Record Temperatures Help Catch Tarsal Coalitions in Kids!

With the record setting high temperatures the past few weeks in Columbus, kids have been soaking up the sun and playing outside as much as possible. While the exercise is excellent for foot health, some new pains may develop from the sudden increase in activity level. Parents need to pay careful attention to new pains as they can sometimes indicate issues more serious than just normal muscle soreness. One of these conditions often identified during childhood years is called a pedal coalition.

Pedal congenital coalitions are caused when the tissues destined to become two separate bones in the foot during development fail to separate and remain united as one bone. These two bones may be united together by bone, fibrous or cartilage tissue. The type and amount of tissue connecting what should be two separate bones will determine how much motion will be allowed where the joint would normally be.

While some coalitions may never cause any problems and go unnoticed, others can cause severe foot pain, stiffness, muscle spasm and foot deformity. Some of the symptoms of a foot bone coalition can resemble the normal pains of post-playtime soreness with aching, and fatigue. These symptoms are brought about by activity, and thus kids with lower activity levels may remain asymptomatic and undiagnosed. The bones involved in a coalition can be identified by matching up the normal time the bones are ossifying with the onset of symptoms. For example, a child who develops the foot pain and joint stiffness around three to five years of age would have a coalition between the talus and navicular bones as a possible diagnosis.

Luckily, the most common congenital coalition in a child’s foot is typically not painful and is a fusion of the two bones that make up the fifth or “pinky” toe. However, common coalitions that occur in the tarsal bones will cause symptoms in an active child. Fusion of the talus and calcaneus, or heel bone, is the most common of the tarsal coalitions. The subtalar joint, which is located between these two bones, requires mobility in each phase of walking or running and a coalition of the talus and calcaneus will limit that mobility. When movement necessary for normal ambulation becomes limited, the body will try to force through the motion, causing pain, or will make changes to work around the need for that movement, causing deformity. Commonly, with the talus-calcaneus coalition, overpronation will be part of the deformity and the child may appear flat footed.

Early identification of these symptoms can result in earlier treatment and improved quality of life for the affected child. Whether the coalition is congenital or has been acquired later in life as a result of osteoarthritis wear and tear or a fracture within the joint, a visit to your podiatrist can help relieve pain and work towards allowing your feet to function in the best way possible!

Please visit for more information or call 614-885 FEET (3338) to schedule an appointment with a podiatrist in Columbus, Ohio. Columbus Podiatry & Surgery is located on the North side of Columbus, Ohio near Worthington.

By Dr. Animesh (Andy) Bhatia