Tarsal Coalition Treatment in Los Angeles

What is a Tarsal Coalition?

A tarsal coalition is a condition in which two or more bones in the midfoot or hindfoot are abnormally connected by bone, cartilage, or fibrous tissue. This restricts normal movement and often leads to stiffness, pain, and difficulty walking. Some people are born with a genetic joining of two foot bones that are normally separated from each other. This is called a coalition. Coalitions of the foot are usually in the rear foot or the tarsus, contributing to reduced foot flexibility.

A coalition is a birth defect of the foot, but the joining between the bones is soft tissue, and the bones can move more freely, so most babies and children do not have pain. During development, the soft tissue joining between the bones will promote flattening of the arch. The soft tissue then becomes bone during growth. Once it has developed into bone, the foot can become painful at any time. Pain is usually triggered by a simple or severe foot sprain from an injury or sports. The arch will continue to flatten and can become a rigid flatfoot. Over time, painful arthritis can develop at the joints due to their abnormal movements, causing cartilage and joint damage.

While this condition usually affects the rearfoot (tarsus), symptoms may not appear until adolescence or early adulthood when the bones fully develop.

The two main tarsal coalitions are:

1. Calcaneonavicular Coalition: Between the heel bone and the inside arch bone. Often called a CN Bar.
2. Talocalcaneal Coalition: Between the ankle bone and the heel bone. Often called a Subtalar Coalition.

If you suspect you or your child may have this condition, it’s important to find an expert opinion from the best tarsal coalition doctor in Los Angeles. At Foot and Ankle Specialty Group, we understand how to diagnose and treat this condition and are here to help!

Signs and Symptoms of Tarsal Coalition

Signs and Symptoms of Tarsal Coalition

• The most common symptoms of tarsal coalition may include:
• Stiffness and limited range of motion in the foot
• Pain, especially after physical activity
• Frequent ankle sprains or a tendency to walk with an altered gait
• Flatfoot deformity, as the restricted motion prevents normal arch development

Diagnosing Tarsal Coalition

Dr. Soomekh diagnoses tarsal coalition through a combination of clinical evaluation and imaging tests to assess bone structure and movement, and may include:

• Thorough foot examination and gait analysis
• Specialized X-rays to assess bone structure
• In-office CT scans for detailed imaging of bone relationships

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Tarsal Coalition Treatment Options

In many cases, surgery is warranted to reduce or remove the coalition. Early surgical treatment can reduce the chance of arthritis and the need for joint fusions. Treatment ranges from conservative management to surgical intervention, depending on severity, and could include the following:

• Orthotics to support the foot and reduce strain
• Physical therapy to improve mobility and strengthen the surrounding muscles
• Anti-inflammatory medications to manage pain and swelling
• Surgical intervention in severe cases to restore mobility and alleviate discomfort
• Cortisone injections can help reduce the inflammation and pain at the site