What is tarsal coalition?
Tarsal coalition is a condition characterized by an abnormal connection between two or more bones in the hindfoot (also known as the tarsal bones). This abnormal connection can be made up of bone, cartilage, or fibrous tissue and can cause stiffness and a limited range of motion in the affected foot.
Tarsal coalition is most often present from birth, though symptoms typically don't appear until late childhood or early adolescence when the connection begins to harden.
What causes tarsal coalition?
In most cases, tarsal coalition develops during fetal development when the bones of the foot do not fully separate as they should. It is often hereditary, meaning it can run in families.
Tarsal coalition can also lead to an increased risk of developing arthritis in the affected joint over time.
What are the symptoms of tarsal coalition?
Some people with tarsal coalition never experience symptoms. When symptoms do occur, they may include:
- Pain or stiffness in the foot, heel, or ankle, often described as a dull ache that worsens with activity
- Fatigue or cramping in the lower leg
- Flat feet or a low arch on the affected foot
- An awkward or stiff walking pattern
- Muscle spasms in the lower leg, particularly in the peroneal muscles along the outer ankle
Symptoms most commonly appear between the ages of 8 and 16, as the cartilage or fibrous connection between bones begins to harden into bone. Adults can also develop symptoms, particularly following an injury or with increased activity.
How is tarsal coalition diagnosed?
CT scans are the most used imaging tool to diagnose tarsal coalition. MRI scans may be ordered in certain cases of the condition to provide further information on the soft tissues and bones in the affected area. Following your diagnostic imaging, your doctor will receive and interpret your results and come up with a treatment plan best suited to you.
What are treatment options for tarsal coalition?
Treatment for tarsal coalition depends on the severity of symptoms, the type of coalition, and the patient's age and activity level. Your doctor may begin with conservative efforts, such as:
- Activity modification
- Immobilization
- Orthotics
- Physical therapy
- Anti-inflammatory medications to manage symptoms
- Corticosteroid injections
In more severe cases of tarsal coalition where a patient’s condition is not responding to conservative treatment options, surgical intervention may be recommended to remove the abnormality in bone connections or further fuse the affected joint. The goal of these surgeries to relieve pain and improve the function of the hindfoot.
Last Medically Reviewed on April 29, 2026.