Tarsal Coalition

Tarsal Coalition

Tarsal coalition is when the bones of the foot fuse together. It is an abnormal bony fusion or connection between the bones. This can be from the fusion of bone, cartilage, and/or fibrous tissue and results in limited range of motion at the joint. This coalition is genetically inherited and can occur in both feet.

The tarsal bones are the seven larger bones that make up the back of the foot; behind the toes and the attached metatarsal bones.  Bone coalitions are not too common. Coalition can lead to antalgic postures or altered movement patterns that don’t load the correct structures of the foot or leg.

What are the symptoms of tarsal coalition?

  • Pain during weight bearing
  • Tired legs
  • Supination of the foot when walking
  • Flat or pronated feet
  • Walking with a antalgic postures
  • Stiffness of the foot and ankle

When is tarsal coalition typically diagnosed?

Commonly diagnosed during childhood, tarsal coalition may present as a flat, rigid foot.  This condition restricts the natural movement of the bones in the foot, which is the main cause of pain. Pain is typically felt around the ankle joint, and is normally felt ‘deep’ within the foot.

Patients will typically see their GP or physiotherapist about an undiagnosed tarsal coalition due to pain or loss of mobility such as running.

The calcaneonavicular and talocalcaneal joints are the most common tarsal joins found.

How is tarsal coalition diagnosed?

A tarsal coalition is detected with specific x-ray views and CT scans that are more accurate in identifying the specific area of the joining.  There are a number treatments for this condition.


  • A physiotherapist can perform manual therapy to increase joint range of motion and decrease pain
  • A structured exercise program to increase the strength of the muscles around the joint
  • Medication to reduce the inflammation and swelling
  • In cases where rest is needed, immobilisation of the joint can take pressure off the area.
  • In some cases surgery may be required

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