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Tarsal Coalition: Still Flat Feet

The teenage years are a time of transition and change, when the body starts to reach physical maturity and the bones stop growing. Most of the time this means the body gets stronger, sturdier, and ready for life ahead. Sometimes, though, adolescence can reveal problems that might have gone unnoticed for a long time. This is often the case with tarsal coalition.

Abnormally Attached Bones

Tarsal coalition is a problem that most people actually have from birth, but don’t develop pain or problems with until the teen years. With this issue, two of the many tarsal bones in your arch and the back of your foot end up abnormally joined together by excess tissue. This “bridge” of tissue is usually made of cartilage, extra bone, or fibrous connective tissue, and it restricts movement between the tarsals.

Now, the tarsal bones do not normally move very much. They do adjust slightly, however, to help your body absorb shock and support your bodyweight—and the heel bone can move quite a bit. A bar of abnormal tissue that prevents this can cause significant foot and ankle stiffness. When you’re young, this tissue bar is usually soft, but by adolescence it typically hardens (along with the rest of your foot bones). This creates a flat, rigid foot that may not easily accommodate normal walking.

Teen Flatfoot Pain

Foot and ankle stiffness can make enjoying normal activities fairly difficult. Rigid flatfoot doesn’t handle pressure and shock efficiently, thereby making your teen more prone to pain when he or she spends too much time standing or participating in hard-impact activities. Your teen’s legs may feel tired frequently. He or she might be prone to muscle spasms in the legs. If the discomfort is significant enough, he or she may end up walking with a limp. The condition often contributes to significant overpronation, which can also make your teen more susceptible to ankle sprains.

Managing the Flatfoot Deformity

To provide the best care, your teen needs an accurate diagnosis that identifies the problem and its severity. This means a thorough lower limb evaluation. Dr. Noah Levine will carefully examine your teen’s arches. Most likely, our team will take X-rays or some other diagnostic images to check for a tissue bridge joining two tarsals. Once tarsal coalition has been identified, we’ll begin treatment.

Most treatment is actually conservative, especially to start. Reducing pressure and motion in the affected joint can help alleviate pain. Shoe changes and prescription orthotics to support the arch are one common method. Orthotics can be especially beneficial—they limit motion in the painful joint and distribute weight away from it. Very painful feet may need to be immobilized for resting purposes. We might recommend either oral rounds or direct injections of anti-inflammatory medications. If the pain is persistent, your teen may actually need surgery to remove the excess tissue holding the two tarsals together.

Your teen doesn’t have to suffer with frequent flatfoot pain. The right care can manage tarsal coalition. You and your teen don’t have to figure all this out on your own, however. Let the experts at Absolute Foot Care Specialists in Las Vegas help you take care of any and all lower limb discomfort. Just call (702) 839-2010 or use our website to make an appointment today.