Tarsal coalition occurs when there’s an abnormal connection between the bones on the top of your foot. This genetic condition typically develops before birth, but symptoms usually aren’t apparent until late childhood or early adulthood.
The tarsal bones are located toward the back of your foot where your arch, heel and ankle meet. These bones work together harmoniously for proper foot function. Sometimes, however, there’s an abnormal connection between two or more of these bones. This is called a tarsal coalition.
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Most cases of tarsal coalition are caused by genetic factors. However, it’s also possible to develop the condition due to infection, injury or arthritis.
Tarsal coalition generally affects children and teens, with symptoms beginning between the ages of nine and 16. However, the condition can develop in some adults as well.
Tarsal coalition only affects about 1% to 6% of the population. Approximately half of all people with tarsal coalition have issues with both feet (bilateral tarsal coalition).
Children or adults with tarsal coalition may experience mild or severe symptoms, ranging from occasional aches and pains to walking difficulties and other functional issues.
Yes. There are several different types of tarsal coalitions. A coalition occurs whenever bone cartilage or fibrous tissue grows across the joints in your foot. Most commonly, this occurs between your talus (ankle bone) and calcaneus (heel) bones or your calcaneus and navicular bones. There are also other, more rare types of tarsal coalitions.
In most instances, tarsal coalition occurs when your foot bones develop improperly during fetal development. Tarsal coalition causes in adults include:
Many tarsal coalitions are never diagnosed because they don’t cause visible deformities or painful symptoms. Those who experience symptoms may notice:
The onset of these symptoms can vary significantly. Some people notice pain in late childhood or adolescence, while others may not develop symptoms until adulthood.
Your healthcare provider will examine your foot and ankle. They’ll also order imaging tests to help confirm your diagnosis. These tests may include:
Treatment is only recommended when tarsal coalitions cause symptoms. Tarsal coalition can be treated with surgical or nonsurgical methods, depending on the severity of the condition.
In some cases, people may experience enough pain and discomfort that it keeps them from the activities they enjoy. Left untreated, tarsal coalition can lead to a stiff foot later in life.
As with any surgical procedure, there are risks involved. Complications after tarsal coalition surgery may include:
At the first sign of a flare-up, you should stop any activity that could be contributing to your symptoms. Rest is often sufficient, but if you have persistent pain, schedule an appointment with your healthcare provider. They may recommend injections or orthotics to manage your discomfort.
Healing time can vary from person to person. Typically, recovery after tarsal coalition surgery takes between six and 12 months. However, it may take longer depending on your age, severity of the condition and whether or not you have arthritis.
In most cases, tarsal coalition is genetic, so it can’t be totally prevented. However, symptoms can be managed successfully with proper care.
Many people with tarsal coalition don’t experience issues until late childhood or early adulthood. Some people may never develop symptoms.
If you start noticing pain that doesn’t go away and stiffness, you should see your healthcare provider to establish a management plan. They can recommend treatment that’s tailored to your needs.
While sports can be more challenging for people with tarsal coalition, it’s possible to participate in athletics with the condition. If you’ve been diagnosed with tarsal coalition, ask your healthcare provider about any limitations.
A note from Cleveland Clinic
Tarsal coalition pain can be frustrating or debilitating and is sometimes hard to diagnose. Fortunately, there are diagnostic and therapeutic treatments available that can help ease your symptoms and improve your quality of life. Reach out to your healthcare provider for a personalized treatment plan.
Last reviewed by a Cleveland Clinic medical professional on 12/14/2021.
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