoot can lead to arthritis and other issues that cause discomfort or wear down the bones.
Supporting and Stabilizing the Midfoot
If you notice your own or your teenager’s feet are flat and feel stiff and uncomfortable, especially during activities, the problem may be tarsal coalition. Our doctors will need to evaluate the affected foot and its flexibility. This will involve a variety of diagnostic tests, including images like X-rays or CT scans, to look for changes or connections between bones. Then our expert team will develop a plan to manage your condition.
There are ways to relieve your foot distress using conservative therapies. You’ll need to take a break from your activities to rest your foot so the tarsals are less strained. In some cases you may need to spend time in a boot or a cast so the foot is immobilized to prevent additional damage. Then you’ll need to support your arch so it stays stable and handles the force of your steps better. Typically this involves custom orthotics that are designed to match the specific needs of your feet. If you’re still struggling with pain, you may need direct injections of medication to help relieve the discomfort.
When Non-Invasive Treatments Don’t Solve Your Problem
Conservative methods treat the symptoms, but don’t correct the issues in the bones. If these treatments are not successful for managing your discomfort, you may need surgery to resection the affected bones. This procedure involves cutting away the extra tissue that joins the tarsals, restoring normal foot functions. If you have developed a severe condition with signs of arthritis, however, it may not be possible to save a joint. You may need to have the bones fused to eliminate the pain and help your foot maintain proper alignment.
Tarsal coalition can be a serious problem affecting one or both of your feet, making it difficult to participate in normal activities. It’s uncomfortable, but you don’t have to live with the pain. There are options to manage your discomfort. Instead of suffering with stiff, flattened feet, contact Steven Brook, D.P.M., Robert Einhorn, D.P.M., and Akmal Atmar, D.P.M. at Country Foot Care in NY for more information. You can request an appointment through our website contact form or by calling (516) 741-FEET.